Healthcare Delivery Term Paper

Total Length: 1865 words ( 6 double-spaced pages)

Total Sources: 1+

Page 1 of 6

structure of the American Healthcare System has long been a topic of much debate. The purpose of this discussion is to trace the evolution of the structure of the American system delivery service. We will begin with a timeline of the healthcare system. We will then examine the evolution of the structure of the healthcare delivery system.

Timeline

According to a timeline created by PBS the evolution of healthcare delivery services has been dramatic. At the start of the 20th century the American medical Association becomes a very important organization for doctors. In the ten years between 1900 and 1910 the membership of the American Medical Association goes from 8,000 to 70,000. It is during this time frame that the AMA gained a tremendous amount of respect and physicians focused on ways to deliver organized medicine to Americans. ("Healthcare Crisis: Healthcare crisis")

During the ten-year span between 1900 and 1910, Surgeries to remove tonsils and tumors were common. It was during this time that many surgeries were being perfected by physicians. This allowed doctors all over the country and around the world to better understand the human body and doctors could share their expertise with other physicians. ("Healthcare Crisis: Healthcare crisis")

The most significant development of the time was that doctors were allowed to charge patients in hospitals a fee for the care that they received. Prior to that time physicians performed the work for free. Compensation for physicians was a milestone in the medical world at that time and ultimately physicians would become some of the highest paid professionals in the country. ("Healthcare Crisis: Healthcare crisis")

Compensation for physicians also led to some of the first employer sponsored medical programs for workers. According to the PBS timeline, the Railroad industry was among the first to implement comprehensive employee medical benefits. ("Healthcare Crisis: Healthcare crisis") Medical benefits allowed workers to receive healthcare with very little out of pocket expense. The development of health benefits was beneficial to the railroads because the cost associated with losing an employee to illness was greater than the cost of providing the workers with healthcare benefit. So then the implementation of such benefits was beneficial to both the employee and the employer.

During the 1920's the cost of healthcare rose sharply and affected the middle class in ways that had never been seen before. The rise in expenses associated with the delivery of healthcare services was compounded by the fact that the federal government was not attempting to stabilize the cost of healthcare. However, employers were attempting to aid employees with healthcare expenses and General Motors teams up with Metropolitan Life to ensure that 180,000 employees had the proper medical coverage.("Healthcare Crisis: Healthcare crisis")

By the 1950's healthcare expenditures compose 4.5% of GDP. Many working Americans had private insurance and the poor were granted healthcare through welfare programs. ("Healthcare Crisis: Healthcare crisis")

The 1970's saw the advent of Health Management Organizations (HMO). Richard Nixon implemented HMO's which are susceptible to certain government regulations and government assistance. Also during this time,

Healthcare costs are escalating rapidly, partially due to unexpectedly high Medicare expenditures, rapid inflation in the economy, expansion of hospital expenses and profits, and changes in medical care including greater use of technology, medications, and conservative approaches to treatment. American medicine is now seen as in crisis." ("Healthcare Crisis: Healthcare Timeline")

During the 80's and 90's the structure of the hospital system begins to become more centralized because corporations begin to consolidate the system. During the 80's the structure of Medicare also changes and begins to grant payment by diagnosis. In the 90's the cost of healthcare increased to twice the rate of inflation and managed care was expanded. By the year 2000, sixteen percent of America's citizens did not have any healthcare coverage.

As you can see the American healthcare system changed drastically during the twentieth century. Much of this change was due in part to the industrial revolution and the increase in the number of women that joined the workforce. The industrial revolution caused such changes in the healthcare system because production became essential to the American way of life. Business owners understood that the productivity of employees was essential to the prosperity and success of the business. Employers wanted to make sure that employees had access to medical care so that absenteeism would be minimized because absenteeism leads to a reduction in productivity.

The increase in the number of women joining the workforce also had an impact on the changes in the healthcare system.
Businesses found that women were good workers and they wanted them to remain a part of the workforce. To accomplish this business had to offer the women health benefits and maternity leave. In addition, during the 80's and 90's there was an increase in the number of single mothers. Business owners recognized that healthcare benefits needed to be extended to these women and their children.

Now that we have discussed the societal influences that led to many of the changes in the healthcare system during the twentieth century, let's discuss the technical side of the evolution. The technical aspects of the evolution have to do with the institutions that make up the healthcare system and the logistical changes these institutions have undergone and a result of the information age.

Evolution of the Structure of the Healthcare Systems service delivery

An article in Health Services Research magazine describes the various aspects of this evolution. The article breaks the evolution down and explains the challenges faced by the institutions that make up the system, which are: health plans, hospitals and physicians. The article concedes that hospitals and health plans are more advanced than the medical profession.

The author describes the evolution of hospitals as changing from a cottage industry to a highly consolidated enterprise. It is estimated that 72% of all the hospitals in America are a part of a network. The article also states that "hospitals are developing a considerable database and information-processing capacity." (Shortell)

The evolution of hospitals is critical to the quality of care that individuals receive. Advances in information technology have made networking and database management feasible and attractive to hospitals.

This evolution has also allowed for the introduction of state of the art facilities and technology to better meet the needs of patients.

Health plans have also done a great deal to consolidate and along the way these insurance companies have worked to develop fair premiums for employers and those that are self-employed. The article asserts that health plans have also made great strides in the processing of claims and marketing their services. (Shortell)

Although health plans have developed well in terms of logistics, many complain that health insurance is too expensive and that the government must do something about it. In recent years, the problem of high health insurance premiums has caused many small businesses to stop offering health benefits to employees.

Unlike hospitals and health plans the evolution of the medical profession has been slow. The article in Health Services Research explains, "While most of the nation was coming "off the farms" and capturing the advantages of economies of scale and scope in the manufacturing and service sectors, medicine largely remained a solo or small partnership enterprise."(Shortell) The article notes that at the present time most of the medical groups in the country employ less than nine physicians. The article also reports that only 45% of doctors practice in a group at all. (Shortell)

Shortell asserts that as a result of the various levels of evolution within the healthcare institutions the healthcare system is broken. Shortell explains, as we enter the electronic/information age, an important and sizable component of the U.S. health system has not yet fully entered the industrial age. Thus, efforts to significantly change healthcare in local markets reflect the challenge of dealing with institutions that are at radically different places in their current stage of evolution. Many physicians not only lack the financial and volume incentives to manage care differently; they also lack the information technology, organizational know-how, and sense of a team-oriented culture to do so. (Shortell)

The assertions made in this article would lead one to believe that the evolution of the health care system is not yet complete. It seems apparent that the institutions that make up the healthcare system are striving to change so that the delivery of healthcare services will be more efficient. The hospitals and health plans have already made strides to accomplish this goal. Both of these institutions understand the purpose behind networking and the need to develop an infrastructure that has information technology at the core.

Health plans and hospitals also understand the benefits of careful planning and teamwork and they know how to "manage" healthcare and not just "provide" healthcare.

The physicians must charge forth and decide to implement changes that will benefit the public and the profession. Much of this could be accomplished if doctors had access to the information technology and the logistics training that is needed.….....

Show More ⇣


     Open the full completed essay and source list


OR

     Order a one-of-a-kind custom essay on this topic


Related Essays

Healthcare Delivery System Model

A Model Healthcare Delivery System Introduction The healthcare delivery system also referred to in short as the HCDS is the most effective system that works for most healthcare organizations in all countries with fair, effective and efficient distribution of resources. It is a fast growing service that demands attention from various quarters and domains. At the optimal level, the service program presents relief and hope to the individual, and the general population. The system offers a balanced quality care service through efficiency and fairness. HCDS varies across the world but its focus… Continue Reading...

Nursing Premise for Healthcare Delivery

One of the major theoretical models for healthcare delivery is the Parse theory of human becoming, created by Rosemarie Rizzo Parse—originally titled the man-living-health theory (2011). This theory focuses on healthcare and the human through the lens of quality of life. This theoretical premise for delivering and receiving healthcare was able to gain steam as a result of its alternative to the more standard bio-medical method and the biological-psychological-social and spiritual method contained in the bulk of other theories of nursing. This theory has enjoyed much attention and use when delivering healthcare as a result of the… Continue Reading...

Healthcare Management for Eldercare Advocacy Organization

for how people experience quality of life. Just like economical issues, healthcare is a topic for debate in many countries. The healthcare delivery system is reflective of the government’s performance in most countries, hence being integral to the identity of the nation as a whole. With the execution of the planned change in the eldercare advocacy organization, the patient will receive focused care at home. This is a shift from the disease centered approach of care offered in hospitals. The patient centered medical home (PCMH) favors the delivery of care at home, seeing this as the most attractive option for the patient. This allows the patient to be a stakeholder in… Continue Reading...

Healthcare Challenges in the United States

Reducing the operating costs means that some services have to be cut or reduced and this has a direct impact on healthcare delivery (Bai & Anderson, 2015). Stakeholders who are only concerned with reducing the costs of the organization lose sight of what is needed and this means that some essential services might be cut. For example, staffing levels in most healthcare organizations have been on the decline and this is mainly due to the cost-cutting measures implemented. Nurses are the most affected yet they are the ones who are directly charged with caring for the patients. Reduced numbers of nursing staff result in the few nurses having to work long… Continue Reading...

Impact of Nurses on Health Care Policy

States, and not…[…… parts of this paper are missing, click here to view the entire document ]…Regulatory Organizations on Healthcare Delivery The impact that regulatory organizations should have on healthcare delivery is that they should ensure that the laws are being followed. This should make health care delivery more streamlined, especially if the laws themselves are reasonable and logical. Regulatory bodies also ensure that standards are maintained, which should be a strongly positive impact on healthcare delivery. For the problems that the US health care system has with access, the actual quality of service delivery once access is gained, is actually quite good, and the regulatory bodies do play… Continue Reading...

Costs and Delivery Healthcare System

of this paper is to analyze the different costs linked to healthcare delivery system, and delineate the manner in which these costs impact different populations and how it also affects health care delivery. Analyze the different costs associated with the healthcare delivery system The health care sector comprises of a range of clinicians, hospitals, together with other health care organizations, insurance plans together with buyers of health care services, all functioning in different configurations of groups, networks, in addition to independent practices. In its entirety, this is what is referred to as the health care delivery system. Imperatively, numerous costs are… Continue Reading...

Accreditation Costs of Healthcare Organizations

accreditation is deemed to be a valuable means of promoting accountability in healthcare delivery; a positive status has generally been employed as an organizational marketing instrument (Menachemi et al., 2008). A discussion of the financial, time, and associated costs of earning and maintaining accreditation One view regarding the issue is that substantial personnel time and efforts, and organizational funds, are devoted to accreditation; these precious organizational resources may be put to better use elsewhere (for instance, in pursuing clinical care and service programs). Accreditation-related costs are a greatly debated and discussed issue in health plans. Accreditation is one major investment, but healthcare… Continue Reading...

Humana Care Delivery for Patients

hospitals, and regulators to all come together so that the needs of each are met. This paper will select one healthcare delivery organization in the U.S. that provides care to patients and discuss the relationship between this organization and the other stakeholders in healthcare -- in particularly how it links and aligns with these stakeholders. As the Institute of Medicine (2009) points out, "healthcare delivery organizations play a critical role because of their ability to drive practice trends, set standards, and influence smaller practices by sharing information, resources, and guidelines." This is something that Humana Care Delivery Organization is able to help achieve through its extensive network within the overall… Continue Reading...

Organizations That Mandate Knowledge Based Healthcare

its own knowledge management and for the delivery of knowledge-based healthcare. The organizations that are primarily responsible for ensuring knowledge-based healthcare delivery are also specific to their areas of expertise. For example, the Centers for Disease Control and Prevention and the United States Public Health Service oversee knowledge-based healthcare service delivery related to infectious diseases and other public health concerns, whereas Medicare covers knowledge-based healthcare services for the senior population nationwide (Institute of Medicine Committee on Assuring the Health of the Public in the 21st Century, 2005). Professional organizations like the American Medical Association and the American Dental Association are also dedicated to the provision of knowledge-based healthcare services under… Continue Reading...

Health Industry Professional Boards

healthcare atmosphere; a bigger RN and APRN (advanced practice RN) role in primary and basic healthcare delivery; and securing federal grants for nursing education/training (American Nurses Association, 2016). AMA Among the responsibilities of the AMA is: petitioning numerous governmental health-division organizations such as the National health IT Coordinator and the DHHS (Department of Health and Human Services) with regard to health IT matters. From time to time, the organization collaborates with the CDC (Centers for Disease Control and Prevention) and other entities in requesting reforms or improvements to current health policies affecting patients and the routine work of the nation's healthcare workforce (Rouse, 2015). The… Continue Reading...

The Link Between Mental Health and Trauma Informed Care

prevent re-traumatisation during the course of care delivery. Indeed, re-traumatisation is a common outcome in mental healthcare delivery (Wilson, Hutchinson & Hurley 2017). Trauma-informed care focuses on not only patients, but also clinicians (Isobel & Edwards 2017). Similar to patients, clinicians may be victims of traumatic experiences, hence the need for addressing their needs. In fact, nurses may not effectively address the needs of patients if they are not properly empowered. Empowering nurses creates an environment where nurses also feel emotionally safe to address the psychological needs of patients. It is worth noting that trauma-informed care does not necessarily mean that nurses should identity and treat… Continue Reading...

Enhancing Nursing Service Delivery and Minimizing Errors

where solutions to the problem of medical errors are identified. The concept of patient education is important in healthcare delivery. Often, literate patients can help nurses in reducing the number of medical errors like improper dosage or skipping medical procedures. Since illiteracy contributes to the errors, the introduction of patient education has helped reduce medical errors in many ways. For example, many patients know how to manage their health conditions and help the nurses in monitoring their healing process. The increase… Continue Reading...

Collaboration Using Systems Thinking

stakeholders in care delivery processes (Kleinpell, 2013). The implementation of this project would require collaboration between the different stakeholders in the healthcare delivery process in order to enhance the effectiveness of the processes such as medication adherence. Bilingual interpreters will act as intermediaries between the healthcare provider/clinicians and the patient and his/her family. The role of these interpreters would involve helping patients and their families to better understand the various processes in management or treatment of their conditions. In essence, these interpreters will act as third parties who facilitate communication between the healthcare provider and the patient and his/her family. They will work in collaboration with the healthcare provider and nurses… Continue Reading...

Role and Importance of Bilingual Interpreters

Hispanics are always disadvantaged due to language barriers that often necessitate the use of an interpreter in the healthcare delivery process. In urgent medical cases like diabetes, ad hoc interpreters who are usually family members act as interpreters between the patient and the healthcare provider. While these family members continue to play a critical role in patient-provider communication, many elderly Hispanics fail to adhere to medications and other treatment regimes effectively. This compromises the quality of healthcare and patient outcomes among this population, especially those suffering from diabetes. Therefore, the healthcare sector is faced with the need for improving patient-provider communication among elderly Hispanic patients suffering from diabetes.… Continue Reading...

Provider Patient Communication Through Professional Interpreters

to language barriers that often necessitate the use of an interpreter in the healthcare delivery process. Sample To help complete the project and achieve its purpose, an appropriate representative sample was identified and included in the study. The researcher identified a sample of forty (40) elderly Hispanic patients with diabetes. These patients are currently suffering from diabetes and use family members as ad hoc interpreters to help overcome the language barriers they face in provider-patient communication. Diabetic elderly Hispanic patients at the Wellness Center in Los Angeles were eligible for the project if they were between 50-75 years at the commencement of the… Continue Reading...

Nursing Shortage Essay

done soon to mitigate the nursing shortage, the entire globe could witness major crises in healthcare delivery.  Nurses have recently made inroads to improve the role and status of the profession, but much more needs to be done. The burgeoning patient population implies ever-increasing demand for qualified nursing staff, but there is no real plan in place anywhere to ensure that enough nurses will be staffed at the healthcare institutions or in the communities in which they are needed most. Nursing education programs at the level of higher education are overburdened, and even qualified students eager to participate in the healthcare professions are turned down… Continue Reading...

Nursing Leadership and Competency Evaluation

or at the topmost (executive) level) cultivates among subordinates a shared vision wherein superior-quality healthcare delivery is paramount. Nursing leaders ought to be client-oriented, which involves taking a holistic approach to patients and not viewing them only with regard to their ailment (Seitovirta, 2017). Staff nurses and other nursing leaders ought to grow into individuals who are admired and considered role models by their followers. Besides regard for human dignity, a vital nurse leadership attribute is courage. Furthermore, a nursing leader needs to earn his/her ‘role model’ status; it isn’t a ready-made accompaniment to the leadership job title. Meanwhile, fear-based approaches to leadership have… Continue Reading...

Using Evidence Based Practice to Resolve a Nursing Issue

nurses to be asking questions on how they can improve healthcare delivery. EBP has assisted the nursing profession in numerous ways. Nursing education has been changed because of EBP and colleges and universities have had to change their BSN program in order to incorporate EBP. The programs encourage critical thinking skills and nursing students are encouraged to consider clinical, religious, cultural, and socioeconomic backgrounds of the patients as well as using the relevant scientific research available. EBP has led to an increased interest in and emphasis on nursing research. EBP has also improved patient outcomes in that nurses can now… Continue Reading...

sample essay writing service

Cite This Resource:

Latest APA Format (6th edition)

Copy Reference
"Healthcare Delivery" (2003, February 22) Retrieved April 27, 2024, from
https://www.aceyourpaper.com/essays/healthcare-delivery-143381

Latest MLA Format (8th edition)

Copy Reference
"Healthcare Delivery" 22 February 2003. Web.27 April. 2024. <
https://www.aceyourpaper.com/essays/healthcare-delivery-143381>

Latest Chicago Format (16th edition)

Copy Reference
"Healthcare Delivery", 22 February 2003, Accessed.27 April. 2024,
https://www.aceyourpaper.com/essays/healthcare-delivery-143381