Share This Article:

Health Systems as Complex Systems

Full-Text HTML XML Download Download as PDF (Size:2300KB) PP. 113-126
DOI: 10.4236/ajor.2013.31A011    6,208 Downloads   6,392 Views   Citations

ABSTRACT

Health systems are paradigmatic examples of human organizations that blend a multitude of different professional and disciplinary features within a critically performance environment. Communication failure and defective processes in health systems have a tremendous impact in society, both in the financial and human aspects. Traditionally, health systems have been regarded as linear hierarchic structures. However, recent developments in the sciences of complexity point out to health systems as complex entities governed by non-linear interaction laws, self-organization and emergent phenomena. In this work we review some aspects of complexity behind health systems and how they can be applied to improve the performance of healthcare organizations.

Cite this paper

M. Martínez-García and E. Lemus, "Health Systems as Complex Systems," American Journal of Operations Research, Vol. 3 No. 1A, 2013, pp. 113-126. doi: 10.4236/ajor.2013.31A011.

References

[1] P. E. Plsek and T. Greenhalgh, “The Challenge of Complexity in Health Care,” British Medical Journal, Vol. 323, No. 7313, 2001, pp. 625-628, doi:10.1136/bmj.323.7313.625
[2] P. Anderson, “Complexity Theory and Organization Science,” Organization Science, Vol. 10, No. 3, 1999, pp. 216-232. doi:10.1287/orsc.10.3.216
[3] B. J. Zimmerman, C. Lindberg and P. E. Plsek, “Edgeware: Complexity Resources for Healthcare Leaders,” VHA Publishing, Irving, 1998.
[4] L. B. Smith and E. Thelen, “Development as a Dynamic System,” Trends in Cognitive Sciences, Vol. 7, No. 8, 2003, pp. 343-348. doi:10.1016/S1364-6613(03)00156-6
[5] H. Maturana and F. Varela, “Autopoiesis and Cognition,” Reidel, Dordrecht, 1980. doi:10.1007/978-94-009-8947-4
[6] F. Baumgartner and B. Jones, “Positive and Negative Feedback in Politics in Policy Dynamics,” In: F. Baumgartner and F. B. Jones, Eds., University of Chicago Press, Chicago, 2002.
[7] T. Schelling, “Micromotives and Macrobehavior,” Norton Publishing, New York, 1978.
[8] T. Schelling, “Dynamic Models of Segregation,” Journal of Mathematical Sociology, Vol. 1, No. 2, 1971, pp. 119-132. doi:10.1080/0022250X.1971.9989794
[9] H. Simon, “The Architecture of Complexity,” Proceedings of the American Philosophical Society, Vol. 106, No. 6, 1962, pp. 467-482.
[10] R. May, “Simple Mathematical Models with Very Complicated Dynamics,” Nature, Vol. 261, No. 5560, 1976, pp. 459-467. doi:10.1038/261459a0
[11] L. V. Bertalanffy, “General Systems Theory,” George Braziller, New York, 1968.
[12] D. Bernstein, “Feedback Control: An Invisible Thread in the History of Technology,” IEEE Control Systems Magazine, Vol. 22, No. 2, 2002, pp. 53-68. doi:10.1109/37.993315
[13] P. Erdi, “Complexity Explained, Springer Complexity Series,” Springer-Verlag, Berlin, 2008.
[14] J. P. Crutchfield and M. Mitchell, “The Evolution of Emergent Computation,” Proceedings of the National Academy of Sciences of the U.S.A., Vol. 92, No. 23, 1995, pp. 10742-10746. doi:10.1073/pnas.92.23.10742
[15] J. Goldstein, “Emergence as a Construct: History and Issues,” Emergence: Complexity and Organization, Vol. 1, No. 1, 1999, pp. 49-72.
[16] A. Korotayev, A. Malkov and D. Khaltourina, “Introduction to Social Macrodynamics: Compact Macromodels of the World System Growth,” URSS, Moscow, 2006.
[17] C. Brown, “The Application of Complex Adaptive Systems Theory to Clinical Practice in Rehabilitation,” Disability and Rehabilitation, Vol. 28, No. 9, 2006, pp. 587-593. doi:10.1080/00222930500219175
[18] H. Benson, “Chaos and Complexity: Applications for Healthcare Quality and Patient Safety,” Journal for Healthcare Quality, Vol. 27, No. 5, 2005, pp. 4-10. doi:10.1111/j.1945-1474.2005.tb00571.x
[19] A. L. Goldberger, “Nonlinear Dynamics for Clinicians: Chaos Theory, Fractals, and Complexity at the Bedside,” Lancet, Vol. 347, No. 9011, 1996, pp. 1312-1314. doi:10.1016/S0140-6736(96)90948-4
[20] H. R. Priesmeyer, L. F.Sharp, L. Wammack and J. D. Mabrey, “Chaos Theory and Clinical Pathways: A Practical Application,” Quality Management in Health Care, Vol. 4, No. 4, 1996, pp. 63-72.
[21] J. W. Begun, B. Zimmerman and K. Dooley, “Health Care Organizations as Complex Adaptive Systems,” In: S. M. Mick and M. Wyttenbach, Eds., Advances in Health Care Organization Theory, Jossey-Bass, San Francisco, 2003, pp. 253-288.
[22] M. Arndt and B. Bigelow, “Commentary: The Potential of Chaos Theory and Complexity Theory for Health Services Management,” Health Care Management Review, Vol. 25, No. 1, 2000, pp. 35-38. doi:10.1097/00004010-200001000-00004
[23] R. Axelrod, “The Evolution of Cooperation,” Basic Books, New York, 1984.
[24] G. J. Bazzolli, S. M. Shortell, N. Dubbs, C. Chan and P. Kralovec, “A Taxonomy of Health Networks and Systems: Bringing Order out of Chaos,” Health Services Research, Vol. 33, No. 6, 1999, pp. 1683-1717.
[25] G. T. Savage and A. M. “Roboski, “Integration as Networks and Systems: A Strategic Stakeholder Analysis,” Advances in Health Care Management, Vol. 2, Elsevier Science, London, 2001, pp. 37-62
[26] R. Cross and A. Parker, “The Hidden Power of Social Networks,” Harvard Business School Press, Boston, 2004.
[27] R. Agranoff and M. McGuire, “Managing in Network Settings,” Policy Studies Review, Vol. 16, No. 1, 1999, pp. 18-41. doi:10.1111/j.1541-1338.1999.tb00839.x
[28] J. Anderson, “Evaluation in Health Informatics: Social Network Analysis,” Computers in Biology and Medicine, Vol. 32, No. 3, 2002, pp. 179-193. doi:10.1016/S0010-4825(02)00014-8
[29] S. P. Borgatti and P. C. Foster, “The Network Paradigm in Organizational Research: A Review and Typology,” Journal of Management, Vol. 29, No. 6, 2003, pp. 991-1013.
[30] S. P. Borgatti and J. L. Molina, “Ethical and Strategic Issues in Organizational Social Network Analysis,” Journal of Applied Behavioral Science, Vol. 39, No. 3, 2003, pp. 337-349. doi:10.1177/0021886303258111
[31] P. S. Dodds, D. J. Watts and C. F. Sabel, “Information Exchange and the Robustness of Organizational Networks,” Proceedings of the National Academy of Sciences, Vol. 100, No. 21, 2003, pp. 12516-12521. doi:10.1073/pnas.1534702100
[32] T. Wilson, T. Holt and T. Greenhalgh, “Complexity Science: Complexity and Clinical Care,” British Medical Journal, Vol. 323, No. 7314, 2001, pp. 685-688. doi:10.1136/bmj.323.7314.685
[33] R. Axelrod and M. D. Cohen, “Harnessing Complexity: Organizational Implications of a Scientific Frontier,” Free Press, New York, 1999. doi:10.5812/jhs.4623
[34] J. W. Begun and K. R. White, “The Profession of Nursing as a Complex Adaptive System: Strategies for Change,” In: J. J. Kronenfeld, Ed., Research in the Sociology of Health Care, JAI Press, Lexington, 1999. pp.189-203
[35] A. Baghbanian, G. Torkfar and Y. Baghbanian, “Decision-Making in Australia’s Healthcare System and Insights from Complex Adaptive Systems Theory,” Health Scope, Vol. 1, No. 1, 2012, pp. 29-38. http://dx.doi.org/10.5812/jhs.4623
[36] L. A. Lipsitz, “Understanding Health Care as a Complex System: The Foundation for Unintended Consequences,” The Journal of the American Medical Association (JAMA), Vol. 308, No. 3, 2012, pp. 243-244. doi:10.1001/jama.2012.7551
[37] A. E. Motter, N. Gulbahce, E. Almaas and A. L. Barabási, “Predicting Synthetic Rescues in Metabolic Networks,” Molecular Systems Biology, Vol. 4, 2008, Article No. 168. doi:10.1038/msb.2008.1
[38] J. P Sturmberg, D. M. O’Halloran and C. M. Martin, “Understanding Health System Reform—A Complex Adaptive Systems Perspective,” Journal of Evaluation in Clinical Practice, Vol. 18, No. 1, 2012, pp. 202-208. doi:10.1111/j.1365-2753.2011.01792.x
[39] A. Shiell, P. Hawe and L. Gold, “Complex Interventions or Complex Systems? Implications for Health Economic Evaluation,” British Medical Journal, Vol. 336, No. 7656, 2008, pp. 1281-1283. doi:10.1136/bmj.39569.510521.AD
[40] C. Lessard, “Complexity and Reflexivity: Two Important Issues for Economic Evaluation in Health Care,” Social Science & Medicine, Vol. 64, No. 8, 2007, pp. 1754-1765. doi:10.1016/j.socscimed.2006.12.006
[41] R. A. Anderson, and R. R. McDaniel Jr., “Managing Health Care Organizations: Where Professionalism Meets Complexity Science,” Health Care Management Review, Vol. 25, No. 1, 2000, pp. 83-92. doi:10.1097/00004010-200001000-00010
[42] J. Paley, “The Appropriation of Complexity Theory in Health Care,” Journal of Health Services Research & Policy, Vol. 15, No. 1, 2010, pp. 59-61. doi:10.1258/jhsrp.2009.009072
[43] T. G. Kannampallil, G. F. Schauer, T. Cohen and V. L. Patel, “Considering Complexity in Healthcare Systems,” Journal of Biomedical Informatics, Vol. 44, No. 6, 2011, pp. 943-947. doi:10.1016/j.jbi.2011.06.006
[44] K. Resnicow and S. E. Page, “Embracing Chaos and Complexity: A Quantum Change for Public Health,” American Journal of Public Health, Vol. 98, No. 8, 2008, pp. 1382-1389. doi:10.2105/AJPH.2007.129460
[45] J. van den Heuvel, “The Effectiveness of ISO 9001 and Six Sigma in Healthcare,” Beaumont Quality Publications, Beaumont, 2006.
[46] H. Bevan, N. Westwood, R. Crowe and M. O’Connor, “Lean Six Sigma: Some Basic Concepts,” NHS Institute for Innovation and Improvement, Nottingham, 2007.

  
comments powered by Disqus

Copyright © 2017 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.