Healthcare Systems Across the World Term Paper

Excerpt from Term Paper :



Access and Availability

The biggest problem in terms of access to healthcare is in rural areas. Our investigation found that there are very few if any rural clinics or healthcare facilities.

Access to healthcare is also limited to those that can afford insurance or qualify for Medicare or Medicaid. The unemployed and the poor are at a major disadvantage when it comes to gaining access to healthcare. The location of healthcare facilities is limited to the larger municipalities.

Accountability

The entity that is responsible for the healthcare system is the United States Government. In addition, Puerto Rico has a governor and a cabinet in place to ensure that the appropriate laws are carried out. The entity that makes laws concerning healthcare is outside of the country but the entity that enforces these laws is inside the country. Services are evaluated by state run entities and agencies of the United States government such as that CDC and Health and Human Services. These entities are effective at evaluating problems but not so effective at finding solutions. The people of the territory participate in the evaluations but have little to do with the actual decision making process.

Planning

Priorities for improving the condition of the healthcare system in Puerto Rico have not been set. Like the mainland-United States, it is obvious that problems exist within the healthcare system but the ability to fix these problems has not been realized. There is a centralized planning entity within the local government on the island. Consumer groups, especially patient advocacy groups are attempting to draft a solution to the problems that plague the healthcare system in Puerto Rico.

Patient Autonomy and Satisfaction

Many patients are displeased with the type of care that they receive because of the restraints placed on their doctors by insurance companies. Many insurance companies will not pay for procedures that are perceived to be experimental even it may be the only way to save the patients' life. Within the territory patients have the same rights as American patients because Puerto Ricans are American citizens.

Patients' rights are limited in that insurance companies also have rights and they have a certain amount of power over patients because they have deep pockets. Patient satisfaction is recognized but rarely responded to by the appropriate government entities. The inequities in the system have to do with the treatment of the poor, elderly and uninsured.

Effectiveness of Overall Healthcare System

Overall, the healthcare system is moderately effective. The population is healthier in some respects but less healthy in other respects. The health problems that plague Puerto Rico are similar to those of the United States. Diabetes and obesity are major concerns. These healthcare issues are being addressed through early screening and education. This issue of HIV / AIDS is a growing concern and the importance of testing must be addressed. However, the system is broken and must be repaired. Steps to ensure that it will be repaired must include comprehensive health coverage for all and discounts to those that are elderly, unemployed and underemployed.

Conclusion

The purpose of this research was to focus on the healthcare system of Puerto Rico. We investigated Population characteristics, the economy, health status parameters, Financial Parameters, Access and Availability, Accountability, Planning, Patient Autonomy and Satisfaction. We found that all of these factors contributed to the level of healthcare available to the people of Puerto Rico. In addition, we determined how these factors influenced the effectiveness of the overall healthcare system on the island of Puerto Rico. We found that the healthcare system in Puerto Rico is broken but is still moderately effective.

References

The World Factbook -- Puerto Rico. Retrieved November 8, 2004 from; http://www.cia.gov/cia/publications/factbook/geos/rq.html#People

Puerto Rico: Estimated Number of Persons Living with AIDS at the End of 2002. Retrieved November 8, 2004 from; http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=HIV%2fAIDS&subcategory=Persons+Living+with+AIDS&topic=All+Ages

HIV / AIDS Among Hispanics. Retrieved November 8, 2004 from; http://www.cdc.gov/hiv/PUBS/Facts/hispanic.pdf

Puerto Rico: Total Number of Adults with Diagnosed Diabetes, 2002. Retrieved November 8, 2004 from;

http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=Health+Status&subcategory=Diabetes&topic=Total+Prevalence+of+Diagnosed+Diabetes

Puerto Rico: Total Number of Adults with Diagnosed Diabetes by Age Group, 2002. Retrieved November 8, 2004 from; http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=Health+Status&subcategory=Diabetes&topic=Prevalence+of++Diabetes+by+Age+Group

Infant Health Among Puerto Ricans - Puerto Rico and U.S. Mainland, 1989 -- 2000. Retrieved November 8, 2004 from; http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5242a2.htm

The World Factbook -- Puerto Rico. Retrieved November 8, 2004 from; http://www.cia.gov/cia/publications/factbook/geos/rq.html#People

Puerto Rico: Number of Federally Qualified Health Centers, 2004. Retrieved November 8, 2004 from; http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=Providers+%26+Service+Use&subcategory=Federally+Qualified+Health+Centers&topic=Total+Health+Centers

Puerto Rico: Number of Rural Health Clinics, 2004. Retrieved November 8, 2004 from;

http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=Providers+%26+Service+Use&subcategory=Rural+Health+Clinics&topic=Total+Health+Clinics

Puerto Rico: Total Hospitals, 2002. Retrieved November 8, 2004 from;

http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=Providers+%26+Service+Use&subcategory=Hospitals&topic=Total+Hospitals

Percent of Women Ages 18-64 Who Report Having Had a Pap Smear Within the Last Three Years, 2000. Retrieved November 8, 2004 from;

http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=Providers+%26+Service+Use&link_category=Women%27s+Health&link_subcategory=Pap+Smears&link_topic=Pap+Smear+Rate

Percent of Women Ages 50-69 Who Report Having Had a Mammogram Within the Last Two Years, 2000. Retrieved November 8, 2004 from;

http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=Providers+%26+Service+Use&link_category=Women%27s+Health&link_subcategory=Mammograms&link_topic=Mammogram+Rate

Percentage of Persons Aged 18-64 Who Reported Ever Receiving an HIV Test, 2001. Retrieved November 8, 2004 from; http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=Providers+%26+Service+Use&link_category=HIV%2fAIDS&link_subcategory=HIV+Testing&link_topic=HIV+Testing+Rate+%2d+Ever+Tested

Puerto Rico: Total Retail Prescriptions Filled (in Thousands), 2003. Retrieved November 8, 2004 from; http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=Health+Costs+%26+Budgets&subcategory=Prescription+Drugs&topic=Total+Number+of+Retail+Rx+Drugs

Puerto Rico: Population Distribution by Insurance Status, state data 2002-03, U.S. 2003. Retrieved November 8, 2004 from;

http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=Health+Coverage+%26+Uninsured&subcategory=Insurance+Status&topic=Distribution+by+Insurance+Status

Puerto Rico: Rate of Nonfederal Physicians per 100,000 Civilian Population, 2003. Retrieved November 8, 2004 from;

http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=Providers+%26+Service+Use&subcategory=Physicians&topic=Nonfederal+Physicians+per+100%2c000+Population

Puerto Rico: Per Capita Personal Health Care Expenditures, 1998. Retrieved November 8, 2004 from; http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=Health+Costs+%26+Budgets&subcategory=Personal+Health+Care+Expenditures&topic=Per+Capita+Total+Expenditures

Puerto Rico: Distribution of Personal Health Care Spending by Service (in Millions), 1998. Retrieved November 8, 2004 from; http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=Health+Costs+%26+Budgets&subcategory=Personal+Health+Care+Expenditures&topic=Spending+by+Service

Distribution of Medicaid Spending. Retrieved November 8, 2004 from;

http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=United+States&category=Health+Costs+%26+Budgets&link_category=Medicaid+%26+SCHIP&link_subcategory=Medicaid+Spending&link_topic=Distribution+of+Spending+by+Enrollment+Group

MEDICARE MANAGED CARE PLAN in PUERTO RICO EXPANDS to INCLUDE BENEFICIARIES in 26 MUNICIPALITIES. Retrieved November 8, 2004 from; http://www.cms.hhs.gov/media/press/release.asp?Counter=487

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