van Wietmarschen Herman A, Wortelboer Heleen M, van der Greef Jan
Department of Microbiology and Systems Biology, TNO Netherlands Organization for Applied Scientific Research, PO Box 360, 3700, AJ, Zeist, The Netherlands.
J Eval Clin Pract. 2018 Feb;24(1):269-277. doi: 10.1111/jep.12679. Epub 2016 Dec 29.
This article addresses the urgent need for a transition in health care to deal with the increasing prevalence of chronic diseases and associated rapid rise of health care costs. Chronic diseases evolve and are predominantly related to lifestyle and environment. A shift is needed from a reductionist repair mode of thinking, toward a more integrated biopsychosocial way of thinking about health. The aim of this article is to discuss the opportunities that complexity science offer for transforming health care toward optimal treatment and prevention of chronic lifestyle diseases. Health and health care is discussed from a complexity science perspective. The benefits of concepts developed in the field of complexity science for stimulating transitions in health care are explored. Complexity science supports the elucidation of the essence of health processes. It provides a unique perspective on health with a focus on the relationships within networks of dynamically interacting factors and the emergence of health out of the organization of those relationships. Novel types of complexity science-based intervention strategies are being developed. The first application in practice is the integrated obesity treatment program currently piloted in the Netherlands, focusing on health awareness and healing relationships. Complexity science offers various theories and methods to capture the path toward unhealthy and healthy states, facilitating the development of a dynamic integrated biopsychosocial perspective on health. This perspective offers unique insights into health processes for patients and citizens. In addition, dynamic models driven by personal data provide simulations of health processes and the ability to detect transitions between health states. Such models are essential for aligning and reconnecting the many institutions and disciplines involved in the health care sector and evolve toward an integrated health care ecosystem.
本文论述了医疗保健领域迫切需要转型，以应对慢性病患病率不断上升以及相关医疗成本迅速增长的问题。慢性病不断演变，且主要与生活方式和环境相关。需要从还原论的修复思维模式转向更综合的生物心理社会健康思维方式。本文旨在探讨复杂性科学为将医疗保健转变为对慢性生活方式疾病进行最佳治疗和预防所提供的机遇。从复杂性科学的角度讨论健康与医疗保健。探讨了复杂性科学领域所形成的概念对推动医疗保健转型的益处。复杂性科学有助于阐明健康过程的本质。它提供了一个独特的健康视角，重点关注动态相互作用因素网络中的关系以及这些关系的组织如何产生健康。基于复杂性科学的新型干预策略正在不断开发。在实践中的首次应用是目前在荷兰试行的综合肥胖治疗项目，该项目侧重于健康意识和治愈关系。复杂性科学提供了各种理论和方法来把握通往不健康和健康状态的路径，有助于形成关于健康的动态综合生物心理社会视角。这种视角为患者和公民提供了对健康过程的独特见解。此外，由个人数据驱动的动态模型可模拟健康过程，并能够检测健康状态之间的转变。此类模型对于协调和重新连接医疗保健部门涉及的众多机构和学科并朝着综合医疗保健生态系统发展至关重要。
