Healthcare as a Complex Adaptive System: Understanding Health Disparity as an Emergent Phenomenon
摘要
To delineate the criteria that characterize healthcare as a complex adaptive system (CAS), including nonlinearity, self-organization, and emergence. Thereafter, we reframe health disparity as an emergent phenomenon, and show how this alternative perspective can be used to identify novel strategies and opportunities to close the health equity gap.
Recent FindingsIt is a moral imperative to ensure that every individual is afforded a minimal level of medical care, regardless of background or means. Unfortunately, healthcare systems around the world are failing to deliver on this commitment. One of the greatest frustrations is the growing inequity in health outcomes between the ‘haves’ and ‘have nots.’ Traditional models of understanding and addressing health disparity have fallen short and the health inequity gap continues to increase. We need to think differently. Healthcare is a CAS—the interactions between patients, care providers, and suppliers lead to outcomes that are more than the sum of the contributions of the individual agents. In this context, health disparity is an emergent phenomenon, the result of complex interactions among multiple interdependent variables that are unevenly distributed across people of different backgrounds. Using infant mortality rate as our outcome of interest, we define a novel 3-stage framework to understanding health disparity.
SummaryHealthcare is a CAS and health disparity is an emergent phenomenon—it is independent of the motivation of individuals, and is neither intended nor desired. This alternative framework can be used to identify novel strategies and opportunities to close the health equity gap.