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.
