week 3 Healthcare Systems and Organization.pptx
- 1. THE ROLE AND ORGANIZATION OF HEALTH SYSTEMS
- 2. Health systems have a vital and continuing responsibility for people`s health throughout the lifespan. They are crucial to the healthy development of individuals, families and societies everywhere. The real progress in health towards the United Nations Millennium Development Goals and other national health priorities depends vitally on stronger health systems based on primary health care According to the WHO, each national health system should be directed to achieve three overall goals: good health, responsiveness to the expectations of the population, fairness of financial contribution. service provision, resource generation, financing and stewardship Improving health is clearly the main objective of each health system, but it is not the only one. The objective of good health itself is really twofold: the best attainable average level – goodness - and the smallest feasible differences among individuals and groups – fairness. Goodness means a health system responding well to what people expect of it, and fairness means it responds equally well to everyone, without any kind of discrimination
- 3. Health care services and health services organizations Health care is the total societal effort, organized or not, whether private or public, that attempts to guarantee, provide, finance, and promote health. It changed markedly during the 20th century moving toward the ideal of wellness and prevention of disease and disability. Delivery of health care services involves the organized public or private efforts that assist individuals primarily in regaining health, but also in preventing disease and disability Healthcare The goals in the area of development and poverty eradication (to reduce poverty and hunger and to tackle ill-health, gender inequality, lack of education, access to clean water and environmental degradation).These goals are included in the United Nations Millennium Declaration adopted at the Millennium Summit in New York in September 2000, and are now widely referred to as Millennium Development Goals.
- 4. Models of national health care systems based on the sources of funding Model of Health Care System and country in which the model exists Source of funding Main features Type of providers Beveridge model (UK, Ireland, Norway, Finland, Denmark, Sweden, Iceland, Spain, Portugal, Italy, Greece, Canada, Australia and New Zealand) Taxation (State Budget) Not related to income - Universal access to health care for all citizens based on residency - - Comprehensive coverage with basic health benefits - - Strong controls by Ministry of Health and finances facilities - - Bureaucracy, underfunding, rigidness Public: - Predominantly public providers and governmental ownership - National Health Service and self-employed GPs are PHC gatekeepers - -Purchaser-provider split Bismark model (Germany, Holland, Belgium, France, Austria, Switzerland, Israel, Japan, CSEE and FSU countries) Compulsory health insurance, earmarked premiums paid by employers and employees Related to income - Health care as guaranteed, insured good, Coverage of 60- 80% with basic "basket" of health services - - Intermediate role of the state in regulating the system - - Client-friendly, professional autonomy, earmarked budgets - - High costs difficult to control Mixed: - Public and private providers with dominant social ownership Free-market private insurance model (USA) Private insurance and funding Medicare Medicaid - Health care as a commodity - - Weak state control, in general - - Providers are private entrepreneurs - Predominantly private providers with autonomy - Managed care
- 5. Levels of organization of health care systems and health care delivery In accordance with the size of the population served, and specificities of the diseases and conditions treated at certain level, as well as with some organizational characteristics, it is possible to recognize four levels of the health care system and health care delivery
- 6. Typical functions of the overall health care system are: Health services (environmental, health promotion, prevention of diseases and injuries, primary care, specialist medicine, hospital services, services for specific groups, self-help); Financing health care (mobilization of funds, allocation of finances) Production of health resources (construction and maintenance of health facilities, production and distribution of medicines, production, distribution and maintenance of instruments and equipment) Education and training of health manpower (undergraduate training, postgraduate training); Research and development (health research, technology development, assessment and transfer, quality control); Management of a National Health System (health policy and strategy development and it's implementation by action plans, information, coordination with other sectors, regulation of activities and utilization of health manpower, physical resources and environmental health services).
- 7. The main objectives of each national health system 1) universal access to a broad range of health services; 2) promotion of national health goals; 3) improvement in health status indicators; 4) equity in regional and socio-demographic accessibility and quality of care; 5) adequacy of financing with cost containment and efficient use of resources; 6) consumer satisfaction and choice of primary care provider; 7) provider satisfaction and choice of referral services; 8) portability of benefits when changing employer or residence; 9) public administration or regulation; 10) promotion of high quality of service; 11) comprehensive in primary, secondary, and tertiary levels of care; 12) well developed information and monitoring systems; 13) continuing policy and management review; 14) promotion of standards of professional education, training, research; 15) governmental and private provision of services; and 16) decentralized management and community participation.
- 8. Outpatient care is very important part of the health care system representing the first contact of the consumer with the professional health care and the first step of a continuous health care. Outpatient care is delivered to a “moving” patient (not tight to bed), through institutions in which the consumer come for a short visit for consultation, examination, treatment and follow- up, usually once a week or rarely, and in the most of the cases, the contact is realized with an individual health worker. Such kind of services and institutions might be a part of the hospital, community health center or certain polyclinic and dispensaries means admission into hospital or other stationary health organization, including diagnosis, treatment and rehabilitation, with in-patient care and treatment of the most severely ill patients who cannot be treated in ambulatory-polyclinic institutions or at home. Stationary health organizations are institutions, which, in addition to supplying diagnosis, treatment and medical rehabilitation, also provide hospital accommodation, treatment, care and food. They include hospitals, nursing homes, health resorts and rehabilitation centers. Hospital is a health organization which provides consultative-specialist health care and hospital in-patient care with accommodation, treatment and food for the patients in a certain area and for more types of diseases and for persons of all ages, or only for persons diseased from certain illnesses, or for certain group of citizens Outpatient care In-patient care
- 9. Classification of hospitals Length of stay divided into acute care (short term) and chronic care (long term). - Acute care (of short duration or episodic) is a synonym for short term. - Chronic care (or long duration) is a synonym for long term hospitals. - Short-term stay hospitals are those in which more than half of patients are admitted to units in the facility with an average length of stay shorter than 30 days. - Long-term stay hospitals are those in which more than half of patients are admitted to units in the facility with an average length of stay of more than 30 days Types of service denote whether the hospital is “general” or “special”. - General hospitals provide a broad range of medical and surgical care, to which are usually added the specialties of obstetrics and gynecology; rehabilitation; orthopedics; and eye, ear, nose, and throat services. “General” can describe both acute and chronic care hospitals, but usually applies to short-term hospitals. - “Special” hospitals offer services in one medical or surgical specialty (e.g., pediatrics, obstetrics/gynecology, rehabilitation medicine, or geriatrics) or treatment to certain diseases or groups of diseases (TBC, psychiatric diseases, heart and lung diseases etc.) type of control or ownership - for profit (investor owned), or not for profit, - - governmental (federal, state, local, or hospital authority), - religious or voluntary organizations.