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.
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.
Authors: Elizabeth Lennon; Liza Hopkins; Rochelle Einboden; Andrea McCloughen; Lisa Dawson; Niels Buus Journal: Community Ment Health J Date: 2022-05-18
Authors: Kate Churruca; Kristiana Ludlow; Wendy Wu; Kate Gibbons; Hoa Mi Nguyen; Louise A Ellis; Jeffrey Braithwaite Journal: BMC Med Res Methodol Date: 2021-06-21 Impact factor: 4.615
Authors: Marije S Holstege; Monique A A Caljouw; Ineke G Zekveld; Romke van Balen; Aafke J de Groot; Jolanda C M van Haastregt; Jos M G A Schols; Cees M P M Hertogh; Jacobijn Gussekloo; Wilco P Achterberg Journal: Int J Integr Care Date: 2015-12-15 Impact factor: 5.120