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| Healthcare
organizations and their environments |
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This essay is dedicated to analysis of healthcare development,
the existing trends and their consequences for the patients
and the organizations.
It is common knowledge that with the privatization of healthcare
organizations and practices the growth of the number of healthcare
specialists has been witnessed. On one hand, this is a positive
tendency because patients received more possibilities to choose
the type of healthcare, the insurance program, and finally,
the specialist. On the other hand, together with the growth
of number of healthcare organizations and practitioners the
level of healthcare fragmentation has increased. This seems
to be a positive tendency as well, because being a specialist
in all spheres of medicine seems to be impossible; and in
general, the more fragmented the health system is, the higher
is the quality of service.
But at closer consideration, there are negative consequences
of the fragmentation, which nowadays have exceeded the positive
result of it. In 1994, the US Primary Care Policy Fellowship
stated: “Three barriers to health care are shared by
all vulnerable populations: inaccessibility of care, fragmentation
of care, and cultural insensitivity on the part of care providers”
. High level of fragmentation increased the automation of
the healthcare system, reduced the ability of healthcare professionals
to think and act in critical situations; the approach to healthcare
became more standardized compared to individual character
of healthcare in the past.
The general shift to private source of funding has caused
the “optimization” of labor in healthcare system,
which leads to the shortening of observation time, the tendency
to serve as many patients as possible etc. Though this practice
has provided high salaries in healthcare system, the quality
of healthcare has suffered because of the fragmentation. Because
of increasing allied health costs and lengths of stay when
healthcare delivery for individual patients is fragmented,
the wait for hospital beds for patients with vascular conditions
doubles, within the space of a year, from 3 weeks to 6 weeks
.
There also appear problems when institutes are sharing care
with individual professionals; mostly the institutions protect
their areas of interest: there are cases when people that
were using the services of a GP, needed to use the services
of a healthcare institution, and such people were forced to
be diagnosed by a local physician to continue their treatment.
These tendencies reduce the quality of healthcare.
In my opinion, though the separate parts of the healthcare
system are working in comparatively optimal conditions, the
whole system is not patient-oriented. The government needs
to introduce reforms to healthcare system which would give
the possibility to unite the range of healthcare services
into one logically linked system, and the state has to provide
the necessary transmission of information within the system.
There are several specific measures that can be done to enhance
the quality of healthcare service, the main of them are the
following:
• The funding has to shift to a general source;
• There has to be support of the Conyers' Bill-the U.S.
Health Insurance Act for a National Health Plan
• There have to be an overall patient record for all
healthcare services
• Information technologies need to be introduced to
enhance the communication between healthcare organizations
Literature:
1. Zajac JD. The public hospital of the future. Med J Aust
2003; 179: 250-252
2. Campos-Outcalt D, Fernandez R, Hollow W, et al. Providing
quality health care to vulnerable populations. US Public Health
Service Primary Care Policy Fellowship, 1994.
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