HEALTH CARE DELIVERY SYSTEM

HEALTH CARE DELIVERY SYSTEM
IN INDIA AND ABROAD

Introduction

Health is the birth right of every individual. Today health is considered more than a basic human right; it has become a matter of public concern, national priority and political action. Our health system has traditionally been a disease-oriented system but the current trend is to emphasize health and its promotion. The nursing profession exists to meet the health need of the people. Unprecedented changes have occurred in the structure of our society, in lifestyles, in specific and technological advances.
Health is a multi dimensional with physical, biological, economical, social, cultural and vocational. Health is not static. A person who is healthy now may not be healthy the next moment. Public has become more aware and emphasizing on health, health promotion, wellness and self care. Emphasis has shifted from a focus on cure to a focus on prevention and health maintenance. This has led to a evolution of a wide range of health promotion techniques, and programmes including multiphase screening, life time health monitoring programs.
Special efforts being made by the health care professionals to reach and motive members of various cultural and social economic groups concerning life style and health practices. All efforts are to design a health care system that makes comprehensive health care available to all the people at an affordable cost.

Selected health care definitions:
Health: According to WHO, health is defined as “a dynamic state of complete physical, mental and social well-being not merely an absence of disease or infirmity.”
Health care services: It is defined as “multitude of services rendered to individuals, families or communities by the agents of the health services or professions for the purpose of promoting, maintaining, monitoring or restoring health.”

Definitions of health care delivery:

1.Health care delivery system refers to the totality of resources that a population or society distributes in the organisation and delivery of health population services. It also includes all personal and public services performed by individuals or institutions for the purpose of maintaining or restoring health.
Stanhope (2001).

2.It implies the organisation, delivery staffing regulation and quality control.
J.C.Pak (2001).

3.Health care delivery system is the organisation by which health care is provided.
Wikipedia(2005)

4.A collection of fragmented services provided on free for service basis by numerous organisations and providers.
Laddy Susan
Components of Health System:

Concepts e.g. health and disease
Ideas e.g. equity coverage, effectiveness, efficiency, impact.
Objects e.g. hospitals, health centres, health programme
Persons e.g. providers and consumers

Philosophy of Health Care Delivery System:

Every one from birth to death is part of the market potential for health care services.
The consumer of health care services is a client and not customer.
Consumers are less informed about health services than anything else they purchase.
Health care system is unique because it is not a competitive market.
Restricted entry in to the health care system.

Goals/Objectives of Health Care Delivery System:

1)To improve the health status of population and the clinical outcomes of care.
2)To improve the experience of care of patients families and communities.
3)To reduce the total economic burden of care and illness.
4)To improve social justice equity in the health status of the population.

Principles of Health Care Delivery System:
1.Supports a coordinated, cohesive health-care delivery system.
2.Opposes the concept that fee-for-practice.
3.Supports the concept of prepaid group practice.
4.Supports the establishment of community based, community controlled health-care system.
5.Urges an emphasis be placed on development of primary care
6.Emphasizes on quality assurance of the care
7.Supports health care as basic human right for all people.
8.Opposes the accrual of profits by health-care-related industries.
9.Supports individuals’ unrestricted access to the provider, clinic or hospital.
10.Urges that in the establishment of priorities for health-care funding, resource be allocated to maintain services for the economically deprived.
11.Supports efforts to eliminate unnecessary health care expenditures and voluntary efforts to limit increase in health care costs.
12.Endorses to provide age old with special health maintenance.
13.Supports public and private funding.
14.Condemns health care fraud.
15.Supports the establishment of a national health care budget.
16.Supports universal health insurance.

Functions of Health Care Delivery System:
1)To provide health services.
2)To raise and pool the resources accessible to pay for health care.
3)To generate human and physical sources that makes the delivery service possible.
4)To set and enforce rules of the game and provide strategic direction for all the different players involved.
Characters of Health Care Delivery System:
1.Orientation toward health.
2.Population perspective.
3.Intensive use of information.
4.Focus on consumer.
5.Knowledge of treatment outcome.
6.Constrained resources.
7.Coordination of resources.
8.Reconsideration of human values.
9.Expectations of accountability.
10.Growing interdependence.

Providers and Consumers.
A health care provider or health professional is an organization or person who delivers proper health care in a systematic way professionally to any individual in need of health care services. A health care provider could be a government, institution such as a hospital or laboratory physicians, support staff, nurses, therapists, psychologists, veterinarians, dentists, pharmacists, or even a health insurance company.

Financing.
There are generally five primary methods of funding health care systems:
1.Direct or Out-of-Pocket payment.
2.General Taxation,
3.Social Health Insurance,
4.Voluntary or private health insurance, and
Health care systems models.
Purely private enterprise health care systems are comparatively rare. Where they exist, it is usually for a comparatively well-off subpopulation in a poorer country with a poorer standard of health care–for instance, private clinics for a small, wealthy expatriate population in an otherwise poor country. But there are countries with a majority-private health care system with residual public service eg medicare, medicaid.
The other major models are public insurance systems:
Social security health care model, where workers and their families are insured by the State.
Publicly funded health care model, where the residents of the country are insured by the State.
Social health insurance, where the whole population or most of the population is a member of a sickness insurance company.