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Modelling the feedback effects of reconfiguring health services

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  • K Taylor

    (London School of Economics and Political Science)

  • B Dangerfield

    (University of Salford)

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.

Suggested Citation

  • K Taylor & B Dangerfield, 2005. "Modelling the feedback effects of reconfiguring health services," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 56(6), pages 659-675, June.
    • Handle: RePEc:pal:jorsoc:v:56:y:2005:i:6:d:10.1057_palgrave.jors.2601862
    DOI: 10.1057/palgrave.jors.2601862
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    References listed on IDEAS

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    Cited by:

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    4. G Royston, 2009. "One hundred years of Operational Research in Health—UK 1948–2048," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 60(1), pages 169-179, May.
    5. Reda Lebcir & Rifat Atun, 2021. "Resources management impact on neonatal services performance in the United Kingdom: A system dynamics modelling approach," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(3), pages 793-812, May.
    6. Thomas Rohleder & Diane Bischak & Leland Baskin, 2007. "Modeling patient service centers with simulation and system dynamics," Health Care Management Science, Springer, vol. 10(1), pages 1-12, February.
    7. Torres, Juan Pablo & Kunc, Martin & O'Brien, Frances, 2017. "Supporting strategy using system dynamics," European Journal of Operational Research, Elsevier, vol. 260(3), pages 1081-1094.
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    9. M Smits, 2010. "Impact of policy and process design on the performance of intake and treatment processes in mental health care: a system dynamics case study," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 61(10), pages 1437-1445, October.
    10. Morgan, Jennifer Sian & Howick, Susan & Belton, Valerie, 2017. "A toolkit of designs for mixing Discrete Event Simulation and System Dynamics," European Journal of Operational Research, Elsevier, vol. 257(3), pages 907-918.

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