Lecture 7- Healthcare systems Flashcards Preview

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Flashcards in Lecture 7- Healthcare systems Deck (27)
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1

what is a system

Systems- interconnected elements within a defined whole

  • A defined boundary
  • Has to have a purpose, which must be well defined

2

Complicated vs complex systems

complicated- elements and connections equally important

complex- connections are most important 

3

systems can be 

  • Simple or
  • Complex or
  • Complex adaptive

4

systems- predicatibility of behaviour

5

systems- number of interactions

6

systems- locus of decision making

7

systems- strength of interactions

8

systems- causal loop diagram

- vicious cycle

vs

- virtuous cycle

 

A virtuous circle has favorable results, while a vicious circle has detrimental results. Both circles are complex chains of events with no tendency toward equilibrium (social, economic, ecological, etc.) —at least in the short run

 

Balancing elements = most important

  • Reinforcing (Resilient) loop= vicious cycle (red)
  • Reinforcing loop as a virtuous cycle (green)

9

Models of healthcare provision (4)

 

  • Out-of-Pocket Model
  • Bismarck Model
  • National Health Insurance
  • Beveridge Model

10

Out-of-Pocket Model (‘Individual Liability’)

 

  • Most countries in the world do not have universal healthcare provision for their citizens.
  • In those countries, only those rich enough receive healthcare, the others do not.
  • Some have public hospitals that provide free emergency care, but only emergency care. Thereafter, all costs are borne by the patient.
  • Those who can afford to do so, pay for healthcare insurance so that they do not have to go to public hospitals.

11

countries which use out-of-pocket model 

poorer countries e.g.

Africa, India, China and South America

12

Bismarck Model (‘Multi-Payer’ Insurance)

 

  • Named after Otto von Bismarck, Chancellor of Prussia, who invented the welfare state in 1883 as part of the unification of Germany.
  • Healthcare is:
    • provided by private healthcare providers and doctors
    • financed by an insurance system (not-for-profit ‘sickness funds’ that are strictly regulated) that is funded jointly by employers and employees through payroll deduction.

13

countries which use bismark model

Examples include Germany, France, Belgium, Netherlands, Switzerland, Japan and in Latin America.

14

Beveridge Model (‘Single Payer and Provider’)

 

  •  

  • Named after William Beveridge, author of the “Social Insurance and Allied Services” report (1942) that formed the basis of the post-WWII welfare state in the UK including the NHS.
  • Healthcare is:
    • provided mostly by state controlled healthcare providers and doctors
    • financed by the government funded by general taxation.

15

countries which use beveridge model

  • Examples include UK, Spain, most Scandinavian countries, New Zealand and Cuba.

16

National Health Insurance (‘Single Payer’)

 

  • Named after Lloyd George’s National Insurance Act (1911) in the UK in which employers and employees pay National Insurance contributions.
  • Healthcare is:
    • provided by private healthcare providers and doctors 
    • financed by a government run insurance scheme that is funded by citizens’ contributions.

17

countries which use national health insurance model

Examples include Canada, Taiwan and South Korea.

18

in the UK we have

devolved healthcare

19

type of healthcare in england

internal makret healthcare

20

internal market -england

improve performance

control costs

21

type of healthcare in scotland

integrated

22

integrated healthcare- scotland

collaboration

co-ordination

23

type of healthcare in wales

planned

24

planned healthcare (wales)

  • common goals
  • optimal system

25

type of healthcare in NI

health and social care

26

health and social care- NI

pooled resources

27

funding differences throughout the UK