Health Systems Models: A Comparative Analysis
Conclusion
We believe that this work on the administration of services performed in the hospital setting has helped us to understand the crucial factors for effective task management, achieving good quality and efficiency at work. Good leadership is essential, combined with a staff dedicated to meeting established premises. Teamwork is crucial, as is monitoring all situations that hinder the smooth operation of the unit. Addressing problems promptly prevents them from escalating. Among the classical theories from various authors, including Toyota’s Japanese management principles and participatory democratic leadership targeting the 5 zeros, the most promising approach for achieving quality care involves staff engagement and fostering their creativity. From our perspective, many aspects of this theory align with the work being done in healthcare settings, such as decision-making through consensus and collaboration. Active participation is encouraged throughout the process, aiming for every worker to embrace the organization’s values. Most importantly, it prioritizes human needs, a cornerstone of our work.
Intervention/Role of the Nurse
Introduce yourself to the patient and/or family as their nurse and explain your role. Verify that the admission process is complete, including whether the patient received the information brochure and satisfaction survey. Assess the patient and family’s understanding of the center and unit, addressing any questions. Review the nursing assessment, interdisciplinary assessment, pressure ulcer risk assessment, and care management plan completed upon admission, supplementing them as needed. Check for prescriptions or instructions from other healthcare professionals.
Care Plan Development
- Collaborate with the patient and family to identify priority problems.
- Define objectives and timelines for achieving them.
- Determine nursing activities and patient/family contributions to reach the objectives.
- Establish how information, patient education, and family support will be managed.
Health Systems
Health systems are organizational and financial models designed to protect a community’s health. They form the backbone of the health sector, reflecting the individual and social values of the community they serve. Their organization caters to the collective and individual interests of dominant societal groups or the social contract between them.
Mixed Model
This model currently prevails in most Western European health systems. While some argue that “national health systems” are socialist and the rest are mixed, the near-disappearance of communist political systems makes this distinction less clear-cut. European health systems generally follow a mixed model, particularly in their management, with varying degrees of public and private sector involvement in financing, provision, and overall operation.
Components of the Mixed Model:
- Structural Components:
- Primary Care (e.g., general practitioners)
- Specialist Care (e.g., hospitals, diagnostic, and treatment centers)
- Public Health (e.g., sanitation, hygiene, disease prevention, health education)
- Planning and Management
- Socioeconomic Components: Factors related to a country’s specific structure (e.g., GDP, health expenditure, infrastructure).
European Hybrid Models:
- Bismarck Model:
- Originating in Germany, this model guarantees healthcare through compulsory contributions.
- The state owns and manages the public health network.
- Initially, it covered only insured workers, leading to parallel welfare networks for the uninsured.
- Countries with systems derived from this model include France, Germany, Austria, Belgium, Luxembourg, and the Netherlands.
- Beveridge Model:
- Established in the UK in 1948, this model underpins the National Health Service (NHS) in several countries, including the UK, Sweden, Finland, Norway, Denmark, Italy, Spain, and Portugal.
- Public health is financed through the general state budget, ensuring universality, equity, and free access.
- Planning and public health are managed by the state and decentralized communities/municipalities.
- These entities develop mandatory health plans with clear, measurable objectives.
Liberal Model (Friedman)
Also known as the free market model, this system, prevalent in the United States, views healthcare as a commodity not necessarily requiring comprehensive government protection.
Characteristics:
- Focuses on specific health problems (e.g., trauma, stroke).
- Patients prioritize services based on their needs and financial resources.
- Limited government contribution to healthcare.
- Reliance on charitable networks for the disadvantaged, leading to potential inequity and discrimination.
- Direct payment or private insurance for the middle and upper classes.
- Minimal government regulation beyond professional licensing.
- Service utilization driven by supply and demand.
Benefits:
- Competition among providers drives innovation in technology and medical research.
- Cost analysis systems (e.g., diagnosis-related groups) enhance efficiency.
- Attracts top medical talent globally due to higher earning potential.
Cons:
- High healthcare costs (over 12% of GDP in the USA).
- Inequity and discrimination due to reliance on charitable networks.
- Emphasis on healthcare over prevention and health education.
Socialist Model
This model is characterized by full funding through the general state budget, providing universal and free coverage for a comprehensive range of health benefits.
Characteristics:
- Universal and free access to all system services.
- Incompatibility with private health insurance.
Advantages:
- Focus on preventive medicine and health education to optimize resource allocation.
- Emphasis on public health measures (e.g., water supply, waste management, occupational health).
Disadvantages:
- Potential for increased demand for sophisticated and expensive treatments.
- Risk of undervaluing healthcare due to its free provision.