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Health Care in the United Kingdom and Europe, System Dynamics Applications to

Encyclopedia of Complexity and Systems Science

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Abbreviations

Continuous Simulation:

The aggregate method of computer simulation used in system dynamics based on a continuous time analogy with fluid dynamics and used to test out patterns of behavior over time.

Discrete Entity Simulation:

A method of simulation based on the movement of individual entities through systems over time either as processes or as interactions between entities.

Dynamic Complexity:

The number of interacting elements contained in a system and the consequences of their interactions over time.

Feedback:

Feedback refers to the interaction of the elements of the system where a system element, X, affects another system element, Y, and Y in turn affects X perhaps through a chain of causes and effects. Feedback thus controls the performance of the system. Feedback can be either natural or behavioral (created by human intervention) (System Dynamics Society).

Human Activity System:

Any system created and regulated by human intervention.

Qualitative System Dynamics:

The application of systems thinking and system dynamics principles, without formal simulation.

Reductionism:

The opposite of systemic – seeing the world only in its constituent parts.

Reference Mode of Behavior:

An observed past trend and future projected trends used to assist in defining the model scope and time frame.

System:

A collection of elements brought together for a purpose and whose sum is greater than the parts.

System Behavior:

The term used in system dynamics to refer to the behavior over time of a particular structure.

System Dynamics:

A method based on quantitative computer simulation to enhance learning and policy design in complex systems.

System Structure:

The term used in system dynamics to refer to the total structure of a system (composing processes, organization boundaries, information feedback, policy, and delays).

Systems Thinking:

The process of interpreting the world as a complex, self-regulating, and adaptive system.

Unintended Consequences:

Undesirable consequences arising from well-intended action – or vice versa.

Acute Hospitals:

Hospital dealing with short-term conditions requiring mainly one-off treatment.

Clinical Commissioning Groups (CCGs) [Formerly Primary Care Trusts (PCTs)]:

The local operating agencies of the NHS, which both commission (buy) and deliver health services.

Domiciliary Care:

In England, care for older people in their own homes.

Epidemiology:

The study of factors affecting the health and the incidence and prevalence of illness of populations.

General Practitioners (GPs):

Locally based general clinicians who deliver primary care services and control access to specialist health services.

Health Treatment:

The application of drugs, therapies, and medical/surgical interventions to treat illness.

Intermediate Care:

Short-term care to expedite the treatment of noncomplex conditions.

National Health Service (NHS):

The organization in the UK responsible for the delivery of health care.

Nursing/Residential Home Care:

In England, private and public residential establishments for the care of older people.

Outliers:

Patients located in hospital wards not related to their condition, due to bed capacity issues.

Social Services:

In England, care services which provide non-health-related care, mainly for children and older people, located within local government in the UK.

Bibliography

Primary Literature

  • Abdul-Salam O (2006) An overview of system dynamics applications in health care. In: A dissertation submitted to the University of Salford Centre for Operational Research and Applied Statistics for the degree of MSc Centre for Operational Research and Applied Statistics, University of Salford

    Google Scholar 

  • Alonso Magdaleno MI (2002a) Administrative policies and MIR vacancies: impact on the Spanish Health System. In: Proceedings of the 20th international conference of the System Dynamics Society, Palermo

    Google Scholar 

  • Alonso Magdaleno MI (2002b) Dynamic analysis of some proposals for the management of the number of physicians in Spain. In: Proceedings of the 20th international conference of the System Dynamics Society, Palermo

    Google Scholar 

  • Alonso Magdaleno MI (2002c) Elaboration of a model for the management of the number of specialized doctors in the spanish health system. In: Proceedings of the 20th international conference of the System Dynamics Society, Palermo

    Google Scholar 

  • Bayer S (2001) Planning the implementation of telecare services. In: The 19th international conference of the System Dynamics Society, Atlanta

    Google Scholar 

  • Bayer S (2002) Post-hospital intermediate care: examining assumptions and systemic consequences of a health policy prescription. In: Proceedings of the 20th international conference of the System Dynamics Society, Palermo

    Google Scholar 

  • Bayer S, Barlow J (2003) Simulating health and social care delivery. In: Proceedings of the 21st international conference of the System Dynamics Society, New York

    Google Scholar 

  • Bayer S, Barlow J (2004) Assessing the impact of a care innovation: telecare. In: 22nd international conference of the System Dynamics Society, Oxford

    Google Scholar 

  • Brailsford SC, Lattimer VA (2004) Emergency and on-demand health care: modelling a large complex system. J Oper Res Soc 55:34–42

    Article  Google Scholar 

  • Chen Y (2003) A system dynamics-based study on elderly non-acute service in norway. In: Proceedings of the 21st international conference of the System Dynamics Society, New York

    Google Scholar 

  • Coyle RG (1996) A systems approach to the management of a hospital for short-term patients. Socio Econ Plan Sci 18(4):219–226

    Article  Google Scholar 

  • Curram S, Coyle JM (2003) Are you vMad to go for surgery? Risk assessment for transmission of vCJD via surgical instruments: the contribution of system dynamics. In: Proceedings of the 21st international conference of the System Dynamics Society, New York

    Google Scholar 

  • Dangerfield BC (1999a) System dynamics applications to european health care issues. System dynamics for policy, strategy and management education. J Oper Res Soc 50(4):345–353

    Article  Google Scholar 

  • Dangerfield BC, Roberts CA (1989a) A role for system dynamics in modelling the spread of AIDS. Trans Inst Meas Control 11(4):187–195

    Article  Google Scholar 

  • Dangerfield BC, Roberts CA (1989b) Understanding the epidemiology of HIV infection and AIDS: experiences with a system dynamics model. In: Murray-Smith D, Stephenson J, Zobel RN (eds) Proceedings of the 3rd European simulation congress. Simulation Councils Inc., San Diego, pp 241–247

    Google Scholar 

  • Dangerfield BC, Roberts CA (1990) Modelling the epidemiological consequences of HIV infection and AIDS: a contribution from operational research. J Oper Res Soc 41(4):273–289

    Article  Google Scholar 

  • Dangerfield BC, Roberts CA (1992) Estimating the parameters of an AIDS spread model using optimisation software: results for two countries compared. In: Vennix JAM, Faber J, Scheper WJ, Takkenberg CA (eds) System dynamics. System Dynamics Society, Cambridge, pp 605–617

    Google Scholar 

  • Dangerfield BC, Roberts CA (1994a) Fitting a model of the spread of AIDS to data from five european countries. In: Dangerfield BC, Roberts CA (eds) O.R. work in HIV/AIDS, vol 2. Operational Research Society, Birmingham, pp 7–13

    Google Scholar 

  • Dangerfield BC, Roberts CA (1996) Relating a transmission model of AIDS spread to data: some international comparisons. In: Isham V, Medley G (eds) Models for infectious human diseases: their structure and relation to data. Cambridge University Press, Cambridge, pp 473–476

    Chapter  Google Scholar 

  • Dangerfield BC, Roberts CA, Fang Y (2001) Model-based scenarios for the epidemiology of HIV/AIDS: the consequences of highly active antiretroviral therapy. Syst Dyn Rev 17(2):119–150

    Article  Google Scholar 

  • Davies R (1985) An assessment of models in a health system. J Oper Res Soc 36:679–687

    Article  Google Scholar 

  • Derrick S, Winch GW, Badger B, Chandler J, Lovett J, Nokes T (2005) Evaluating the impacts of time-reduction legislation on junior doctor training and service. In: Proceedings of the 23rd international conference of the System Dynamics Society, Boston

    Google Scholar 

  • Dijkgraaf MGW, van Greenstein GJP, Gourds JLA (1998) Interactive simulation as a tool in the decision-making process to prevent HIV incidence among homosexual men in the Netherlands: a proposal. In: Jager JC, Rotenberg EJ (eds) Statistical analysis and mathematical modelling of AIDS. Oxford University Press, Oxford, pp 112–122

    Google Scholar 

  • El-Darzi E, Vasilakis C (1998) A simulation modelling approach to evaluating length of stay, occupancy, emptiness and bed blocking in hospitals. Health Care Manag Sci 1(2):143–149

    Article  Google Scholar 

  • Forrester JW (1961) Industrial dynamics. MIT Press, Cambridge Press

    Google Scholar 

  • Gonzalez B, Garcia R (1999) Waiting lists in spanish public hospitals: a system dynamics approach. Syst Dyn Rev 15(3):201–224

    Article  Google Scholar 

  • Heyne G, Geurts JL (1994) DIAGNOST: a microworld in the healthcare for elderly people. In: 1994 international system dynamics conference. System Dynamics Society, Stirling

    Google Scholar 

  • Holmstroem P, Elf M (2004) Staff retention and job satisfaction at a hospital clinic: a case study. In: 22nd international conference of the System Dynamics Society, Oxford

    Google Scholar 

  • Jun JB, Jacobson SH, Swisher JR (1999) Application of discrete-event simulation in health care clinics: a survey. J Oper Res Soc 50(2):109–123

    Article  Google Scholar 

  • Kim DH, Gogi J (2003) System dynamics modeling for long term care policy. In: Proceedings of the 21st international conference of the System Dynamics Society, New York

    Google Scholar 

  • Lacey P (2005) Futures through the eyes of a health system simulator. Paper presented to the international system dynamics conference, Boston

    Google Scholar 

  • Lagergren M (1992) A family of models for analysis and evaluation of strategies for preventing AIDS. In: Jager JC (ed) Scenario analysis. Elsvier, Amsterdam, pp 117–145

    Google Scholar 

  • Lane DC (2000) Looking in the wrong place for healthcare improvements: a system dynamics study of an accident and emergency department. J Oper Res Soc 51(5):518

    Article  Google Scholar 

  • Lane DC, Husemann E (2008) System dynamics mapping of acute patient flows. J Oper Res Soc 59:213–224

    Article  Google Scholar 

  • Lane DC, Monefeldt C et al (2003) Client involvement in simulation model building: hints and insights from a case study in a London hospital. Health Care Manag Sci 6(2):105–116

    Article  Google Scholar 

  • National Institute for Clinical Excellence (2004) Depression: management of depression in primary and secondary care – NICE guidance, National clinical practice guideline 23

    Google Scholar 

  • Osipenko L (2006) System dynamics model of a new prenatal screening technology (Screening pregnant women). In: 24th international conference of the System Dynamics Society, Nijmegen, 23–27 July 2006

    Google Scholar 

  • Petersen LO (2000) How should the capacity for treating heart decease be expanded? In: 18th international conference of the System Dynamics Society, Bergen

    Google Scholar 

  • Posmta TJBM, Smits MT (1992) Personnel planning in health care: an example in the field of rheumatology. In: Proceedings of the 1992 international system dynamics conference of the System Dynamics Society. Utrecht

    Google Scholar 

  • Ratnarajah M (2005) European union working time directive. In: Proceedings of 7th annual gathering, UK System Dynamics Chapter, Harrogate, Feb 2005

    Google Scholar 

  • Ravn H, Petersen LO (2007) Balancing the surgical capacity in a hospital. Int J Healthcare Technol Manag 14:4023–4089

    Google Scholar 

  • Richmond B (1994) iThink technical manual, ISEE Systems, Hanover

    Google Scholar 

  • Royston G, Dost A (1999) Using system dynamics to help develop and implement policies and programmes in health care in England. Syst Dyn Rev 15(3):293–315

    Article  Google Scholar 

  • Sedehi H (2001) HDS: health department simulator. In: The 19th international conference of the System Dynamics Society, Atlanta

    Google Scholar 

  • Senge P (1990) The fifth discipline. Doubleday, New York

    Google Scholar 

  • Smith G, Wolstenholme EF (2004) Using system dynamics in modeling health issues in the UK. In: 22nd international conference of the System Dynamics Society, Oxford

    Google Scholar 

  • Sterman J (2000) Business dynamics: system thinking and modelling for a complex world. McGrawHill, Boston

    Google Scholar 

  • Sterman T (ed) (2008) Exploring the next frontier: system dynamics at 50. Syst Dyn Rev 23:89–93

    Google Scholar 

  • Taylor KS (2002) A system dynamics model for planning and evaluating shifts in health services: the case of cardiac catheterisation procedures. Unpublished PhD thesis, London School of Economics and Political Science

    Google Scholar 

  • Taylor KS, Dangerfield BC (2004) Modelling the feedback effects of reconfiguring health services. J Oper Res Soc 56:659–675 (Published on-line Sept 2004)

    Article  Google Scholar 

  • Taylor KS, Dangerfield BC, LeGrand J (2005) Simulation analysis of the consequences of shifting the balance of health care: a system dynamics approach. J Health Serv Res Policy 10(4):196–202

    Article  Google Scholar 

  • Tretter F (2002) Modeling the system of health care and drug addicts. In: Proceedings of the 20th international conference of the System Dynamics Society, Palermo

    Google Scholar 

  • Van Ackere A, Smith PC (1999) Towards a macro model of national health service waiting lists. Syst Dyn Rev 15(3):225

    Article  Google Scholar 

  • Van Dijkum C, Kuijk E (1998) Experiments with a non-linear model of health-related actions. In: 16th international conference of the System Dynamics Society, Quebec

    Google Scholar 

  • Vennix AM (1996) Group model building. Wiley, Chichester

    Google Scholar 

  • Vennix JAM, Gubbels JW (1992) Knowledge elicitation in conceptual model building: a case study in modeling a regional Dutch health care system. Eur J Oper Res 59(1):85–101

    Article  Google Scholar 

  • Verburgh LD, Gubbels JW (1990) Model-based analyses of the Dutch health care system. In: System dynamics ’90: proceedings of the 1990 international systems dynamics conference, Chestnut Hill

    Google Scholar 

  • Wolstenholme EF (1993) A case study in community care using systems thinking. J Oper Res Soc 44(9):925–934

    Article  Google Scholar 

  • Wolstenholme EF (1996) A management flight simulator for community care. In: Cropper S (ed) Enhancing decision making in the NHS. Open University Press, Milton Keynes

    Google Scholar 

  • Wolstenholme EF (1999) A patient flow perspective of UK health services: exploring the case for new intermediate care initiatives. Syst Dyn Rev 15(3):253–273

    Article  Google Scholar 

  • Wolstenholme EF (2004) Using generic system archetypes to support thinking and learning. Syst Dyn Rev 20(2):341–356

    Article  Google Scholar 

  • Wolstenholme EF, McKelvie D (2004) Using system dynamics in modeling health and social care commissioning in the UK. In: 22nd international conference of the System Dynamics Society, Oxford

    Google Scholar 

  • Wolstenholme EF, Monk D (2004) Using system dynamics to influence and interpret health and social care policy in the UK. In: 22nd international conference of the System Dynamics Society, Oxford

    Google Scholar 

  • Wolstenholme EF, Monk D, Smith G, McKelvie D (2004a) Using system dynamics in modelling health and social care commissioning in the UK. In: Proceedings of the 2004 system dynamics conference, Oxford

    Google Scholar 

  • Wolstenholme EF, Monk D, Smith G, McKelvie D (2004b) Using system dynamics in modelling mental health issues in the UK. In: Proceedings of the 2004 system dynamics conference, Oxford

    Google Scholar 

  • Wolstenholme EF, Monk D, Smith G, McKelvie D (2004c) Using system dynamics to influence and interpret health and social care policy in the UK. In: Proceedings of the 2004 system dynamics conference, Oxford

    Google Scholar 

  • Wolstenholme EF, Arnold S, Monk D, Todd D, McKelvie D (2005) Coping but not coping in health and social care – masking the reality of running organisations well beyond safe design capacity. Syst Dyn Rev 23(4):371–389

    Article  Google Scholar 

  • Wolstenholme EF, Arnold S, Monk D, Todd D, McKelvie D (2006) Reforming mental health services in the UK – using system dynamics to support the design and implementation of a stepped care approach to depression in North-West England. In: Proceedings of the 2006 international system dynamics conference, Nijmegen

    Google Scholar 

  • Wolstenholme EF, Monk D, McKelvie D (2007a) Influencing and interpreting health and social care policy in the UK. In: Qudrat-Ullah H, Spector MJ, Davidsen PI (eds) Complex decision making: theory and practice. Springer, New York

    Google Scholar 

  • Wolstenholme EF, Monk D, McKelvie D, Gillespie P, O’Rourke D, Todd D (2007) Reallocating mental health resources in the borough of Lambeth, London, UK. In: Proceedings of the 2007 international system dynamics conference, Boston

    Google Scholar 

  • Wolstenholme EF, Monk D, McKelvie D, Todd D (2007) The contribution of system dynamics to cost benefit analysis – a case study in planning new mental health services in the UK. In: Proceedings of the 2007 international system dynamics conference, Boston

    Google Scholar 

  • Wolstenholme E, McKelvie D, Monk D, Todd D, Brad C (2008) Emerging opportunities for system dynamics in UK health and social care – the market-pull for systemic thinking. Paper submitted to the 2008 system dynamics conference, Athens

    Google Scholar 

Books, Reviews and Reports

  • Comptroller and Auditor General (2009) Reducing healthcare associated infections in hospitals in England. Report HC 560 2008–2009. National Audit Office, London

    Google Scholar 

  • Bechberger E, Lane DC, McBride T, Morton A, Quintas D, Wong CH (2011) The National Audit Office uses OR to assess the value for money of public services. Interfaces 41(4):365–374

    Article  Google Scholar 

  • Dangerfield BC (1999b) System dynamics applications to european health care issues. J Oper Res Soc 50(4):345–353

    Article  Google Scholar 

  • Dangerfield B (2011) The role of behaviour change in eating and physical activity in the battle against childhood obesity. In: Proceedings of the international system dynamics conference, Washington DC. Online at www.systemdynamics.org with N Zainal Abidin

  • Dangerfield BC, Roberts CA (eds) (1994) Health and health care dynamics. Special issue of Syst Dyn Rev 15(3):526–567

    Google Scholar 

  • http://www.symmetricpartnership.co.uk

  • http://www.thewholesystem.co.uk/simulation/examples.aspx

  • Lacey P (2011) Integrated care development using systems modelling – a case study of Intermediate Care. In: Jain S, Creasey RR, Himmelspach J, White KP, Fu M (eds) Proceedings of the 2011 winter simulation conference, Boston, Mass

    Google Scholar 

  • Lane DC, Munro E (2010) Appendix 2: applying systems thinking ideas to child protection. In: Munro E (ed) The Munro review of child protection part one: a systems analysis, pp 47–52, UK Government publication, London

    Google Scholar 

  • Lane DC, Bianchi C, Bivona E (eds) (2010) Public sector applications of the system dynamics approach: selected papers from the fourth European system dynamics workshop, University of Palermo, Italy. Special Edition of Systems research and behavioral science, vol 27, issue 4

    Google Scholar 

  • Maliapen M, Dangerfield B (2009) A system dynamics based simulation study for managing clinical governance and pathways in a hospital. J Oper Res Soc 61:255–264

    Article  Google Scholar 

  • McKelvie D. Reducing alcohol related admissions to Hospital, 2011. Paper submitted to the 2011 international system dynamics conference, Washington DC. Online at www.systemdynamics.org

  • Wolstenholme EF (2003) Towards the definition and use of a core set of archetypal structures in system dynamics. Syst Dyn Rev 19(1):7–26

    Article  Google Scholar 

  • Wolstenholme EF (2010) Dynamic cost benefit analysis for mental health reform (with David Monk and David Todd). Kybernetes 39(9–10):1645–1658

    Google Scholar 

  • Zainal Abidin N, Mamat M, Dangerfield B et al. Combating obesity through healthy eating behavior: a call for system dynamics optimization. PloS One 9(12):e114135. doi: 10.1371/journal.pone.0114135

    Google Scholar 

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Acknowledgments

The author would like to acknowledge the many practitioners of system dynamics in health and social care throughout Europe for their dedication to using these methods to improve health and well-being. Particular thanks are due to my colleagues in the International System Dynamics community and its Society and those in the UK Chapter of the Society, without whom I would not have the knowledge base to undertake this review. Special thanks are also due to my colleagues in Symmetric SD, without whom much of the personal work reported here would not have been carried out at all.

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    Eric Wolstenholme

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    Robert A. Meyers

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Wolstenholme, E. (2015). Health Care in the United Kingdom and Europe, System Dynamics Applications to. In: Meyers, R. (eds) Encyclopedia of Complexity and Systems Science. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-27737-5_269-3

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  1. Latest

    System Dynamics Applications to Health and Social Care in the United Kingdom and Europe
    Published:
    25 June 2019

    DOI: https://doi.org/10.1007/978-3-642-27737-5_269-4

  2. Original

    Health Care in the United Kingdom and Europe, System Dynamics Applications to
    Published:
    24 January 2015

    DOI: https://doi.org/10.1007/978-3-642-27737-5_269-3

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