Healthcare organizations and their environments

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
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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