HPSIG Health System Dynamics Wikipedia

Health System Dynamics Wikipedia

The Health System Dynamics Wikipedia page has been redesigned. The ever increasing amount of information that people are contributing to the site has made navigation difficult and confusing. This redesign hopes to make the site more useful.

The site has been organized into two, very broad, main categories - a repository for models and a library. We have also included a note on horizonatal linkages, the technique through which interdependent information from the two main categories is woven together.

Field Model of Health

Within these categories there are, of course, many ways to organize information. We have chosen to use a model developed by Robert Evans, Morris Barer, and Theodore Marmor, taken from their book, "Why Are Some People Healthy and Others Not?" The book is a broad inquiry into the determinants of the health of populations. Their model describes a number of interdependent and causal relationships that when taken together, dynamically describe the general health and well being of populations of people.

HSD Models

This part of the site is for actual models that have been constructed. All models that are uploaded to the site will find a home somehwere in this section of the site. Please do not upload models to this page; follow the Health System Models link and select the category (or categories ) for your model.

The second level of organization (just below the Evans Barer Marmor model) is the type of model. There is a wide variety of modeling approaches that can contribute to the understanding of health systems - system dynamics, agent based, and discrete event modeling to name a few.

The third level of organization relies on the reference point of time. Models that replicate past or present dynamics will be in their respective sub-categories while models that propose new policy and structure and frameworks will be in a third sub-category.

In addition to the categories described in the Evans, Barer, and Marmor model above, there are additional categories where one or more of the categories from Evans, Barer, and Marmor - as well as a number of other dimensions of health dynamics - are brought together to illustrate their interdependency or to propose emerging health system policy. There is also a category called, "Puzzling Health Dynamics" that explores dynamic behavior that does not fall neatly into these categories, but which provide interesting insights into systemic behavior.

There is currently no "standard" for models. For example, system dynamics models may be contributed in Powersim Constructor or Powersim Studio, Vensim, iThink, Stella, or MyStrategy, or any other package that produces such models. Models may be quantitative (dynamic simulations) and/or they may be qualitative, based on causal loop diagrams, and/or non-simulation stock and flow diagrams and/or narratives illustrated with time trend data. Note that more standardised model conventions, documentation and sharing of executable model components is a potential area for ongoing collaboration <link to Collaborative research agenda on Model Library similar to the Systems Biology initiatives>.

HSD Library

The overwhleming majority of the information on this site is found in the Library. In other words, if it is not a dynamic model, it is in the Library. The Library also uses the Evan's Barer, Marmor model for its basic organization.

The main sections of the Library are:

• Disease (epidemiology, natural progression of illness, illness burden, etc.)
• Healthcare Delivery
• Genetics
• Individual Behavior
• Individual Biology
• Physical Environment
• Social Environment
• Health and Function (Societal implications, etc.)
• Prosperity
• Well-Being
• System Dynamics (General Section)
• Generic Structures
• Puzzling Health Dynamics
• Whole system dynamics (and interactions that cross two or more sections )

Within each section there are several standard sub-sections describing the main focus of the material. (This does not rule out others, this is only speaks to the general organization of the site).

• Literature (related to the category)
• Policy considerations and proposals (narratives, not models)
• Generic structures and behaviors (archetypes)
• Economics and Funding
• Etc.

Using Disease and Healthcare Delivery as an example, the organization of information is:

• Disease (epidemiology, natural progression of illness, illness burden, etc.)
  • Literature (related to the category)
  • Policy considerations and proposals (narratives, not models)
  • Generic structures and behaviors (archetypes)
  • Economics and Funding
  • Etc.
• Healthcare Delivery
  • Literature (related to the category)
  • Policy considerations and proposals (narratives, not models)
  • Generic structures and behaviors (archetypes)
  • Economics and Funding
  • Etc.

Horizontal Linkages

The HPSIG site makes extensive use of hyperlinks to create connections between information and models that are located in multiple Evans Barer Marmor model categories. These links serve to unite and aggregate information across categories to provide insights that might not be otherwise possible. These links appear wherever the contributor to the page felt that companion information in another part of the HPSIG site expanded the content's value or understandability. It can also serve to provide a specific view of the database and navigational map for general categories of users such as modelers, clinicians, managers, planners and newbies.