PA 574: Health Systems Organization
Session 1 – April 3, 2013
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Definition
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Properties
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Components
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Network of inter-related components
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Coherence and integration among parts
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Standardized
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Coordinated
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Common support structures
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Includes all the activities whose primary
purpose is to promote, restore or
maintain health
Formal health services, traditional
services, public health, alternatives
Health systems:
 Improve health of populations
 Respond to people’s expectations
 Provide financial protection against costs of ill
health
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Financing
 To obtain health services
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Insurance
 Protection against risks
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Delivery
 Providers of services
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Payment
 Reimbursement
Shi & Singh, Figure 1-1, p. 6
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Education & Research
Suppliers
Insurers
Providers
Payers
Government
Shi & Singh, Table 1-1, p. 3
Illness
Specialized care
Inpatient
Technological
Cost unaware
Institution based
Individual patient
Professional
Curative care
Individual provider
Independent orgs.
Service duplication
Current regulation
Market commodity
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Wellness
Primary care
Ambulatory
Humanistic
Cost accountable
Community-based
Population focus
Managerial
Preventive care
Provider teams
Integrated systems
Service continuum
Re-regulation
Public good
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Social values and cultures
Population characteristics
Political climate
Economic conditions
Physical environment
Technology development
Global influences
Shi & Singh, Figure 1-2, p. 10
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No central governance
Access based on insurance
Imperfect market conditions
Third-party insurers act as intermediaries
Multiple payers make system cumbersome
Balance of power prevents dominant single entity
Legal risks affect practice
New technology creates demand
Continuum of new service settings
Quality and value