Modelling the feedback effects of reconfiguring health services

The shift in the balance of health care, bringing services 'closer to home', is a well-established trend, which has been motivated by the desire to improve the provision of services. However, these efforts may be undermined by the improvements in access stimulating demand. Existing analyse...

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Main Authors: Taylor, K, Dangerfield, B
Format: Journal article
Language:English
Published: 2005
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author Taylor, K
Dangerfield, B
author_facet Taylor, K
Dangerfield, B
author_sort Taylor, K
collection OXFORD
description The shift in the balance of health care, bringing services 'closer to home', is a well-established trend, which has been motivated by the desire to improve the provision of services. However, these efforts may be undermined by the improvements in access stimulating demand. Existing analyses of this trend have been limited to isolated parts of the system with calls to control demand with stricter clinical guidelines or to meet demand with capacity increases. By failing to appreciate the underlying feedback mechanisms, these interventions may only have a limited effect. We demonstrate the contribution offered by system dynamics modelling by presenting a study of two cases of the shift in cardiac catheterization services in the UK. We hypothesize the effects of the shifts in services and produce model output that is not inconsistent with real world data. Our model encompasses several mechanisms by which demand is stimulated. We use the model to clarify the roles for stricter clinical guidelines and capacity increases, and to demonstrate the potential benefits of changing the goals that drive activity. © 2005 Operational Research Society Ltd. All rights reserved.
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spelling oxford-uuid:6484add3-fb26-49b1-9b0b-6d7cf25ea6d72022-03-26T18:19:22ZModelling the feedback effects of reconfiguring health servicesJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:6484add3-fb26-49b1-9b0b-6d7cf25ea6d7EnglishSymplectic Elements at Oxford2005Taylor, KDangerfield, BThe shift in the balance of health care, bringing services 'closer to home', is a well-established trend, which has been motivated by the desire to improve the provision of services. However, these efforts may be undermined by the improvements in access stimulating demand. Existing analyses of this trend have been limited to isolated parts of the system with calls to control demand with stricter clinical guidelines or to meet demand with capacity increases. By failing to appreciate the underlying feedback mechanisms, these interventions may only have a limited effect. We demonstrate the contribution offered by system dynamics modelling by presenting a study of two cases of the shift in cardiac catheterization services in the UK. We hypothesize the effects of the shifts in services and produce model output that is not inconsistent with real world data. Our model encompasses several mechanisms by which demand is stimulated. We use the model to clarify the roles for stricter clinical guidelines and capacity increases, and to demonstrate the potential benefits of changing the goals that drive activity. © 2005 Operational Research Society Ltd. All rights reserved.
spellingShingle Taylor, K
Dangerfield, B
Modelling the feedback effects of reconfiguring health services
title Modelling the feedback effects of reconfiguring health services
title_full Modelling the feedback effects of reconfiguring health services
title_fullStr Modelling the feedback effects of reconfiguring health services
title_full_unstemmed Modelling the feedback effects of reconfiguring health services
title_short Modelling the feedback effects of reconfiguring health services
title_sort modelling the feedback effects of reconfiguring health services
work_keys_str_mv AT taylork modellingthefeedbackeffectsofreconfiguringhealthservices
AT dangerfieldb modellingthefeedbackeffectsofreconfiguringhealthservices