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Research the delivery, finance, management, and sustainability methods of the U.S. health care system. Evaluate the...

Research the delivery, finance, management, and sustainability methods of the U.S. health care system. Evaluate the effectiveness of one or more of these areas on quality patient care and health outcomes. Propose a potential health care reform solution to improve effectiveness in the area you evaluated and predict the expected effect. Describe the effect of health care reform on the U.S. health care system and its respective stakeholders. Support your post with a peer-reviewed journal article.

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Health care system consists web of providers, institutions, facilities, and structures in society for meeting health and illness-related needs. A health care delivery system is defined as a mechanism for providing services that meet the health-related needs of individuals.. Health Care is the fastest growing industry. U.S. spends 17% of GDP on health care (~$9000 per person).U.S has fewer physicians, hospital beds, physician visits, and hospitalizations than most industrialized countries. Only 55-70% of citizens receive the health care they need. Lower life expectancy than other industrialized countries (78.7 years). U.S. health care system ranked 7 out of 7 behind Australia, Canada, Germany, Netherlands, New Zealand, and the UK.

In the U.S health care system Health care services are delivered and financed by three sectors:

  • The public (official, voluntary, and nonprofit agencies)
  • Public/private
  • Private (hospitals, extended-care facilities, hospices, schools, etc.)

Financing - the way in which health care systems are funded

  • Medicaid and Medicare
  • Private insurance - united states
  • Out-of-pocket payments

US spends the most per capita of any country in the world, the highest proportion of its GDP on health care, but isn't the healthiest. There should be :

  • health insurance weaknesses:
  • socioeconomic disparities
  • expensive
  • poor standing in population health status (social problems and health issues that cure-oriented medicine doesn't do much for)


-other countries have universal health care, in which all plans accept everyone, gov covers all citizens and acceptance by hospitals (Pres. Obama attempted to do this)
-The US is the last major industrialized country to not have universal health care coverage for its residents

Patient bill of rights is established by the American hospital association (AHA)replaced in 2003 when the AHA adopted the patient care partnership. Under the terms of this document, patients are assured:

  • high-quality hospital care
  • a clean and safe environment
  • involvement in their care and the decision-making process
  • protection of privacy
  • help when leaving the hospitals and with billing concerns

Quality is defined as meeting or exceeding the customers' expectations. The quality of health care determined by how well a doctor, hospital, health plan, or other providers of health care keeps its members healthy when they are sick.

The National Quality Strategy serves as a catalyst and compass for a nationwide focus on quality improvement efforts and approach to measuring quality. The health services research arm of the US Department of Health and Human Services, complementing the biomedical research mission of its sister agency, the NOH. It is home to research centres that specialize in major areas of healthcare research such as quality improvement in patient safety, outcomes and effectiveness of care, clinical practice and technology assessment, and healthcare organization and delivery systems.

The US medical system overemphasizes process measures which have limited effect on quality, Outcome measurements are mainly performed among specialists and speciality societies, Outcome measurements traditionally focus on clinical status rather than functional status. High-quality interpersonal care, at least for chronic care, is required for good technical care to be implemented.

The goal of health care is to improve health outcomes. It follows that the ultimate goal of quality measurement and quality improvement is to improve health outcomes. Then why don't we forget structure and process and focus on outcomes?

The health care reform is needed where too many people lack health coverage and care. The system focuses on treatment instead of prevention. Lack of attention to SDoH and areas of health disparity. Inefficient delivery and payment system. US healthcare spending is unsustainable. Low ranking US health outcomes. The key provisions for health care reform are Insurance reform, shared responsibility requirements, healthcare exchanged, public health measures, accountable care, and organizations. The major stakeholders who participated in health care reform are :

  • Customers/Buyers (Patients/Health Insurers/Buyers)
  • Owners (NFPs, FPs, government entities)
  • Suppliers/Workers

*Lycourgos Liaropoulos and lias Goranitis, (2015), Health care financing and the sustainability of health systems, International Journal for Equity in HealthThe official journal of the International Society for Equity in Health2015, 14:80, https://doi.org/10.1186/s12939-015-0208-5

*Tolls and stategies for quality improvement, (2008), Chapter 44, ncbi.nlm.nih.gov

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