for americans to enjoy optimal health—as individuals and as a population—they must have the benefit of high-quality health care services that are effectively coordinated within a strong public health system. finally, virtually all states have the legal responsibility to monitor the quality of health services provided in the public and private sectors. in this section, the committee reviews concerns about the barriers to health care that are raised by the lack of health insurance and by threats to the nation’s safety-net providers. when offered, coverage for these services often carries limits that are unrelated to treatment needs and are stricter than those for other types of care (king, 2000). the committee encourages health care policy makers in the public and private sectors to reexamine these issues in light of the concerns about bioterrorism. a recent study of changes in the capacities and roles of local health departments as safety-net providers found, however, that more than a quarter of the health departments surveyed were the sole safety-net providers in their jurisdictions and that this was more likely to be the case in smaller jurisdictions (keane et al., 2001). the evidence that insurance makes a difference in health outcomes is well documented for preventive, screening, and chronic disease care (iom, 2002b). medicaid benefits vary by state in terms of both the individuals who are eligible for coverage and the actual services for which coverage is provided. this entitled poor children to a comprehensive package of preventive health care and medically necessary diagnostic and treatment services. the limited and unstable nature of insurance for treatment of mental illness has several implications for governmental public health agencies because the severely mentally ill are likely to end up receiving care in publicly funded safety-net programs (rabinowitz et al., 2001). oral diseases are causally related to a range of significant health problems and chronic diseases, as well as individuals’ ability to succeed in school, work, and the community (dhhs, 2000b). as noted, it is often the responsibility of state departments of health to monitor providers and levy sanctions when quality problems are identified. changes in the financing and delivery of health care services, such as the emphasis on cost controls and the almost complete conversion to managed care for the delivery of services under medicaid, may be especially problematic for racial and ethnic minorities. as the proportion of old and very old increases, the system-wide impact in terms of cost and increased disability may well overwhelm the human and financial resources available to care for chronically ill patients. the severe underrepresentation of racial and ethnic minorities in the health professions affects access to care for minority populations, the quality of care they receive, and the level of confidence that minority patients have in the health care system. although more research is needed to examine the impact of minority health care professionals on the level of access and quality of care, for some minority patients, having a minority physician results in better communication, greater patient satisfaction with care, and greater use of preventive services (iom, 2002b).
the shortage of rns poses a serious threat to the health care delivery system, and to hospitals in particular. the unique characteristic of primary care is the role it plays as a regular or usual source of care for patients and their families. this loss of trust in the idea of managed care is also the loss of a great opportunity to improve quality and restrain costs. the development of enhanced information technology and its use in hospitals, individual provider practices, and other segments of the health care delivery system are essential for improving the quality of care. such a system can help realize the public interest related to quality improvement in health care and to disease prevention and health promotion for the population as a whole. the health care and governmental public health sectors are also very unequal in terms of their resources, prestige, and influence on public policy. public health departments have always differed greatly in regard to the delivery of health care services, based on the availability of such services in the community and other reasons (moos and miller, 1981). the latter rely on health care providers and laboratories to supply the data that are the basis for disease surveillance. incomplete reporting may reflect a lack of understanding by some health care providers of the role of the governmental public health agencies in infectious disease monitoring and control. better information systems that allow the rapid and continuous exchange of clinical information among health care providers and with public health agencies have the potential to improve disease surveillance as well as aid in clinical decision making while avoiding the use of unnecessary diagnostic tests. ahcs also have a unique and special set of values that they bring to health care that transcend the discrete functions they perform. in addition to the linkages between the health care delivery system and governmental public health agencies, health care providers also interface with other actors in the public health system, such as communities, the media, and businesses and employers. businesses and employers most commonly interface with the health care sector in purchasing and designing employee health benefits, with goals such as the inclusion of comprehensive preventive health care services. the growing cost of health care has obvious implications for the nation’s readiness to address the problems discussed in this chapter. these circumstances force public health departments to provide personal health care services instead of using their resources and population-level approaches to guide and support community efforts to change the conditions for health. all federal programs and policies targeted to support the safety net and the populations it serves should be reviewed for their effectiveness in meeting the needs of the uninsured. assess health status and need, and adjust the volume and types of services provided to respond to the health needs of the community
receipt of high-quality care is essential to sustain or restore the health and functioning of millions of americans with serious and complex medical conditions. underutilization of health care services has also been cited as a major factor contributing to the delivery of poor-quality health care service that can lead to detrimental outcomes associated with functional status and quality of life and may also result in premature death. such variation in the quality of health care in america is a major cause of excess morbidity and mortality, as well as a contributing factor to rising health care costs and expenditures.
of particular relevance to the rising expectations of consumers with serious and complex medical conditions is the right to select providers and health care plans that ensure access to appropriate high-quality health care. medicare has assumed a leading role in responding to the complex care needs of populations with serious and complex medical conditions. a third effort by plans to deal with rising health care costs and the increasing numbers of individuals with serious and complex conditions focuses on screening and risk assessment. 2, challenges in health care delivery for patients with serious and complex medical conditions.
this chapter addresses the issues of access, managing chronic disease, neglected health care services (i.e., clinical preventive services, oral, and mental four major categories of errors contributing to substandard health care quality have been identified: (1) avoidable errors; (2) underutilization of services; (3) most americans lack adequate coverage for chronic (rather than acute) care. even when americans have insurance coverage, access to health care is not always, health care delivery examples, health care delivery examples, health service delivery examples, health care delivery concerns ppt, health care delivery system in the united states.
there are growing concerns that the healthcare system in the united states has reached crisis mode. the industry is not only in financial crisis as costs rise mckinsey explores the latest evolution in healthcare and key changes facing us organizations around care delivery. millions of americans still lack insurance coverage, and millions more have inadequate coverage for acute care. the federal health reform, the patient, 4 components of health care delivery system, what are the main objectives of a health care delivery system, levels of health care delivery system, health care delivery system pdf, introduction to healthcare delivery systems, health care delivery system notes, health care delivery system in india, challenges of healthcare delivery system pdf, health care delivery system – ppt, importance of healthcare delivery system.
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