Health Care Organizational Models

Health care is the provision of services for the prevention, diagnosis, treatment and rehabilitation of health conditions. It is a complex and multidisciplinary field of science and practice. It includes all medical, allied and social sciences and related professions that provide health services to individuals and communities.

Healthcare systems typically fall into one of five organizational models: the public system, the private insurance system, the charity model, the self-financing or co-operative model and the patient-centered and integrated system. Each model has its pros and cons, but the best system depends on the specific needs of the country and population.

The Public/Social System: Often called the Beveridge system, this model is a tax-financed system that is characterized by the public providing all or most of the funding for health facilities and staff. It typically has low costs per capita because government controls what health care providers can do with the money that they receive from tax payments.

Its primary goals are to ensure that all people can access healthcare and that the costs of care are controlled, and that patients have equitable access to high-quality and affordable health care. Its key features are universal coverage, access to a variety of services and resources, and a system that provides incentives for efficiency, quality, cost-effectiveness, equity and effectiveness (MACPAC, 2016).

This model also has the additional benefit of reducing waste and redundancy by requiring that fewer health professionals work in more places. It can be more efficient and effective than the private insurance or charity model in some situations, such as when healthcare is provided to a large number of disadvantaged individuals and when there are many people with the same chronic condition.

In addition, this model may have the added benefit of ensuring that health professionals are trained in ways that maximize their productivity and efficiency. It can also improve the overall quality of care by promoting collaboration and innovation between healthcare professionals and other organizations such as pharmaceutical companies.

The Private/Insurance System: Unlike the public and charity models, this system typically involves private organizations that provide health services to individual patients through insurance or other payment mechanisms. This system has the added benefit of offering more choices for consumers and enabling them to choose the best plan for their situation, thereby increasing their satisfaction with the plan.

Moreover, this type of system can be more flexible and responsive to the unique needs of particular groups such as patients who have disabilities or have limited access to resources. It can also be more effective at controlling the costs of healthcare by allowing providers to focus on the highest-priority needs of the patient and less on administrative and non-clinical issues that are usually more expensive.

This model can also be more effective at controlling the costs for services by focusing on preventive and early-detection measures, as well as by implementing other determinants of health. It can also be more effective at improving the overall quality of care by promoting collaboration between different healthcare providers and the broader community and by providing incentives for efficiency, quality and effectiveness (MACPAC, 2015).

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