Document Detail

People at the centre of complex adaptive health systems reform.
MedLine Citation:
PMID:  20955127     Owner:  NLM     Status:  MEDLINE    
Health systems are increasingly recognised to be complex adaptive systems (CASs), functionally characterised by their continuing and dynamic adaptation in response to core system drivers, or attractors. The core driver for our health system (and for the health reform strategies intended to achieve it) should clearly be the improvement of people's health - the personal experience of health, regardless of organic abnormalities; we contend that a patient-centred health system requires flexible localised decision making and resource use. The prevailing trend is to use disease protocols, financial management strategies and centralised control of siloed programs to manage our health system. This strategy is suggested to be fatally flawed, as: people's health and health experience as core system drivers are inevitably pre-empted by centralised and standardised strategies; the context specificity of personal experience and the capacity of local systems are overlooked; and in line with CAS patterns and characteristics, these strategies will lead to "unintended" consequences on all parts of the system. In Australia, there is still the time and opportunity for health system redesign that truly places people and their health at the core of the system.
Joachim P Sturmberg; Diana M O'Halloran; Carmel M Martin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Medical journal of Australia     Volume:  193     ISSN:  0025-729X     ISO Abbreviation:  Med. J. Aust.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-19     Completed Date:  2010-11-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400714     Medline TA:  Med J Aust     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  474-8     Citation Subset:  IM    
Department of General Practice, Monash University, Melbourne, VIC, Australia.
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MeSH Terms
Delivery of Health Care / organization & administration*
Health Care Reform / organization & administration*
Health Services Needs and Demand

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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