{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T08:08:04Z","timestamp":1772784484017,"version":"3.50.1"},"reference-count":53,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,6,27]],"date-time":"2013-06-27T00:00:00Z","timestamp":1372291200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Ontario Problem Gambling Research Centre (OPGRC) Doctoral Fellowship Awards"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Rationale, aims and objectives<\/jats:title><jats:p>The presence of lotteries can be witnessed worldwide. Charitable lotteries are often portrayed as \u2018good works\u2019, and recently, hospitals have utilized them as a popular fundraising vehicle to raise necessary funds to help achieve organizational goals and objectives. Research indicates that lotteries contribute to gambling\u2010related harms; however, research into charitable lotteries has been underdeveloped. Both the gambling and the health care industries are complex and evolving, consisting of many interacting stakeholders with often different and competing interests. This article seeks to present systems thinking as a conceptual framework to help fill the gap in understanding the use of gambling within hospitals and its possible benefits and unforeseen negative consequences. Addressing the gap in knowledge is important to help inform decision making aimed at reducing gambling\u2010related harms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This article proposes how the school of systems thinking, specifically framing hospitals as complex adaptive systems and system dynamics modelling, can be utilized to understand the policy implications of the adoption of lotteries as a revenue source for hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Hospitals have a duty to care, inform and protect. Hospital charitable lotteries have become big business; however, its incorporation into critical funding strategies needs to be carefully understood. Systems thinking theory and methodologies provide an integrated approach to examine this dynamic and evolving fundraising initiative. Findings from this article can inform the development of action strategies, including policy development at multiple levels.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.12066","type":"journal-article","created":{"date-parts":[[2013,6,28]],"date-time":"2013-06-28T04:06:40Z","timestamp":1372392400000},"page":"1090-1094","source":"Crossref","is-referenced-by-count":2,"title":["Hospital charitable lotteries: taking a gamble on systems thinking"],"prefix":"10.1111","volume":"19","author":[{"given":"Jennifer","family":"Reynolds","sequence":"first","affiliation":[{"name":"Dalla Lana School of Public Health University of Toronto  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,6,27]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Lottery gambling: a review[database on the Internet] (2010) [cited 1 May 2010]."},{"key":"e_1_2_7_3_1","unstructured":"North American Association of State and Provincial Lotteries(2010)Lottery history. 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Scientific Games (2009) Available at:http:\/\/www.scigames.com\/sections\/industry\u2010information\/lottery\u2010industry.aspx(last accessed 3 May 2010)."},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/14459800108732286"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1016636214258"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01014590"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01014592"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2003.00336.x"},{"key":"e_1_2_7_11_1","volume-title":"Treatment of Problem Gambling in Ontario: Service Utilization, Client Characteristics and Trends","author":"Rush B.","year":"2004"},{"key":"e_1_2_7_12_1","doi-asserted-by":"crossref","DOI":"10.3138\/9781442687547","volume-title":"Casino State: Legalized Gambling in Canada","author":"Cosgrave J.","year":"2009"},{"key":"e_1_2_7_13_1","volume-title":"Gambling and Governments in Canada, 1969\u20131998: How Much? 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