Health care delivery systems and models

Healthcare Delivery System

Health care delivery system

This essay is based on the health care delivery system and in a bid to elaborate more on this topic; the essay will begin with a description of the current health care delivery structure in an organization, then a comparison of two different health care delivery systems will be done. Thirdly the effects of licensing and regulatory factors on health care delivery requirements will also be highlighted and the changes occurring in the economy or with regards to licensing and regulatory factors that must be considered in the future will also be mentioned. Lastly the essay will look at the national trends that are affecting competition and pricing initiatives in the healthcare sector before concluding by noting the quality indicators that affect pricing at the local level in health care sector.

The health care delivery system

According to Starr (1982, 99-106) he described the current healthcare delivery structure as a system that has been designed with the main aim of meeting the health care needs of people within the aforesaid organization. According to the report released by the World Health Organization in 2000, the main goals of a healthcare delivery system within an organization is to accord good health to the people within that organization, act as a response to the expectation of this people and as an element of fair financial distribution.

The providers of health care may include paramedics, nurses, doctors, dentists, specialist therapist, medical laboratory employees, pharmacists, psychologists, chiropractors and optometrists. These trained professional may either be employed permanently by the organization or they can be contracted for their services by the organizations. Important to note is that organizations that specialize in employing these trained health care professionals are known as health care providers.

Generally there are five ways through which healthcare system can be funded and this may include; the tax revenue collected by the state, municipality or council, through private or voluntary health insurance, the social insurance, through donations or payment out-of-pocket by the patients. Within an organization the funding of healthcare is mostly through out-of-pocket payments, social insurance and private health insurance. Porter and Teisberg (2006, 54-67) in their studies pointed out that in the description of the current healthcare system it is important to note that there is a special branch that consists of military medicine, school health services and occupational safety and health that is applicable within an organization.

Comparison of healthcare delivery systems

From the national level, healthcare systems can differ in respect to each country, for example in some countries health care planning is delegated to the industry players while in others that responsibility is mainly held by the government and other relevant authorities. From the perspective of organizations the delivery of health care system may differ on the issue of who is in charge of it, it could be the providers who are out sourced or are permanent employees of the organization. The mode of payment and also the sources of funding may also differ across different organizations.

For organizations that are located in the United Kingdom the government caters for the healthcare of all UK residents who also include employees, using funds from tax collector, while for organizations that are located in the United States the government only pays for about 27% of the entire population and employers are reported to be paying for only about 59% of entire population. For individuals who work in organizations either in the UK or U.S. It can be presumed that both their health care cost is provided for by the government or employer. However in the U.S., it has been noted that employers are slowly reducing their contribution the health care cost of their staff because cost has been on an increase ever since.

Effects of licensing and regulations on healthcare delivery

Licensing and regulatory factors that affect health care delivery requirement are implemented by the legislative arm of the government. Thus through the legislations laid down it can be determined what programs or services of healthcare that the state will cover and those that citizens will have to bear for themselves. Licensing laws on the other hand determine which health care provider may perform what services and on reimbursement the regulator will determine who can be paid for performing various healthcare services. Referring to the studies conducted by Safriet (1992, 417-488) they suggest that with the continuous changes and the redefinition of healthcare policy and programs has affected the size, composition and activities of health care providers. Consequently this infers that licensing and regulatory factors have a huge impact on the health care delivery requirement within an organization.

Changes in the healthcare delivery systems

After the recent economic recession in the periods of 2007 to 2010, the cost of health care sky rocketed and most governments had to reconsider their budget allocation to the healthcare sector. For example in the U.S., it had already been mentioned that employers are continually reducing their contribution towards their employees' health care requirements. The government has not being left out either as it is also seen to cut down its' spending on the healthcare cost.

The increase in national healthcare cost forced some hospitals to increase their prices and new trends were observed as result of this move that include; decrease in referrals to specialty services and length of stay of patients also declined.

The joint commission has in the recent past introduced stringent regulatory measures that are meant to make healthcare providers that also include hospitals to adhere to higher standards in order to give quality health care to Americans. Non-compliance leads to closure of care centre or revocation of medical practicing license.

National trends affecting competition and pricing

One of the most influential national trends in the U.S. that has greatly affected competition and pricing in the healthcare sector is the cost of health care itself. Ginsburg, (2005, 1512-1522) wrote that during the 1970s and 1980s the cost of health insurance was escalating just as it did in the recent past, this trend forced employers as well as the government to introduce cost control measures. Healthcare providers were on the other hand forced to reduce cost due to competition in the market. This trend resulted in a reduction in the cost of corporate health care which analysts view it will lead to a reduction in the quality of health care.

Other trends such as technological advancement, consumer awareness and emphasis on effective service provision have had a positive impact on the pricing and competition in the healthcare sector. Advance technology reduces pricing and it enhances competition, consumer awareness and the demand for quality care also raises the competition level and pricing is also justified.