A health care system is the organization of people, institutions, and resources that deliver health care services, financing, access to care, quality of care, and health equity to meet the health needs of target populations.
Nations design and develop health systems in accordance with their needs and resources.
Common elements in virtually all health systems are primary healthcare and public health measures.
Health care planning has been described as often evolutionary rather than revolutionary.[2][3]
Responsibility for the Delivery of Care
Health system planning is distributed among market participants. In others, there is a concerted effort among governments, trade unions, charities, religious organizations, or other co-ordinated bodies to deliver planned health care services targeted to the populations they serve.
Types of Health Care Systems
Universal health care is a health care system which provides health care and financial protection to all its citizens.
Health policy influences and is influenced by many contextual features.
The health care system and the complexities of institutional care and its financing have significant impact on the physician-patient relationship. Witness the constant complaint that health reform legislation, up to the Affordable Care Act (ACA) of 2010, will disrupt the personal relationship between individuals and their doctors.
The broad field of bioethics does address questions of health policy, which are subjected to ethical analysis under the rubric of justice. This book, devoted to clinical ethics, does not directly deal with health policy.
++ Still, clinicians and clinical ethicists will encounter cases in which the structures and policies of existing health or institutional policy create a clinical ethical problem. For example, they will often be faced with a case in which a patient should be discharged from the hospital but still required specialized care, which is unavailable in their community. Changes and reforms are the preconditions for the solution of such problems; we shall see examples in the following pages. Cases caught in these situations may sometimes motivate reform but often must be managed with less than optimal resolution. In general, the focus of this book is on clinical cases that arise and must be managed medically and ethically within extant structures. Those who desire to learn more about the ethics of health policy may consult the extensive bioethical literature on justice and health care.
The implementation of health care policy is complex. There is flow from health-related policy development to program implementation and to health outcomes. Operational policies are the rules, regulations, guidelines, and administrative norms that governments use to translate national laws and policies into programs and services. The policy process encompasses decisions made at a national or decentralized level (including funding decisions) that affect whether and how services are delivered. Thus, attention must be paid to policies at multiple levels of the health system and over time to ensure sustainable scale-up. A supportive policy environment will facilitate the scale-up of health interventions.
Politics and evidence can influence the decision of a government, private sector business or other group to adopt a specific policy. Evidence-based policy relies on the use of science and rigorous studies such as randomized controlled trials to identify programs and practices capable of improving policy relevant outcomes. Most political debates surround personal health care policies, especially those that seek to reform healthcare delivery, and can typically be categorized as either philosophical or economic. Philosophical debates center around questions about individual rights, ethics and government authority, while economic topics include how to maximize the efficiency of health care delivery and minimize costs.
The modern concept of healthcare involves access to medical professionals from various fields as well as medical technology, such as medications and surgical equipment. It also involves access to the latest information and evidence from research, including medical research and health services research.
In many countries it is left to the individual to gain access to healthcare goods and services by paying for them directly as out-of-pocket expenses, and to private sector players in the medical and pharmaceutical industries to develop research. Planning and production of health human resources is distributed among labour market participants.
Other countries have an explicit policy to ensure and support access for all of its citizens, to fund health research, and to plan for adequate numbers, distribution and quality of health workers to meet healthcare goals. Many governments around the world have established universal health care, which takes the burden of healthcare expenses off of private businesses or individuals through pooling of financial risk. There are a variety of arguments for and against universal healthcare and related health policies. Healthcare is an important part of health systems and therefore it often accounts for one of the largest areas of spending for both governments and individuals all over the world.
There are many categories of health policies, including
Personal healthcare policy
pharmaceutical policy,
public health such as vaccination policy, tobacco control policy or breastfeeding promotion policy.
They may cover topics of financing and delivery of healthcare, access to care, quality of care, and health equity.
Health-related policy and its implementation is complex. Conceptual models can help show the flow from health-related policy development to health-related policy and program implementation and to health systems and health outcomes. Operational policies are the rules, regulations, guidelines, and administrative norms that governments use to translate national laws and policies into programs and services. The policy process encompasses decisions made at a national or decentralized level (including funding decisions) that affect whether and how services are delivered. Thus, attention must be paid to policies at multiple levels of the health system and over time to ensure sustainable scale-up. A supportive policy environment will facilitate the scale-up of health interventions.
There are many topics in the politics and evidence that can influence the decision of a government, private sector business or other group to adopt a specific policy. Evidence-based policy relies on the use of science and rigorous studies such as randomized controlled trials to identify programs and practices capable of improving policy relevant outcomes. Most political debates surround personal health care policies, especially those that seek to reform healthcare delivery, and can typically be categorized as either philosophical oreconomic. Philosophical debates center around questions about individual rights, ethics and government authority, while economic topics include how to maximize the efficiency of health care delivery and minimize costs.
The modern concept of healthcare involves access to medical professionals from various fields as well as medical technology, such asmedications and surgical equipment. It also involves access to the latest information and evidence from research, including medical research and health services research.
In many countries it is left to the individual to gain access to healthcare goods and services by paying for them directly as out-of-pocket expenses, and to private sector players in the medical and pharmaceutical industries to develop research. Planning and production ofhealth human resources is distributed among labour market participants.
Other countries have an explicit policy to ensure and support access for all of its citizens, to fund health research, and to plan for adequate numbers, distribution and quality of health workers to meet healthcare goals. Many governments around the world have established universal health care, which takes the burden of healthcare expenses off of private businesses or individuals through pooling of financial risk. There are a variety of arguments for and against universal healthcare and related health policies. Healthcare is an important part of health systems and therefore it often accounts for one of the largest areas of spending for both governments and individuals all over the world.
Global
Continental
Country
State
Province
Town
Hospital
- Health Care Systems
Paying for Health Care
Access to Health Care
Reimbursing Health Care Providers
How Health Care Is Organized—I: Primary, Secondary, and Tertiary Care
How Health Care Is Organized—II: Health Delivery Systems
The Health Care Workforce and the Education of Health Professionals
Painful versus Painless Cost Control
Mechanisms for Controlling Costs
Quality of Health Care
Prevention of Illness
Long-Term Care
Medical Ethics and Rationing of Health Care