Models in Health System Analysis: Logic, Casual & Conceptual

Instructor: Alexandra Unfried

Alexandra earned her master's degree in nursing education and is currently a hospital supervisor/administrator.

Health system analysis models examine the relations between chosen entities to see how they interact. This lesson will discuss the logic, causal, and conceptual models in health systems.

Choosing a Model for Health System Analysis

It is important in healthcare to perform an analysis of various procedures, program, processes, and systems to determine how effective interventions and treatments are. Different models can be used to examine health outcomes.

Gwen is working with her evidence-based research committee. They are interested in finding out if multimodal pain management is effective in chronic pain patients. Their hospital has a difficult patient population because they see a lot of patients with chronic pain. This makes managing their acute pain episodes difficult to treat in the hospital setting due to narcotic tolerance. Gwen is hoping to find that using different classifications of pain medication will work together to control these patients' pain.

Gwen is guiding her committee to look at different health system analysis models to assess their research question. They are looking at logic, causal, and conceptual models to see which one will they actually use when applying this concept to their patients. Gwen explains the differences between the models.

  • Logic model: assesses how a program or process is supposed to work by exploring how outcomes are associated with the process and how it is assumed to work
  • Causal model: identifies a cause and effect relationship that happens with each individual while strengthening the tests used to prove the hypothesis
  • Conceptual model: shows how one aspect influences other different aspects by describing how different parts of a problem interacts with each other

Completing research to apply to a health system analysis model
Completing research to apply to a health system analysis model

Gwen thinks that the committee should break into three groups with each one creating a framework for pain management using one of the models.

Logic Model for Pain Management

Group one chooses the logic model and begins to identify how they will organize their framework. Knowing that the logic model makes underlying assumptions about how a program works, the group decides to identify the different parts of their design.

Explanation Example
Population Who the model represents Patients in the hospital with a history of chronic pain who need to be treated for acute pain
Underlying assumption How the process works related to patients, staff, and hospital What multimodal medications will be offered and how treatment is relayed to the patient
Resources/Challenges What resources are needed Physician education about the new treatment program and how medications are offered
Activities Interventions needed to reach the goal Timing of different classifications of medications to control pain
Outputs Results of applying the interventions How many patients are treated, what medications are used, patients' pain scores
Outcomes Benefits of the interventions Is pain controlled in chronic pain patients using multimodal treatment

Group one presents their information to the rest of the committee and emphasizes that a logic model is cost efficient, does not require a lot of resources, and applies critical thinking and planning. This model can identify what works and what needs to be changed.

Causal Model for Pain Management

Group two selects the causal model. They think that this model works well because it uses a cause and effect comparison of individuals. This will provide a lot of information about how the same type of treatment works on different patients. The group decides to review two types of causal models.

Sufficient Component Cause Model

A sufficient component cause (SCC) model helps identify a relationship between what causes the problem in order to treat it appropriately. The group plans to organize a list of different reasons for chronic pain. Once these are recognized, the group decides how multimodal pain management will affect these causes.

Potential Outcome Model

A potential outcome (PO) model measures the effects of a cause on the problem. This model is a little more complex because it places the individual patient into two disease states. One disease state is what they are experiencing and the other is an imagined state with different variables. The cause or medical history of the patient is used to recognize the possible source of chronic pain in order to adjust pain management. The patient is then imagined to have a different cause of chronic pain to see how pain management will change.

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