Healthcare Delivery Systems: Components and Challenges

Abstract

Healthcare delivery systems, which refer to the way people, institutions, and resources are organized to offer medical services, address the diverse health needs of the targeted populations, and are paramount in all countries. Government agencies and institutions, as well as private organizations, strive to offer ideal health services to the people. For a healthcare delivery system to offer ultimate health services, it should have various major components. However, the efforts of healthcare delivery systems to have these components are counteracted by numerous challenges. This paper describes healthcare delivery systems, the major components of an ideal system, and the challenges that they face.

Introduction

A healthy population is vital in all countries worldwide. Various efforts have been made by governments as well as private institutions to ensure that people access quality health care to address their diverse health-related needs through healthcare systems. However, the efforts have encountered numerous challenges that hinder the full realization of the goal. According to the World Health Organization (WHO), healthcare delivery systems incorporate organizations, people, and resources whose main aim is to enhance, maintain, or restore health in a population. The efforts of the healthcare systems encompass influencing health determinants and activities that have a direct curative and preventive impact on the target populations (Hawk, Ndetan, & Evans, 2012). A healthcare delivery system refers to the way people, institutions, and resources are organized to offer medical services to address the diverse health needs of the targeted populations.

Major Aspects of an Ideal Healthcare System

In the United States and internationally, the main objective of the healthcare delivery system is to offer a variety of services whose combination optimizes the health of the population (Hawk et al., 2012). Therefore, much effort has been directed towards the achievement of this goal. An ideal health care system adopts the principle of inclusive health, which holds that all humankind should have adequate access to quality medical care (MacLachlan, Khasnabis, & Mannan, 2012). A healthcare system that uses this principle offers superior quality care to individuals and communities with the help of various crucial components.

The first crucial aspect of an ideal healthcare system is safety. An ideal healthcare delivery system is always safe in its entire processes for all people who depend on it for health services; that is, it does not cause accidental injuries to its patients. For instance, a health system should always safeguard patient’s information all the time to offer the required intervention precisely. Secondly, an ideal healthcare system offers effective medical care. This means that the care provided is determined by the utilization of systematically acquired evidence. The use of this evidence determines whether the best results of a particular health case would be achieved through preventive services, diagnostic assessments, treatment, or no intervention would be needed (Shortell, 2013). In an effective health care system, health services are effective in improving people’s health and wellbeing as well as striving to prevent the occurrence of diseases and social conditions that compromise well-being.

The third aspect of a high-quality healthcare system is patient-centeredness. This concept refers to maintaining respect for diverse values, articulated needs, and preferences of patients; coordinating and integrating care; informing, communicating, and educating; providing physical comfort and emotional support as well as involving relatives and friends. Timeliness of service delivery is the fourth aspect of a first-rate healthcare system; care is offered and delivered with no delays that possibly provoke anxiety and lead to inefficiency (Mohammed et al., 2016). The fifth concept is efficiency. An efficient system utilizes resources to achieve the maximum value of money used in the process of service delivery and management of its operations. Wastage is maintained at extremely minimal levels or entirely eradicated. As a result, health services become affordable to individuals and communities targeted by the system.

An ideal health system should also be equitable; meaning that the care provided should be by the needs of an individual patient rather than personal characteristics that are not related to the condition of the client (Mohammed et al., 2016). Health financing is also a pillar of healthcare systems. A country offering ultimate healthcare services to its citizens has policies aimed at facilitating universal coverage through the removal of financial access barriers (Hurst & Kelley Patterson, 2014). Well-performing health providers also help a health system function to its ultimate capacity (Mohammed et al., 2016). Healthcare providers refer to institutions or people who offer healthcare services. Individuals such as the health professionals can be working in their facilities for self-employment or employed in health institutions such as hospitals or clinics which can be operated by the government, privately for profit, or as not-for-profit. These professionals may not necessarily deliver direct care to patients; some of them work in medical laboratories, public agencies such as health departments, or institutions for training health-related courses.

Human resources involved in the provision of health services include physicians, nurses, community health workers, medical laboratory scientists, dentists, midwives, pharmacists, therapists, among others. With top-notch human resources, a healthcare delivery system develops the capability to respond to the needs of the population that it serves and becomes fair and efficient (Hastings, Armitage, Mallinson, Jackson, & Suter, 2014). To have a well-performing workforce, strategies such as coming up with adequate levels of the appropriate mix (including numbers, skills, and diversity), payment systems with the right compensations and benefits, the right regulatory mechanisms, conducive work environment and collaboration of the entire stakeholders, for instance, health workers, donors, private sectors, clients, and professional associations, are paramount.

Finally, an ideal healthcare delivery system has a properly functioning information system since it greatly assists in the delivery of advanced health care (Mohammed et al., 2016). In developing countries, information and communication technologies have been of much help in the improvement of health. These technologies have been specifically used for monitoring treatment, communicating health and treatment information to population groups, as well as making a computer-aided diagnosis (Shortell, 2013). The storage and retrieval of information regarding medical records of patients, activities of the health personnel and hospital administration as well as the human resources have been made extremely easy by the modern health information systems.

Challenges

Not all healthcare delivery systems offer their patients ideal services. Some of the issues that hinder these systems from offering ultimate health services include inefficiencies, increasing costs, as well as issues related to the management of human resources. In the US, the costs associated with healthcare have increased rapidly as compared to the growth rate of the states’ economies. Health expenditure accounts for the largest percentage of the United States’ budget; higher than even expenses on defense (Dixon-Woods, McNicol, & Martin, 2012). The proportion is not expected to decrease anytime soon and instead; it is projected to occupy a fifth of the gross domestic product of the United States by the year 2024. It is worth noting that high health care services costs do not always translate to high-quality care. For instance, although the costs of health services per person in the United States are the highest as compared to other countries, this does not mean that the American population is healthier than people in nations whose costs are relatively lower.

Another challenge faced by health care systems is inefficiencies, which refer to the wastage of resources during health service delivery processes. Inefficiencies account for a large share of the total costs associated with healthcare systems. The entire health system can be improved and the associated costs significantly reduced and controlled by reducing even a small proportion of the inefficiencies without interfering with the appropriate care (Dixon-Woods et al., 2012). Excess treatment, failures in care coordination and execution processes, complex administration, inappropriate pricing, and fraud are some of the major factors that cause inefficiencies in healthcare systems. Healthcare systems that experience misuse or use of unnecessary services, for instance, the offering of primary care in emergency quarters and prescription of inappropriate medications/procedures have high levels of inefficiencies. Lastly, various issues are related to the development of a well-performing workforce (Gantz et al., 2012). The major issues include challenges in developing better strategies for recruiting, educating, training, distributing, and retaining high-quality workers as well as improving their productivity and performance.

Conclusion

Healthcare delivery systems comprise various but interconnected building blocks including service delivery, having a well-performing health team, incorporating a properly functioning information system, offering access to vital medical products, provision of sufficient funding, as well as leadership and governance. Since the effectiveness of healthcare delivery systems is paramount for the health and well-being of any population, all the stakeholders in the health sector should work together to assess the needs of the population they are supposed to serve and formulate as well as implement strategies that precisely address them. Effective ways of reducing wastage and inefficiencies and addressing human resource management in the systems are crucial for the achievement of ultimate population health.

References

Dixon-Woods, M., McNicol, S., & Martin, G. (2012). Ten challenges in improving quality in healthcare: Lessons from the Health Foundation’s programme evaluations and relevant literature. BMJ Quality & Safety, 1(10), 876-884.

Gantz, N. R., Sherman, R., Jasper, M., Choo, C. G., Herrin‐Griffith, D., & Harris, K. (2012). Global nurse leader perspectives on health systems and workforce challenges. Journal of Nursing Management, 20(4), 433-443.

Hastings, S. E., Armitage, G. D., Mallinson, S., Jackson, K., & Suter, E. (2014). Exploring the relationship between governance mechanisms in healthcare and health workforce outcomes: A systematic review. BMC Health Services Research, 14(1), 479-482.

Hawk, C., Ndetan, H., & Evans, M. W. (2012). Potential role of complementary and alternative health care providers in chronic disease prevention and health promotion: An analysis of National Health Interview Survey data. Preventive Medicine, 54(1), 18-22.

Hurst, K., & Kelley Patterson, D. (2014). Health and social care workforce planning and development–an overview. International Journal of Health Care Quality Assurance, 27(7), 562-572.

MacLachlan, M., Khasnabis, C., & Mannan, H. (2012). Inclusive health. Tropical Medicine & International Health, 17(1), 139-141.

Mohammed, K., Nolan, M. B., Rajjo, T., Shah, N. D., Prokop, L. J., Varkey, P., & Murad, M. H. (2016). Creating a patient-centered health care delivery system: A systematic review of health care quality from the patient perspective. American Journal of Medical Quality, 31(1), 12-21.

Shortell, S. M. (2013). Bridging the divide between health and health care. The Journal of the American Medical Association, 309(11), 1121-1122.

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