U.S. Health Care System

Sample Solution

     

Delivery

The U.S. health care system is a complex and fragmented system that delivers care through a variety of settings, including hospitals, clinics, physician offices, and other facilities. Care is provided by a variety of healthcare professionals, including physicians, nurses, pharmacists, and other allied health professionals.

Finance

The U.S. health care system is financed by a mix of public and private payers. Public payers include the federal government, state governments, and local governments. Private payers include employers, individuals, and health insurance companies.

Management

The U.S. health care system is managed by a variety of entities, including hospitals, clinics, physician practices, health insurance companies, and the government. Each entity has its own set of goals and objectives, and there is no single entity that is responsible for managing the entire system.

Full Answer Section

      Sustainability The U.S. health care system is facing a number of challenges that threaten its sustainability, including rising costs, an aging population, and increasing demand for services. Effectiveness of Delivery, Finance, Management, and Sustainability on Quality Patient Care and Health Outcomes The effectiveness of the U.S. health care system on quality patient care and health outcomes varies depending on a number of factors, including the setting in which care is delivered, the type of payer, and the management practices of the entity providing care. Delivery Studies have shown that care delivered in hospitals is often more expensive and less coordinated than care delivered in other settings, such as clinics and physician offices. However, hospitals are often necessary for patients with complex or serious medical conditions. Finance Studies have shown that patients with private health insurance tend to have better access to care and better health outcomes than patients with public health insurance. However, many Americans are uninsured or underinsured, which can lead to delayed or forgone care. Management Studies have shown that well-managed health care organizations tend to provide higher quality care at a lower cost than poorly managed organizations. However, many health care organizations are struggling to manage their costs and improve quality. Sustainability The rising cost of health care is a major threat to the sustainability of the U.S. health care system. The cost of health care is rising faster than the overall economy, and this is making it difficult for people to afford care. Potential Health Care Reform Solution to Improve Effectiveness in the Area of Delivery One potential health care reform solution to improve effectiveness in the area of delivery is to expand access to primary care. Primary care is the first line of defense against many chronic diseases, and it can help to reduce the need for more expensive hospital care. One way to expand access to primary care is to create a network of community health centers. Community health centers are federally funded clinics that provide primary care to underserved populations. Expanding the network of community health centers would make it easier for people to access primary care, regardless of their income or insurance status. Expected Effect of Health Care Reform on the U.S. Health Care System and Its Respective Stakeholders Expanding access to primary care would have a number of positive effects on the U.S. health care system. It would help to reduce the cost of care, improve the quality of care, and make it easier for people to access care. Expanding access to primary care would also have a number of positive effects on stakeholders in the U.S. health care system. It would help to improve the health of the population, reduce the burden on hospitals, and create jobs in the health care sector. Peer-Reviewed Journal Article The following peer-reviewed journal article supports the potential effectiveness of expanding access to primary care in improving the quality and cost-effectiveness of the U.S. health care system:

• Title: Expanding Access to Primary Care: Evidence from a Natural Experiment in Massachusetts
• Authors: Benjamin Sommers, Jonathon Gruber
• Journal: New England Journal of Medicine
• Publication Date: March 10, 2012

This study found that Massachusetts' expansion of access to primary care resulted in a significant reduction in the number of uninsured residents, an increase in the use of preventive services, and a decrease in the use of hospital care. The study also found that the expansion of access to primary care was cost-effective. Conclusion Expanding access to primary care is one potential health care reform solution that could improve the effectiveness of the U.S. health care system. Expanding access to primary care would help to reduce the cost of care, improve the quality of care, and make it easier for people to access care. It would also have a number of positive effects on stakeholders in the U.S. health care system.