Applications of system dynamics modelling to support health policy
Applications of system dynamics modelling to support health policy
复制标题
DOI：
10.17061/phrp2531531
复制
发表时间：
2015-07-01
影响因子：
4.4
通讯作者：
Wilson, Andrew
中科院分区：
文献类型：
--
作者：
Atkinson, Jo-An M.;Wells, Robert;Wilson, Andrew
系统科学建模方法在卫生部门的价值正日益得到认可。特别有希望的是，这些方法有可能改善卫生保健能力和提供的业务方面，分析卫生系统改革的政策选择，并指导投资，以解决复杂的公共卫生问题。因为系统动力学建模本身是一种参与式方法，所以它是一种特别吸引人的方法，旨在使利益相关者对问题的潜在原因的理解保持一致，并为行动达成共识。本综述的目的是确定卫生政策系统动力学建模的有效性，并探讨其应用的范围和性质。方法：系统检索PubMed、Web of Knowledge、Embase、ScienceDirect和谷歌Scholar数据库中截至2015年4月发表的文章。灰色文献也被搜索。符合纳入条件的论文是那些描述系统动力学建模应用于支持各级政府卫生政策的论文。结果和讨论：确定了六篇论文，包括八个应用系统动力学建模支持卫生政策的案例研究。没有发现分析研究检验这种类型的建模的有效性。只有三个例子涉及多学科利益相关者在集体模型构建中。据报告，利益攸关方参与建立模型促进了健康问题共同“心理地图”的制定，从而就最佳政策战略达成共识，并为合作行动赢得支持。相关论文的缺乏表明，尽管提倡系统动力学建模价值的描述性文献数量可观，但其在卫生政策制定方面的实际应用尚未得到常规应用和严格评估。结论：软件方面的进步使参与性模型建立方法得以扩展到更复杂的多方法模型，为决策者提供更有力的工具，以支持设计针对复杂卫生问题的有针对性、有效和公平的政策对策。建设能力和投资于传播以促进这些建模方法，以及记录和评估它们的应用，对于支持决策者采用这些方法至关重要。
Introduction: The value of systems science modelling methods in the health sector is increasingly being recognised. Of particular promise is the potential of these methods to improve operational aspects of healthcare capacity and delivery, analyse policy options for health system reform and guide investments to address complex public health problems. Because it lends itself to a participatory approach, system dynamics modelling has been a particularly appealing method that aims to align stakeholder understanding of the underlying causes of a problem and achieve consensus for action. The aim of this review is to determine the effectiveness of system dynamics modelling for health policy, and explore the range and nature of its application.Method: A systematic search was conducted to identify articles published up to April 2015 from the PubMed, Web of Knowledge, Embase, ScienceDirect and Google Scholar databases. The grey literature was also searched. Papers eligible for inclusion were those that described applications of system dynamics modelling to support health policy at any level of government.Results and discussion: Six papers were identified, comprising eight case studies of the application of system dynamics modelling to support health policy. No analytic studies were found that examined the effectiveness of this type of modelling. Only three examples engaged multidisciplinary stakeholders in collective model building. Stakeholder participation in model building reportedly facilitated development of a common 'mental map' of the health problem, resulting in consensus about optimal policy strategy and garnering support for collaborative action. The paucity of relevant papers indicates that, although the volume of descriptive literature advocating the value of system dynamics modelling is considerable, its practical application to inform health policy making is yet to be routinely applied and rigorously evaluated.Conclusion: Advances in software are allowing the participatory model building approach to be extended to more sophisticated multimethod modelling that provides policy makers with more powerful tools to support the design of targeted, effective and equitable policy responses for complex health problems. Building capacity and investing in communication to promote these modelling methods, as well as documenting and evaluating their applications, will be vital to supporting uptake by policy makers.