This research paper will examine the health care and management systems of two nations; the United States of America and Britain. There is no perfect health care delivery and management system for any nation. While some models seem to work better than others, the truth is that each has its own weaknesses and advantages.
The health care delivery system can be broadly categorized as a diffused or a tiered system. The tiered system is comprised of regionalized systems of healthcare delivery systems divided into primary care, secondary care, and tertiary care. Such a pyramidal system is more common in the United Kingdom, and in Health Maintenance Organizations in the United States.
Primary care refers to those activities that are concerned with the prevention and treatment of common medical problems concerned with the outpatient setting. While in the US, care is delivered by primary care practitioners the same service is provided by general care practitioners in the United Kingdom. In the diffuse system, patients can directly approach the specialists without consulting GPS or PCPs first. The boundaries between GPs, internists, family practitioners, and pediatricians have been eliminated.
The diffusive system is more abundant in the United States as compared to the United Kingdom. It is a diamond sort of a system in which most hospitals provide a mix of multi-specialty secondary and tertiary services.
The health care system in the United States is mostly outside governmental care. Therefore, this leaves the hospital capacity, regulation, and residency allocation amongst the primary, secondary and tertiary centers in the hands of private entities. The physician groups control the policy, occupational standards, occupational standards, and entry requirements for licensing. As a result, their professional interests and favor for technology and inpatient capacity have also resulted in the expansion of hospital facilities. Healthcare over the last decade has been delivered increasingly at hospitals rather than at the offices of physicians.
The health care delivery and management system has been fragmented by nation, state, community, and practice levels. As mentioned above, there is no single governing authority that maintains the guiding principles for all; each state divides its tasks amongst numerous agencies while the providers and people caring for the same patients often work independently of each other.
As a result of this fragmentation, the overall health care system in the United States has suffered greatly. A number of flaws have come across as a result of this fragmentation. These problems include; patients’ and families’ navigational issues regarding assistance across different providers and care settings which amounts to frustrated and dangerous patient experiences.
There is a huge problem of the poor problem of communication and lack of accountability for a patient amongst; resulting in medical errors, wastage, and duplication. Added to the above issues, there is the absence of peer accountability, quality improvement infrastructure, and clinical services. Even the information systems result in poor quality of health care and high cost, intensive medical intervention is given priority over higher-value primary care; including preventive medicines and even the management of chronic illnesses.
In comparison to the above system, the system in the United Kingdom has witnessed a radical makeover –the National Health Service as new strategies have come about which have resulted in a shift from the hospital dominated focus for the major provider of health care services to the provision of local, relevant and accessible services. These recent reforms have been a prominent feature of the public sector reforms in the United Kingdom.
The very first distinction is the fact the health care system in the United Kingdom is under the direct authority of the government whereas in the United States that isn’t the case. As a result, when the UK government upgraded its public sector in 1997, the health care regime was also upgraded subsequently. The political emphasis on health promotion and disease prevention demands that there should be comprehensive primary health care within the community rather than institutional settings and as health care becomes community-centered; the role of hospitals will be greatly reduced. (Smith 2008).
A feature of the United States that is a reason for its health care still being rated highly by individuals across the world is the fact though this fragmentation has become an issue for the patients as a result of the poor communication and exchanges between the practitioners themselves. However, this community-based health care management and delivery mean that there is greater personal access instead of one single entity monitoring the entire health care system.
Within a state, different priorities have been established as in certain regions certain diseases are found in greater abundance and hence different systems allow certain variances to be accommodated. Even the health care system in the United Kingdom has been transformed over the last decade and has become increasingly community-based.
Though certain issues with the health care and management system of the United Kingdom were outlined above, the fact cannot be ignored that the present is accommodating greater patient and provider exchanges. The current system is also trying to increase monitoring in order to improve the quality, care, and patients experiences of the health care system.
On the other hand, one of the greatest flaws within the United States is the absence of proper leadership which is critical to the success of delivery and management systems. Some organization is required in order to ensure that the patients have access to relevant information at all times, patient care is coordinated amongst the multiple providers and the transitions across care settings are actively managed. Through proper leadership; accountability can be ensured within interstate providers and proper review can be carried out. Collaboration can be ensured in order to provide high-quality health care.
The System in the United Kingdom was one on which the government had complete control and the focus was that of hospitals. As a result, the system faced a lot of criticism for its inefficiency and lack of proper health care service available for all; equity issue. Since the health care services were central-based, there was an issue of less supply and greater demand. Though, there have been some improvements in the recent decade. Much more is required to make the health care system efficient, effective, and productive. (Glied 2008).
Policies have been introduced which have resulted in improved operational effectiveness, performance management, and talent management resulting in lower rates of infection, lower readmission rates, more satisfied patients, etc, therefore, showing that the United Kingdom has already started a reformation process to overcome this basic weakness.
One aspect of the National Health Care service in the UK which has resulted in a comprehensive patient care system has been the proper organization and structure. The above policies were introduced as a result of the centralized system as the government initiated a complete overhaul of the public sector. Consequently, the health care system was also reformed, and hence, it has progressed by leaps and bounds. (Richardson 2008).
Thus, two totally different health care delivery and management systems have been compared above – along with their subsequent weaknesses and advantages and it has been shown that how each system can be improved through the introduction of certain policies.
Means R, Richards S, and Smith R.” Community Care: Policy and Practice” Palgrave MacMillan. 2008.
Sherry A. Glied, “Health Care Financing, Efficiency, and Equity,” National Bureau of Economic Research Working Paper 2008.
Castro P.J, Dorgan S, and Richardson B, A healthier health care system for the United Kingdom 2008.