Exploring the drivers of unsustainable pressures in health and social care: A qualitative system dynamics approach

Le Khanh Ngan Nguyen, Holly McCabe, Susan Howick, Itamar Megiddo, Soumen Sengupta and Alec Morton

Social Science & Medicine, 2025, vol. 371, issue C

Abstract: Health and social care systems face immense pressures that emerge from complex interdependencies between system components, transcending conventional explanations of demand-capacity mismatches. Although multiple theoretic perspectives (e.g., “complex adaptive systems”, “sociotechnical systems”) have been advocated as ways to capture and characterise the nature of that complexity, consolidating it into actionable insights for coordinated stakeholder efforts remains challenging, perpetuating implementation failure. This study introduces a novel application of qualitative system dynamics, using Causal Loop Diagrams (CLDs), to reveal the deeper structural patterns that drive persistent challenges and explain why policies have often fallen short.

Keywords: System dynamics; Causal loop diagrams; Complex adaptive systems; Healthcare; Social care; Integrated care; Personalised care (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1016/j.socscimed.2025.117913

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