Systems Science and Evidence-Informed Deliberation to Mitigate Dilemmas in Situations of Dual Agency at the Hospital Level; Comment on “Dual Agency in Hospitals: What Strategies Do Managers and Physicians Apply to Reconcile Dilemmas Between Clinical and Economic Considerations”

Document Type : Commentary

Author

Department for Health Evidence (HEV), Radboud Institute for Health Sciences (RIHS), Radboud University Medical Center, Nijmegen, The Netherlands

Abstract

The article by Waitzberg et al on dual agency in hospitals reports on three strategies to mitigate dilemmas arising from conflicting clinical and economic considerations. This could be further explored by using systems science methods that allow in-depth analyses of (health) system dynamics, networks, and agent-based modelling, and that take into account local context, incentives and how institutions work. Future studies may also draw on the literature of multi-criteria decision-making and evidence-informed deliberative processes (EDPs) that are increasingly being used to optimise legitimate health benefit package design. Toolkits to assist hospital professionals in improving their decision-making need to be practical, with ample attention for the process of decision-making, including transparency, use of evidence, and opportunities for health professionals (and possibly others stakeholders) to contest or formally appeal against certain decisions.

Keywords

  • epublished Author Accepted Version: February 13, 2022
  • epublished Final Version: March 2, 2022

References

  1. Waitzberg R, Gottlieb N, Quentin W, Busse R, Greenberg D. Dual agency in hospitals: what strategies do managers and physicians apply to reconcile dilemmas between clinical and economic considerations? Int J Health Policy Manag. 2021. doi:34172/ijhpm.2021.87
  2. Doyle S. Member checking with older women: a framework for negotiating meaning. Health Care Women Int. 2007;28(10):888-908. doi:1080/07399330701615325
  3. Birt L, Scott S, Cavers D, Campbell C, Walter F. Member checking: a tool to enhance trustworthiness or merely a nod to validation? Qual Health Res. 2016;26(13):1802-1811. doi:1177/1049732316654870
  4. Chambers DA, Glasgow RE, Stange KC. The dynamic sustainability framework: addressing the paradox of sustainment amid ongoing change. Implement Sci. 2013;8:117. doi:1186/1748-5908-8-117
  5. Peters DH. The application of systems thinking in health: why use systems thinking? Health Res Policy Syst. 2014;12:51. doi:1186/1478-4505-12-51
  6. Luke DA, Stamatakis KA. Systems science methods in public health: dynamics, networks, and agents. Annu Rev Public Health. 2012;33:357-376. doi:1146/annurev-publhealth-031210-101222
  7. Decouttere C, Banzimana S, Davidsen P, et al. Insights into vaccine hesitancy from systems thinking, Rwanda. Bull World Health Organ. 2021;99(11):783-794D. doi:2471/blt.20.285258
  8. Decouttere C, Vandaele N, De Boeck K, Banzimana S. A systems-based framework for immunisation system design: six loops, three flows, two paradigms. Health Syst. 2021:1-16. doi:1080/20476965.2021.1992300
  9. Broekhuizen H, Ifeanyichi M, Cheelo M, et al. Policy options for surgical mentoring: lessons from Zambia based on stakeholder consultation and systems science. PLoS One. 2021;16(9):e0257597. doi:1371/journal.pone.0257597
  10. Baltussen R, Marsh K, Thokala P, et al. Multicriteria decision analysis to support health technology assessment agencies: benefits, limitations, and the way forward. Value Health. 2019;22(11):1283-1288. doi:1016/j.jval.2019.06.014
  11. Thokala P, Devlin N, Marsh K, et al. Multiple criteria decision analysis for health care decision making--an introduction: report 1 of the ISPOR MCDA Emerging Good Practices Task Force. Value Health. 2016;19(1):1-13. doi:1016/j.jval.2015.12.003
  12. Baltussen R, Jansen M, Oortwijn W. Evidence-informed deliberative processes for legitimate health benefit package design-part I: conceptual framework. Int J Health Policy Manag. 2021. doi:34172/ijhpm.2021.158
  13. Oortwijn W, Jansen M, Baltussen R. Evidence-informed deliberative processes for health benefit package design-part II: a practical guide. Int J Health Policy Manag. 2021. doi:34172/ijhpm.2021.159
  14. Cutrer WB, Ehrenfeld JM. Protocolization, standardization and the need for adaptive expertise in our medical systems. J Med Syst. 2017;41(12):200. doi:1007/s10916-017-0852-y
International Journal of Health Policy and Management
Volume 11, Issue 10
October 2022
Pages 2337-2339

Files

History

  • Receive Date: 14 November 2021
  • Revise Date: 08 February 2022
  • Accept Date: 12 February 2022
  • First Publish Date: 13 February 2022

Share

How to cite

Statistics