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Exploring the drivers of unsustainable pressures in health and social care: A qualitative system dynamics approach

Author

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  • Nguyen, Le Khanh Ngan
  • McCabe, Holly
  • Howick, Susan
  • Megiddo, Itamar
  • Sengupta, Soumen
  • Morton, Alec

Abstract

Health and social care systems face immense pressures that emerge from complex interdependencies between system components, transcending conventional explanations of demand-capacity mismatches. Although multiple theoretic perspectives (e.g., “complex adaptive systems”, “sociotechnical systems”) have been advocated as ways to capture and characterise the nature of that complexity, consolidating it into actionable insights for coordinated stakeholder efforts remains challenging, perpetuating implementation failure. This study introduces a novel application of qualitative system dynamics, using Causal Loop Diagrams (CLDs), to reveal the deeper structural patterns that drive persistent challenges and explain why policies have often fallen short.

Suggested Citation

  • Nguyen, Le Khanh Ngan & McCabe, Holly & Howick, Susan & Megiddo, Itamar & Sengupta, Soumen & Morton, Alec, 2025. "Exploring the drivers of unsustainable pressures in health and social care: A qualitative system dynamics approach," Social Science & Medicine, Elsevier, vol. 371(C).
    • Handle: RePEc:eee:socmed:v:371:y:2025:i:c:s0277953625002424
    DOI: 10.1016/j.socscimed.2025.117913
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