ANNOUNCE Health Policy SIG CFP 2006 ISDC

[Gary Hirsch GBHirsch comcast.net]

Posted by ""Gary Hirsch"" <GBHirsch@comcast.net>
CALL FOR PAPERS: DYNAMICS OF HEALTH REFORM AND CHANGE IN HEALTH CARE SYSTEMS FOR 2006 ISDC

Dear Friends,

As you may know, the Health Policy Special Interest Group (HPSIG) of the System Dynamics Society held a special session at the beginning of the 2005 International System Dynamics Conference in Boston focused on the dynamics of health reform and change in health care systems. Discussion at the session led to an agreement that this is a worthwhile topic to pursue in greater depth at the 2006 ISDC in Nijmegen and that we would encourage parallel efforts in a number of countries focused on this topic. These efforts would ideally lead to a set of papers that could be presented in a special HPSIG session organized in conjunction with the 2006 conference. This is a formal call for papers.

The papers will examine major initiatives to reform health care systems and the factors that caused those efforts to succeed, be partially successful, or fail to achieve their objectives. Such initiatives would be attempts to restructure health systems or otherwise make changes in people's access to care, costs of providing care, and/or the emphasis on preventing illness
rather than simply treating it. The papers would describe the reform and
then use the tools of System Dynamics and Systems Thinking to analyze its design and implementation. The papers could, for example, use Causal Loop Diagrams to help display and explain the factors that helped a reform effort succeed or fail. Or they could use an SD model to help demonstrate what happened and project possible alternative outcomes if different policies had
been implemented. Regardless of the tools used, the focus would be on the
factors that enabled or prevented change and what this suggests about designing and implementing successful health reform.

The papers might be about reforms designed for an entire country's health care system or for health care in a particular state, province, or region. They might address reforms slated for an entire population or special populations such as children, older people, or people with a particular health problem or need. One especially interesting possibility might be to analyze a reform initiative mandated at a national level, but implemented differently, with different results, in various states or regions. Another possibility would be to analyze and compare the same type of reform implemented differently in several countries. In doing these papers, we would encourage you to work with colleagues from the health policy community and from other disciplines.

At the end of this e-mail, you will find a ""template"" that we hope will help shape your presentation of the factors that caused a health reform to succeed or fail. Using a common template will make it easier to compare the factors that affect reform across different countries and populations. We plan to schedule a session with sufficient time for people to present papers and then discuss the common factors that determine whether health system reforms achieve their objectives. A good response with a number of papers and in-depth discussion at the 2006 conference could produce the material for a book that makes a significant contribution to health policy.

The following are important dates to assure that we get a critical mass of papers for a session in Nijmegen.

November 1, 2005 Initial Response

Please send a brief description of the reform you intend to analyze, the approach you will take, and who will be involved in the work.

March 1, 2006 Draft Papers Due

We would like to receive draft papers by this point to have a sense of what is available for presentation, begin to design the session for the July conference, and get the Program Committee's endorsement for scheduling such
a session. The papers would also have to arrive by this point to go
through the ISDC's peer review process.

We look forward to hearing from you and look forward to an exciting session at the 2006 conference. Please contact one of us if you have any questions or want to share ideas about the session with us.

For the HPSIG,

Gary Hirsch GBHirsch@comcast.net

Geoff McDonnell gmcdonne@bigpond.net.au

Jack Homer jhomer@comcast.net

Bobby Milstein bmilstein@cdc.gov

Suggested Outline for Papers Submitted for Special HPSIG
Session on Health Reform and Change in Health Systems

The following ""template"" may help to structure your paper on health reform.

1. Describe the reform you are analyzing
- its objectives, key mechanisms for change, and population affected
- the context in which it was implemented (e.g., very brief description of
your country's health care system; past attempts at reform)
- a brief history of its implementation and its consequences as perceived
by different stakeholders
- its current status-are the mechanisms introduced or strengthened by the
reform currently in place or have they been supplanted by something
else?

2. Analyze the factors that shaped the reform's impact-this can utilize CLDs
or a quantified SD model or some other presentation of the relevant
structure.
- What factors supported the reform? Which ones served as impediments? How
did they interact? Specifically:
- What were the key political factors? How did the anticipated or
actual consequences of the reform motivate different
stakeholders to react? Which stakeholders had the most important roles at each stage of the reform's design and implementation? Did the reform help some groups while leaving others behind?
- How did the reform change the economics of health care? Did this
help to achieve the reform's objectives or was it an
unintended consequence?
- Was the reform aimed at improving living conditions that affect
people's health, making improvements in the efficiency, effectiveness, or quality of health services, or some combination of these? If the focus was on health services, did the reform strive to improve people's health status as well? How well did the reform
achieve its various objectives? For which groups and for
how long? If accomplishments were only partial in one or more areas (or,
worse, backfired), what were the possible reasons?
- What drove the dynamics that were observed? For example, was there an
initial success that could not be sustained in the long run?
If so, what limits were reached? What feedback mechanisms interfered?

3. Alternative outcomes
- What are alternative approaches that might have made this reform more
effective?
- What are the leverage points that might have been better utilized?
- What could have been the outcome?
- What would have resulted in more fundamental changes in the health of
the population? How might these have been promoted?
- Going forward, what are the different trajectories that the reform and
its implementation might take in the future? What resources and
policies would be necessary to achieve a desirable outcome?

4. Conclusions-- Reflecting on your analysis of this specific reform, what can you generalize about the requirements for effective health reform? Posted by ""Gary Hirsch"" <GBHirsch@comcast.net> posting date Thu, 29 Sep 2005 08:34:29 -0400