Healthcare systems Flashcards
(27 cards)
How is healthcare funded?
- Taxation
- Social insurance
- Private healthcare insurance
- Direct out of pocket payments
- OR mixture
The way the health system is set up is important because it affects people’s access to care.
How is healthcare funded on a micro- level?
- GPs are often self employed in UK & are ‘contractors’ rather than NHS employees.
- Payment formulas are used - involve capitation.
- Elsewhere - some hospitals are paid by results; & some pay staff by performance.
How is healthcare funded internationally?
Universal, government funded health system
Universal, public insurance system
Universal, public-private insurance system
Universal private health insurance system
Non-universal, insurance system
What is Universal, government-funded health system? Advantages & disadvantages? Examples of countries?
Advantages;
- maximum benefit for most people
Funded through taxation
- payment compulsory- more efficient
Disadvantages:
- funding allocated to budget is a political decision- may not be adequate for true health needs of pop
- can be inefficient- slow to respond to changing demand
-prioritise whole pop over individuals
E.g. UK, Australia, canada, Taiwan
What is Universal, public insurance system? Examples of countries?
workers have social insurance w/ both employers & employee contributions
- unemployed can’t register so ineligible for free health care
South Korea, Qatar, Belgium
What is Universal, public-private insurance system? Advantages & disadvantages? Examples of countries?
People receive health care via private insurance & from government if they are not eligible for it.
Disadvantages:
- higher administrative costs
- Problems reaching disfranchised people
Advantages:
- More efficient than tax-based systems.
- Money is allocated to regardless of health expenditure- any profit can be invested to grow fund.
Germany, TURKEY, Algeria
What is Universal private health insurance system? Examples of country?
- People receive healthcare via mandatory private insurance.
- Like car insurance - up to you want coverage you want.
- Usually subsidised by government for low-income citizens
E.g. Israel, Netherlands, Switzerland
What is Non-universal, insurance system? Advantages & disadvantages? Examples of country?
Largely private insurance mainly funded through employment- many jobs come w/ health insurance
Advantages:
- shorter waiting times
- Personalised care
Disadvantages
- Does not provide universal coverage
- Expensive system- spend large % of GDP on health care than UK
E.g. USA
What are the key features of Beverage model used in UK?
NHS funded from taxation
Free at point of use
Based on principle of equal access for equal equal need
Advantages of NHS?
- Universal coverage
- Equitable
- Free at point of access (for most things)
- Controls the cost in line w/ affordability
Disadvantages of NHS?
Long waiting times
Lower number of doctors & nurses per head
Higher infant mortality
Fewer MRI & CT scans
Lower survival rates for breast & cervical cancer
How does WHO monitor the effectiveness of health systems?
Divides health systems into 6 block:
Service delivery
Health workforce
Information
Medical products, vaccines, technologies
Financing
Leadership/ governance
What is social delivery?
services need to be accessible by population, efficient, affective & timely- otherwise patient may not accept it or access it
Need to understand demand for service, have well-functioning network of providers, maintain effective infrastructure
What is meant by health workers?
backbone of healthcare
shortage of healthcare workers very important- longer waiting times, patients not satisfied
What is meant by information?
access to info, both for professionals & patients, is critical component of effective health system
health policies & interventions need to be based on evidence, especially as new technologies are being adopted.
What is meant by medical products, vaccines, technologies?
plays vital roles in prevention, diagnosis & treatment.
Effective health system needs to ensure safe & efficient use of these products by establishing norms, regulating processes, & providing financial support in the research & development, production of all medical products
What is meant by health system financing?
Healthcare provision is expensive- systems will be dysfunction in absence of funding
What is meant by leadership & governance?
systems w/ good leadership continually innovate & strive for quality in all areas of healthcare
Empower staff to be leaders
Bring about +ve change
What Are the main goals of WHO?
Improved health care- includes measure of premature death & morbidity. Includes equitable share of resources to minimise gap btw rich and poor.
Responsiveness- way in which system respond to expectations of population. Focuses on patient satisfaction in areas e.g. patient-entered care & personal respect. Ethical considerations too e.g. autonomy, dignity etc
Social & finance risk protection-targets risk of causing poverty as result of health care expenditure- protection achieved through pooling of finance risk
Improved efficiency- involves facilitation of the progress towards health system goals w/in given resources.
Name the different sectors involved in health.
public sector
private sector
NGOs
Patient groups
How is public sector funded? Advantages & disadvantages?
Funded & delivered by government by taxation of public.
Advantages:
- Provision for vulnerable populations - gov are responsible for delivering good & fair health care for all citizens.
- Allows risk to be pooled
Disadvantages:
- Doesn’t always take account for the needs of the individual e.g. concave chest wall procedure
- Slow to respond to changes in demand
- Level of funding spent is a political decision & does not always meet true need.
E.g. UK, canada, France, Germany
How is private sector funded? Advantages & disadvantages?
Where private industries deliver health care services for a profit.
Advantages:
- Can lead to innovation through competition & response to markets.
- May be more cost-efficient.
Disadvantages:
- Patients must make out of pocket payments or use private health insurance
- No safety net if people lose jobs= compound social inequality.
- Typically serves a smaller population.
E.g. USA
How are NGOs funded? Advantages & disadvantages?
Consist of small local charities or large organisations e.g. WHO.
Advantages:
- Serves those who can’t pay - help LICs by providing free or heavily subsidised health care.
- Fills in gaps in a service
Disadvantages:
- Some say NGO goals are not aligned w/ actual local health care needs.
- Funding may disproportionately favour treatment of certain diseases e.g. HIV, malaria to the detriment of others i.e. donors influence where money goes.
What is patient groups? Advantages & disadvantages?
- Can provide clinical services, educate patients, change policy & support research.
- Often informal
- But increasingly formalised where patients can contribute to service design
