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Modelling the feedback effects of reconfiguring health services

Taylor, K and Dangerfield, BC 2005, 'Modelling the feedback effects of reconfiguring health services' , Journal of the Operational Research Society, 56 (6) , pp. 659-675.

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Abstract

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.

Item Type: Article
Themes: Subjects / Themes > Q Science > QA Mathematics > QA275 Mathematical Statistics
Subjects / Themes > H Social Sciences > HA Statistics
Subjects outside of the University Themes
Schools: Colleges and Schools > College of Business & Law > Salford Business School > Operations and Information Management
Journal or Publication Title: Journal of the Operational Research Society
Publisher: Palgrave Macmillan
Refereed: Yes
ISSN: 0160-5682
Depositing User: H Kenna
Date Deposited: 22 Aug 2007 10:25
Last Modified: 28 Jul 2015 17:37
URI: http://usir.salford.ac.uk/id/eprint/289

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