Regional Health Care Model

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A Hybrid model for individual clinical, services and policy decisions for ICT enabled Regional health care. Focus is on care network dynamics, particularly health service networks.

Contents

Background

  • This model is planned as an exemplar for Health Care Hybrid modeling using Model Frameworks for Health Care
  • Interestingly, it was suggested by David Harel (of statechart fame) as a grand challenge at a Canadian Health Services conference around 2005

Relevant Insights

Problem situation intervention focus

  • Rural Public Health Interventions
  • Use of iEpi data and hybrid models
  • Diabetes Care

Notes

  • In Australia's Health 2012 p17 Health Care Services at the MacroLevel are described as:
    • Hospital Services (Public and Private)
    • Medical Services
    • Medications
    • Community and Public Health Services
    • Dental Services
    • Other (Health Professions?)
    • Admin & Research
    • Note Aged Care and Disability Services are defined as Welfare (social) Services, as well as Family and Children's Services
    • Funding sources are Australian Government, State Government, Private and Out of Pocket, with subsidies and rebates from AG to Private and OOP
  • The NHRA National Health Reform Agreements has adapted the National Health Performance Framework (originating from Canada's cihi) NHPF to the regional level, with the ABS defining comparable regions and public performance indicators listed on the MyHospitals website and a forthcoming MyCommunities website.
  • National Health Performance Framework NHPF Components and p30 Australia's Health 2012 are
    • Health Status (health conditions, human function, wellbeing, deaths)
    • Determinants of Health (environmental factors, community and socioeconomic, health behaviours, biomedical factors)
    • Health System Performance (effectiveness, continuity of care, safety, accessibility, responsiveness, efficiency and sustainability)
  • Hospital Services are currently focussed on waiting times in ED (NEAT National Emergency Access Targets) and elective surgery (with exclusions and limitations)
  • Hospital Services are
    • Cancer
    • Coronary Care
    • Dialysis
    • Elective Surgery (by specialty)
    • Emergency
    • Geriatric assessment
    • Intensive Care
    • Palliative Care
    • Psychiatry
    • Rehabilitation
    • Outpatients
  • Overlap with Social Care and Engaged Informal Care (including self-care) esp for
    • Mental Health
    • Drug and Alcohol
    • Disability
    • Aged Care
    • Chronic Care
  • Promotion and Prevention at the Individual (Healthy Behaviours) and Community level

Related Concepts

Basic Structure

  • People located in care networks with concerns seek assistance from health service networks.
  • Their needs are assessed, diagnosed, treated and managed using services delivered by formal and informal carers with healthy behaviours
  • Service delivery involves the use of effective knowledge, skills, attitudes and technologies
  • Agents learn healthy behaviours and acquire abilities to make effective long term decisions
  • Governance mechanisms control equity, efficiency and effectiveness of care cost, quality, access and organization.
  • The system evolves through a mix of coordination and synthesis, analysis and specialisation at multiple scales of social and regional structures

Key Flows and Decisions

  • People
    • Ageing (birthing and dying)
    • Mobility (Day night work and home trips migration)
    • Social group
    • Residence (household, cared accommodation) Living arrangements
    • Wants based on life pursuits and concerns for self and others
    • Demands based on seeking care (presentations, making appointments)
    • Needs based on professional assessment
    • Values (espoused, perceived, expected, used)
    • Roles as (informal and formal carers and care recipients)
  • Services Provision
    • Service lifecycle based on adaptive cycle (aware, available [price and quality and access], invest, consume, conserve, establish [based on technology innovation or imitation], maintain, improve, retire)
    • Value, Resilience, Capacity
    • Workforce (training, profession, employment[create job,seek and accept job, leave job], migration, hours worked, retirement, registration)
    • Teams competency, skill mix, roles, shared thinking doing values
    • Infrastructure
    • Supplies
    • Technology
  • Service User
    • Resilience (self, social supports, community)
    • Patient Flows seeking care type and place if aware
    • Care Process Flows
    • States (well, unwell, disabled, in care ,cure, acute chronic)
    • Seek (want health, healthy behavior, care service, information), Present Wait, Use Leave, Return, Adhere)
  • Options (Choice behaviors)
    • aware, informed, considered, accepted, rejected, retained
    • preferred, presented, stated (communicated), tested, revealed
    • based on attribute utility (see DCE IM-2914 as part of behavior IM-3345 ) prices, rules, routines
    • See Action oriented JWF award paper IM-2439 and consider Agent based version
  • Information

Multiscale Patterns

  • Available time series data
  • Important mechanisms from other models/theories

References

Questions & Comments to Geoff McDonnell
Personal tools