The Logics of Healthcare : The Professional's Guide to Health Systems Science

Health service production is troubled by increasing demand and constrained supply. Despite best efforts, productivity and health value improvement are below expectations. Management methods imported from manufacturing provide variable results. The Logics of Healthcare: The Professional's Guide to Health Systems Science presents the argument that healthcare is not one industry with one logic and one set of solutions. Healthcare can be segmented into seven types based on how demand and supply meet; what needs to be done and what can be done. These Demand-Supply-based Operating logics (DSO) are Emergency, Prevention, One Visit, Electives, Cure, Care, and Projects. They are business models with distinct value propositions, customer segments, processes, resources, and revenue models. The argument is developed starting from the fundamentals of purposeful action and a conception of healthcare as socio-techno-economic systems, where physical, biological, and behavioral technologies are bundled into production functions that are organized as processes and structures. Services are state changes accomplished by producer-customer collaboration. Health services deal with dilemmas, such as provide help and health, sell promises to patients buying hope, mass-produce individual healing relationships, and operate both plannable and explorative processes. The DSO model provides a conceptual framework for health systems science to identify managerially distinct areas, and to select appropriate methods for improvement. Book jacket.