{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T04:38:45Z","timestamp":1794026325856,"version":"4.8.0"},"reference-count":45,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health&amp;#65533;Serv&amp;#65533;Insights"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>The \u201cGoldilocks Zone\u201d, a term borrowed from astrophysics, describes the optimal range where conditions are just right to support life. In healthcare, this metaphor captures the imperative to balance underuse and overuse of medical services, ensuring care is neither excessive nor insufficient but instead maximally effective, equitable, and sustainable. As health systems confront rising costs, workforce constraints, and growing demands for person-centred care, the search for this balance has become increasingly urgent. This review explores how the concept of the Goldilocks Zone can be operationalized in modern healthcare systems. We examine two core dimensions that define this balance: person-centredness and operational efficiency. Person-centredness requires attention to accessibility, patient satisfaction, and equity. Drawing on global data, we explore how barriers such as cost, geography, and social inequality limit access to care, and we highlight the role of robust primary care systems and tailored wait-time benchmarks in ensuring responsive, equitable delivery. At the same time, we caution against the misuse of performance metrics that may obscure real disparities. Operational efficiency is evaluated across the continuum of screening, diagnosis, and care management. We review frameworks such as Wilson and Jungner\u2019s screening principles and their modern adaptations, as well as diagnostic threshold models and strategies to reduce inappropriate care utilization. Key indicators, including avoidable hospitalizations and ambulatory care-sensitive condition rates, offer insight into system inefficiencies and opportunities for reform. We propose a practical framework for identifying whether a healthcare system is within the Goldilocks Zone and recommend policy levers to help maintain or widen this zone. Ultimately, the Goldilocks Zone is not a fixed destination but a dynamic and evolving balance that requires continual adaptation. As healthcare systems grow more complex, the value of this metaphor lies in guiding both conceptual thinking and concrete policy design.<\/jats:p>","DOI":"10.1177\/11786329251388774","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T05:13:47Z","timestamp":1762233227000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Defining and Measuring the Goldilocks Zone in Healthcare: A Review of Metrics and Models"],"prefix":"10.1177","volume":"18","author":[{"given":"Hannah Yu Kit","family":"Lee","sequence":"first","affiliation":[{"name":"NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun En","family":"Yau","sequence":"additional","affiliation":[{"name":"NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin Xiang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, Department of Surgery, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason Chin Huat","family":"Yap","sequence":"additional","affiliation":[{"name":"Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1843-5948","authenticated-orcid":false,"given":"Isaac Kah Siang","family":"Ng","sequence":"additional","affiliation":[{"name":"NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore"},{"name":"Division of Rheumatology &amp; Allergy, Department of Medicine, National University Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8561-2513","authenticated-orcid":false,"given":"Qin Xiang","family":"Ng","sequence":"additional","affiliation":[{"name":"Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore"},{"name":"SingHealth Duke-NUS Global Health Institute, Duke-NUS Medical School, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1355819618790985"},{"issue":"1","key":"e_1_3_2_3_2","article-title":"Ten health policy challenges for the next 10 years","volume":"1","author":"Phillips KA","year":"2023","unstructured":"Phillips KA, Marshall DA, Adler L, et al. 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