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Models and Systems of Health Services Organization

Models and Systems of Health Services Organization. PA 574: Health Systems Organization Session 1 – April 3, 2013. What is a System?. Definition Properties Components. What is a System?. Network of inter-related components Coherence and integration among parts Standardized Coordinated

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Models and Systems of Health Services Organization

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  1. Models and Systems of Health Services Organization PA 574: Health Systems Organization Session 1 – April 3, 2013

  2. What is a System? • Definition • Properties • Components

  3. What is a System? • Network of inter-related components • Coherence and integration among parts • Standardized • Coordinated • Common support structures

  4. What is a Health System?Do we have one in the U.S.?What are its properties?What are its components?

  5. What is a Health System? • Includes all the activities whose primary purpose is to promote, restore or maintain health • Formal health services, traditional services, public health, alternatives • Health systems: • Improve health of populations • Respond to people’s expectations • Provide financial protection against costs of ill health

  6. Functional Components Shi & Singh, Figure 1-1, p. 6 • Financing • To obtain health services • Insurance • Protection against risks • Delivery • Providers of services • Payment • Reimbursement

  7. Key Elements in a Complex System Shi & Singh, Table 1-1, p. 3 • Education & Research • Suppliers • Insurers • Providers • Payers • Government

  8. Tensions in the Health System Illness <------------------> Wellness Specialized care <------------------> Primary care Inpatient <------------------> Ambulatory Technological <------------------> Humanistic Cost unaware <------------------> Cost accountable Institution based <------------------> Community-based Individual patient <------------------> Population focus Professional <------------------> Managerial Curative care <------------------> Preventive care Individual provider <------------------> Provider teams Independent orgs. <------------------> Integrated systems Service duplication <------------------> Service continuum Current regulation <------------------> Re-regulation Market commodity <------------------> Public good

  9. External Forces Affecting Health Services Shi & Singh, Figure 1-2, p. 10 • Social values and cultures • Population characteristics • Political climate • Economic conditions • Physical environment • Technology development • Global influences

  10. Differentiating Characteristics of the U.S. System No central governance Access based on insurance Imperfect market conditions Third-party insurers act as intermediaries Multiple payers make system cumbersome Balance of power prevents dominant single entity Legal risks affect practice New technology creates demand Continuum of new service settings Quality and value

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