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Understanding health system reform – a complex adaptive systems perspective
Author(s) -
Sturmberg Joachim P.,
O'Halloran Di M.,
Martin Carmel M.
Publication year - 2012
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2011.01792.x
Subject(s) - complex adaptive system , attractor , meaning (existential) , perspective (graphical) , metaphor , outcome (game theory) , systems thinking , health care , complex system , healthcare system , health care reform , health policy , public health , management science , medicine , psychology , sociology , nursing , computer science , economics , economic growth , mathematics , artificial intelligence , mathematical economics , social science , psychotherapist , mathematical analysis , linguistics , philosophy
Background Everyone wants a sustainable well‐functioning health system. However, this notion has different meaning to policy makers and funders compared to clinicians and patients. The former perceive public policy and economic constraints, the latter clinical or patient‐centred strategies as the means to achieving a desired outcome. Design Theoretical development and critical analysis of a complex health system model. Results and conclusions We introduce the concept of the health care vortex as a metaphor by which to understand the complex adaptive nature of health systems, and the degree to which their behaviour is predetermined by their ‘shared values’ or attractors. We contrast the likely functions and outcomes of a health system with a people‐centred attractor and one with a financial attractor. This analysis suggests a shift in the system's attractor is fundamental to progress health reform thinking.