This book is an introduction to health care as a complex adaptive system, a system that feeds back on itself. The first section introduces systems and complexity theory from a science, historical, epistemological, and technical perspective, describing the principles and mathematics. Subsequent sections build on the health applications of systems science theory, from human physiology to medical decision making, population health and health services research. The aim of the book is to introduce and expand on important population health issues from a systems and complexity perspective, highlight current research developments and their implications for health care delivery, consider their ethical implications, and to suggest directions for and potential pitfalls in the future.
Joachim P Sturmberg MBBS, DORACOG, MFM, PhD, FRACGP I am Adjunct A/Prof of Monash University, Melbourne, and Conjoint A/Prof of General Practice in the Department of General Practice in the Department of General Practice, General Practice, The Newcastle University, Newcastle, Australia. I am a graduate from Lübeck Medical School, Germany, where I also completed my PhD. Since 1989 I work in an urban group practice on the NSW Central Coast, with a particular interest in the ongoing patient-centred care of patients with chronic disease and the elderly. In 1994 I started to pursue systems and complexity research with an inquiry into the effects of continuity of care on the care processes and outcomes. Since then my research has expanded and includes the areas of understanding the complex notion of health, health care and healthcare reform, showing that health is an interconnected multi-dimensional construct encompassing somatic, psychological, social and semiotic or sense-making domains, that health care has to embrace the patient’s understanding of her health as the basis for effective and efficient care, and that an effective and efficient healthcare system ought to put the patient at the centre. I am joint chief editor of the Forum on Systems and Complexity in Medicine and Healthcare in the Journal of Evaluation in Clinical Practice. Together with Carmel Martin and Jim Price I chair the Complexity SIG in WONCA.
Carmel C Martin MBBS, MSc, PhD, MRCGP, FRACGP, FAFPHM I am Visiting Academic Department of Public Health and Primary Care, Trinity College, Dublin, and an Associate Professor of Family Medicine at the Northern Ontario School of Medicine. I am active in clinical general practice with a particular interest in chronic disease and illness and patient centered care and integrated care using information technology, informed by complex adaptive systems theories. I am an Australian medical graduate from the University of Queensland. I completed my Mastersin Community Medicine at the London School of Hygiene, University of London and my PhD at the Australian National University. My research in Australia, Canada and Ireland has focused on reforms related to primary health care and chronic care, the nature of health in body, mind, society and the environment and meaning and sensemaking about personal health. My PhD. on the care of chronic illness in general practice, explored the nature of the experience of illness and care associated with multi-morbidity from the perspectives of those afflicted and their general practitioner/primary care physician as the key ‘users’ of care. This PhD led to a wide range of systems based interventions, underpinned by complex adaptive systems theory and social constructionist perspectives in Australia, Canada and Ireland. I am joint chief editor of the Forum on Systems and Complexity in Medicine and Healthcare in the Journal of Evaluation in Clinical Practice.
