A review of implementation of behavioural aspects in the application of OR in healthcare

This article presents a survey of the literature on the application of operational research (OR) in healthcare, with a particular focus on behavioural considerations. In order to explore the extent to which behavioural aspects are included, we perform a search of the most relevant OR journals for articles with content related to the representation of behaviour in models, evidence of behavioural change using models, and the impact on organisations beyond the use of a model. A detailed analysis of 130 articles is presented and shows that the majority are focused on improving service delivery at an organisational level. The most common OR methods depicting behaviour are simulation and qualitative methods, but there is evidence of the use across a range of methods. However, in many cases, authors do not necessarily acknowledge the behavioural aspects in their papers. Given many aspects of healthcare are influenced by human behaviour, it is important that future work makes more explicit the assumptions used to represent behaviour, test the sensitivity of models to different behavioural assumptions, and offer more information about how users employ models to make decisions