[ANSWERED 2024] Briefly discuss the various organizational structures and share which one of these structures you would like to work in and why?

Written By: Dan Palmer, RN

Briefly discuss the various organizational structures and share which one of these

Briefly discuss the various organizational structures and share which one of these

Question 1:

When you think of the term Healthcare System what comes to your mind and why.

Question 2:

Describe the general involvement of hospitals from “warehouses for the dying” to institutions dedicated to healing and welfare of people.

Question 3:

Share your understanding of “Medicare Managed Care.”

Question 4:

Many, if not all health services organizations, have organizational structures and portals of care.

  • What is your understanding of patient portals?
  • Briefly discuss the various organizational structures and share which one of these structures you would like to work in and why?

Expert Answer and Explanation

When you think of the term, “Healthcare System,” what comes to your mind and why.

When I think of the term “healthcare system,” several different aspects come to mind. First and foremost, I think of the various organizations and professionals that make up the healthcare system, such as hospitals, clinics, doctors, nurses, and other healthcare providers (World Health Organization, 2020). These individuals and institutions are responsible for providing medical care and treatment to individuals in need, whether it be through in-person visits, telemedicine appointments, or other means.

I also think of the various policies and regulations that govern the healthcare system, such as insurance coverage, reimbursement rates, and quality standards (Centers for Medicare & Medicaid Services, 2020). These policies and regulations can have a significant impact on the accessibility and affordability of healthcare for individuals, as well as the overall quality and efficiency of the healthcare system.

Finally, I think of the ongoing challenges and issues facing the healthcare system, such as rising costs, access to care, and disparities in healthcare outcomes (Centers for Disease Control and Prevention, 2021). These challenges highlight the need for ongoing efforts to improve the healthcare system and address the needs of all individuals, regardless of their socio-economic status or other factors.

Overall, the healthcare system is a complex and multifaceted entity that plays a vital role in the health and well-being of individuals and communities. It is constantly evolving and adapting to the changing needs of society, and it will continue to be an important topic of discussion and debate in the years to come.

References

Centers for Disease Control and Prevention. (2021). Health Equity. Retrieved from https://www.cdc.gov/healthequity/

Centers for Medicare & Medicaid Services. (2020). Health Insurance Marketplace. Retrieved from https://www.healthcare.gov/

World Health Organization. (2020). Health Systems. Retrieved from https://www.who.int/topics/health_systems/en/

Describe the general involvement of hospitals from “warehouses for the dying” to institutions dedicated to healing and welfare of people

Historically, hospitals were often viewed as “warehouses for the dying,” where individuals with serious illnesses or injuries were sent to receive medical care and treatment (Blumenthal, 2020). These early hospitals were often overcrowded, unsanitary, and lacking in basic amenities, and they were not always able to provide the best possible care for their patients (Blumenthal, 2020).

However, over time, hospitals have evolved and transformed into institutions that are dedicated to the healing and welfare of people. Today’s hospitals are typically well-equipped and staffed with trained professionals who are committed to providing the highest quality of care to their patients (Blumenthal, 2020). They often offer a wide range of medical services and treatments, including preventive care, diagnostic testing, surgery, and rehabilitation, as well as support services such as nutrition, social work, and spiritual care (American Hospital Association, 2020).

In addition to providing medical care, many hospitals are also actively involved in the wider community, working to address public health issues and promote the overall well-being of the people they serve (American Hospital Association, 2020). For example, hospitals may partner with local organizations to provide health education, screenings, and vaccination clinics, or they may participate in disaster preparedness and response efforts (American Hospital Association, 2020).

Overall, the role of hospitals has changed significantly over time, and they are now widely recognized as important institutions that play a vital role in the health and well-being of individuals and communities.

References

American Hospital Association. (2020). Hospitals in Your Community. Retrieved from https://www.aha.org/advocacy-issues/local-hospitals

Blumenthal, D. (2020). The History of Hospitals: From Ancient Times to Modern Medicine. Retrieved from https://www.medicalnewstoday.com/articles/323705

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Share your understanding of “Medicare Managed Care.”

Medicare managed care is a type of health insurance plan that is offered through Medicare, the federally funded healthcare program for individuals who are 65 and older or who have certain disabilities (Centers for Medicare & Medicaid Services, 2020). In a Medicare managed care plan, enrollees receive their healthcare services through a network of providers that is managed by a private insurance company (Centers for Medicare & Medicaid Services, 2020). These plans may include additional benefits and services beyond those offered through traditional Medicare, such as prescription drug coverage and preventive care services (Centers for Medicare & Medicaid Services, 2020).

There are several types of Medicare managed care plans, including HMOs (health maintenance organizations), PPOs (preferred provider organizations), and Medicare Advantage plans (Centers for Medicare & Medicaid Services, 2020). Each type of plan has its own unique features and benefits, and enrollees can choose the plan that best fits their needs and preferences (Centers for Medicare & Medicaid Services, 2020).

One of the main benefits of Medicare managed care is that it can provide more predictable and stable healthcare costs for enrollees, as the insurance company negotiates rates with providers and sets copayments and deductibles (Centers for Medicare & Medicaid Services, 2020). However, it is important to note that Medicare managed care plans may have more restrictive networks and require enrollees to choose a primary care provider, which can limit their access to certain providers and services (Centers for Medicare & Medicaid Services, 2020).

Overall, Medicare managed care is a popular option for individuals who are enrolled in Medicare and are looking for a more coordinated and comprehensive approach to their healthcare.

Reference

Centers for Medicare & Medicaid Services. (2020). Medicare Managed Care. Retrieved from https://www.medicare.gov/manage-your-health/medicare-managed-care

Many, if not all health services organizations, have organizational structures and portals of care.

What is your understanding of patient portals?

Patient portals are online platforms that allow patients to access their healthcare information and communicate with their healthcare providers (Office of the National Coordinator for Health Information Technology, 2021). These portals are typically provided by hospitals, clinics, and other healthcare organizations, and they can be accessed through a web browser or a mobile app (Office of the National Coordinator for Health Information Technology, 2021).

Patient portals typically provide a range of features and services, such as the ability to view medical records and test results, schedule appointments, request prescription refills, and communicate with healthcare providers through secure messaging (Office of the National Coordinator for Health Information Technology, 2021). Some patient portals may also offer additional features, such as the ability to pay bills online, access educational resources, or track health data (Office of the National Coordinator for Health Information Technology, 2021).

The use of patient portals can provide several benefits for both patients and healthcare providers. For patients, patient portals can improve access to healthcare information and services, increase communication and coordination with healthcare providers, and empower patients to take a more active role in their own healthcare (Office of the National Coordinator for Health Information Technology, 2021). For healthcare providers, patient portals can improve efficiency and productivity, reduce administrative burdens, and enhance patient engagement and satisfaction (Office of the National Coordinator for Health Information Technology, 2021).

Overall, patient portals are a useful tool for improving the patient-provider relationship and enhancing the overall quality of healthcare.

References

Office of the National Coordinator for Health Information Technology. (2021). Patient Portals. Retrieved from https://www.healthit.gov/faq/patient-portals

When you think of the term Healthcare System what comes to your mind and why

Briefly discuss the various organizational structures and share which one of these structures you would like to work in and why?

There are several different organizational structures that organizations can use to structure their workforce and operations. Some common types of organizational structures include:

  • Hierarchical structure: In this type of structure, authority is centralized at the top and flows downward through a chain of command, with employees at lower levels having less decision-making power (Mintzberg, 1979). This structure is often used in larger organizations where there is a need for clear lines of authority and control.
  • Flat structure: In a flat structure, authority is decentralized and there are fewer levels of management, with employees having more autonomy and decision-making power (Mintzberg, 1979). This structure is often used in smaller organizations or those that value innovation and creativity.
  • Matrix structure: In a matrix structure, employees report to multiple managers and work on cross-functional teams, with the goal of improving communication and coordination across departments (Mintzberg, 1979). This structure is often used in organizations that need to be flexible and responsive to changes in the environment.
  • Team structure: In a team structure, employees are organized into self-managed teams that are responsible for their own work and decision-making (Mintzberg, 1979). This structure is often used in organizations that value collaboration and teamwork.

Personally, I would prefer to work in a flat structure because I believe that this type of structure allows for more autonomy and creativity. I value the ability to make my own decisions and to be able to contribute to the overall direction of the organization. I also believe that a flat structure can foster a more collaborative and inclusive work environment, as employees are able to more easily share ideas and work together.

References

Mintzberg, H. (1979). The Structuring of Organizations. Englewood Cliffs, NJ: Prentice-Hall.

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When you think of the term, “Healthcare System,” what comes to your mind and whyFAQs

4 components of health care delivery system

Health care is an essential service that every individual should have access to. However, the complexity of the health care delivery system can be overwhelming, especially for those who are not familiar with it. The health care delivery system is made up of four components: financing, insurance, delivery, and payment. Each component plays a crucial role in ensuring that patients receive the care they need. In this article, we will explore the four components of the health care delivery system and how they impact the quality of care.

Financing:

Financing is the first component of the health care delivery system. It refers to the means by which health care services are paid for. Financing can come from a variety of sources, including government programs, private insurance companies, and out-of-pocket payments. The most common source of financing for health care in the United States is through employer-sponsored health insurance.

  • Types of financing: There are two primary types of financing for health care: public financing and private financing.
  • Public financing: Public financing refers to the funds that come from government programs such as Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).
  • Private financing: Private financing includes employer-sponsored insurance plans, individual insurance plans, and out-of-pocket payments.

Insurance:

The second component of the health care delivery system is insurance. Insurance is a contract between the patient and the insurer that provides financial protection against the cost of health care services. Health insurance can be provided by the government, private insurance companies, or purchased by individuals.

  • Types of insurance: There are several types of health insurance, including fee-for-service plans, health maintenance organizations (HMOs), preferred provider organizations (PPOs), and point of service (POS) plans.
  • Fee-for-service plans: Fee-for-service plans allow patients to choose their health care providers and pay for services as they receive them.
  • HMOs: HMOs require patients to choose a primary care physician who coordinates their care and provides referrals to specialists when necessary.
  • PPOs: PPOs allow patients to choose their health care providers, but offer financial incentives for using in-network providers.
  • POS plans: POS plans are a combination of HMOs and PPOs, allowing patients to choose their providers but also requiring referrals for specialist care.

Delivery:

The delivery component of the health care delivery system refers to the actual provision of health care services to patients. Health care services can be provided in a variety of settings, including hospitals, clinics, and long-term care facilities. The delivery component also includes the health care professionals who provide care, such as physicians, nurses, and other allied health professionals.

  • Types of health care providers: There are many types of health care providers, including physicians, nurses, dentists, pharmacists, and therapists.
  • Hospital care: Hospitals provide acute care services, such as surgery and emergency care.
  • Outpatient care: Outpatient care includes services such as diagnostic tests, rehabilitation services, and physician visits.
  • Long-term care: Long-term care facilities provide care for patients who require ongoing assistance with activities of daily living.

Payment:

The final component of the health care delivery system is payment. Payment refers to the methods by which health care providers are reimbursed for the services they provide. Payment can come from a variety of sources, including insurance companies, government programs, and patients themselves.

  • Methods of payment: There are several methods of payment for health care services, including fee-for-service among others.

Functions of health care system

The health care system serves several functions, all of which are vital to ensuring the health and well-being of individuals and communities. Some of the key functions of the health care system include:

  1. Providing preventive care: One of the primary functions of the health care system is to provide preventive care to individuals. This includes vaccinations, screenings, and education about healthy lifestyle choices.
  2. Diagnosing and treating illnesses: Another crucial function of the health care system is to diagnose and treat illnesses and injuries. This includes everything from routine check-ups to complex surgeries and cancer treatments.
  3. Managing chronic conditions: The health care system is also responsible for managing chronic conditions, such as diabetes, heart disease, and asthma. This involves monitoring patients’ symptoms, providing ongoing care, and helping patients manage their conditions effectively.
  4. Providing emergency care: In times of crisis, the health care system plays a critical role in providing emergency care to individuals. This includes responding to natural disasters, mass casualties, and other emergencies.
  5. Conducting research: The health care system is also responsible for conducting research into new treatments, drugs, and medical technologies. This research helps to advance medical knowledge and improve patient outcomes.
  6. Educating health care professionals: The health care system is responsible for educating and training health care professionals, including doctors, nurses, and other providers. This ensures that there is a skilled workforce in place to provide high-quality care to patients.

Overall, the health care system plays a vital role in promoting and maintaining the health and well-being of individuals and communities. By providing preventive care, diagnosing and treating illnesses, managing chronic conditions, providing emergency care, conducting research, and educating health care professionals, the system ensures that individuals have access to the care they need to live healthy and productive lives.

Health system definition WHO

Health systems play a crucial role in providing essential health services to people around the world. These systems encompass various organizations, institutions, and resources that work together to improve health outcomes and promote well-being. The World Health Organization (WHO) defines a health system as “all organizations, people, and actions whose primary intent is to promote, restore or maintain health” (WHO, 2000). This definition highlights the importance of collaboration and coordination between different actors in the health sector to achieve the common goal of improving health outcomes.

What is the Health System Definition by WHO?

The health system definition by WHO is a comprehensive framework that provides a holistic understanding of the various components that make up a health system. According to WHO, a health system consists of six building blocks, which are:

  1. Service delivery: The provision of effective, safe, and high-quality health services to the population.
  2. Health workforce: The people who provide health services, including doctors, nurses, midwives, and other health professionals.
  3. Health information system: The collection, analysis, and dissemination of health-related data and information.
  4. Medical products, vaccines, and technologies: The essential medicines, vaccines, and other technologies that are needed to prevent and treat diseases.
  5. Financing: The mechanisms used to fund health services, including public and private funding sources.
  6. Leadership and governance: The policies, regulations, and management systems that guide and support the delivery of health services.

These six building blocks work together to create a functional health system that can meet the health needs of the population. Each building block is interconnected and dependent on the others, and any weakness in one block can have a significant impact on the overall performance of the system.

Why is the Health System Definition Important?

The health system definition by WHO is critical in promoting public health and achieving the Sustainable Development Goals (SDGs) related to health. A functional health system can help to:

  • Improve access to essential health services for all people, including the most vulnerable populations.
  • Ensure the delivery of high-quality health services that meet the needs of the population.
  • Increase efficiency and cost-effectiveness in the use of resources, including financial and human resources.
  • Strengthen health information systems and improve data collection, analysis, and use for decision-making.
  • Promote innovation and the adoption of new technologies to improve health outcomes.
  • Foster collaboration and coordination among different actors in the health sector, including governments, civil society, and the private sector.

What is systems theory in medicine?

Systems theory in medicine is an interdisciplinary framework that views the human body and its various components as interconnected and interdependent systems.

It emphasizes the holistic understanding of health and disease by considering the complex interactions between different biological, psychological, social, and environmental factors. This approach recognizes that the functioning of an organism is more than the sum of its individual parts and that changes in one part of the system can have ripple effects throughout the entire system.

In the context of medicine, systems theory is applied to analyze and understand the dynamics of health and disease at multiple levels, ranging from molecular and cellular processes to organ systems, individuals, families, and communities. The goal is to appreciate the intricate relationships between these levels and to identify how disturbances in one part of the system can affect overall health.

Key principles of systems theory in medicine include:

  1. Holism: Systems theory emphasizes the importance of studying and treating the whole person rather than focusing solely on isolated symptoms or diseases.
  2. Interconnectedness: It recognizes that different components within the body and between individuals are interconnected and influence each other.
  3. Feedback Loops: Systems often involve feedback mechanisms, where changes in one part of the system can result in responses that either amplify or dampen the initial change.
  4. Emergent Properties: Complex systems exhibit emergent properties, meaning that the behavior of the system as a whole cannot be predicted solely by understanding its individual components.
  5. Adaptability: Systems can adapt to changes in their environment, and understanding this adaptability is crucial in developing effective medical interventions.

Applying systems theory in medicine can lead to a more comprehensive understanding of health and disease, improve patient care by considering various factors that contribute to well-being, and guide the development of more effective and personalized treatment strategies. It aligns with the shift towards a patient-centered and holistic approach in modern healthcare.

What is the difference between the health system and the health care system?

The terms “health system” and “health care system” are related but refer to different aspects of the broader healthcare landscape. Here’s a breakdown of the key differences between the two:

  1. Health System:
    • The health system encompasses a broader and more comprehensive perspective, extending beyond the traditional boundaries of medical care.
    • It includes all organizations, institutions, resources, policies, and individuals involved in promoting, maintaining, and restoring health.
    • The health system addresses not only medical services but also public health initiatives, health education, disease prevention, health promotion, social determinants of health, and the coordination of various elements to ensure overall well-being.
    • It considers the interconnections and interactions among different sectors, recognizing that health is influenced by factors beyond the scope of clinical care, such as social, economic, and environmental determinants.
  2. Health Care System:
    • The health care system is a subset of the broader health system, specifically focusing on the delivery of medical care and services to individuals.
    • It includes hospitals, clinics, primary care providers, specialists, allied health professionals, pharmaceutical services, and other entities directly involved in the diagnosis, treatment, and management of illnesses and health conditions.
    • The health care system deals with the organization, financing, and provision of medical services, including preventive, curative, and rehabilitative care.
    • While the health care system is a crucial component of the health system, it represents only one facet of the overall efforts to enhance and maintain population health.

In summary, the health system encompasses a more comprehensive and inclusive concept that goes beyond clinical care, considering a wide array of factors that influence health. On the other hand, the health care system specifically focuses on the delivery and management of medical services. Understanding both concepts is essential for developing effective strategies to improve overall health outcomes and healthcare delivery.

What is meant by a health system?

A health system refers to the organized network of people, institutions, resources, and activities whose primary purpose is to promote, restore, and maintain health.

It is a complex and interconnected framework that involves a range of actors and components working together to deliver health services and address the overall well-being of individuals and communities. Key elements of a health system include:

  1. Health Services: The provision of medical care, including preventive, diagnostic, therapeutic, and rehabilitative services. This involves healthcare professionals, hospitals, clinics, and other healthcare facilities.
  2. Health Workforce: The individuals involved in delivering health services, such as doctors, nurses, pharmacists, technicians, and other healthcare professionals.
  3. Health Facilities: The physical infrastructure, including hospitals, clinics, laboratories, and other healthcare facilities, where health services are provided.
  4. Health Information Systems: The collection, analysis, and dissemination of health-related data and information to support decision-making, policy development, and research.
  5. Medical Products and Technologies: The availability and accessibility of medicines, vaccines, medical equipment, and technologies necessary for the delivery of healthcare.
  6. Financing Mechanisms: The methods and resources used to fund and sustain the health system, including public and private funding, insurance systems, and government budgets.
  7. Leadership and Governance: The policies, regulations, and leadership structures that guide and oversee the functioning of the health system. This includes government agencies, regulatory bodies, and other organizations responsible for health governance.
  8. Community Engagement: Involving individuals, families, and communities in health-related decision-making, awareness, and promotion activities.
  9. Social Determinants of Health: Factors outside the traditional healthcare system, such as socioeconomic conditions, education, employment, and environmental factors, that influence health outcomes.
  10. Intersectoral Collaboration: Cooperation and coordination with other sectors like education, transportation, and housing to address broader determinants of health.

Major problems in the US healthcare system

The U.S. healthcare system faces several challenges that impact its efficiency, accessibility, and overall effectiveness. Some major problems include:

  1. High Healthcare Costs:
    • The United States has one of the highest healthcare costs globally. Factors contributing to this include administrative expenses, high prices for medical services and pharmaceuticals, and the prevalence of expensive diagnostic and treatment technologies.
  2. Lack of Universal Coverage:
    • The U.S. does not have a universal healthcare system, and millions of Americans remain uninsured or underinsured. This can lead to delayed or inadequate medical care for a significant portion of the population.
  3. Fragmented Healthcare Delivery:
    • The healthcare system is often characterized by fragmentation and lack of coordination among various providers and services. This can lead to inefficiencies, duplicative tests, and challenges in managing chronic conditions.
  4. Administrative Complexity:
    • The administrative burden in the U.S. healthcare system is substantial, with complex billing processes, diverse insurance plans, and varying regulations. This complexity contributes to high administrative costs.
  5. Health Disparities:
    • Disparities in health outcomes exist based on factors such as race, ethnicity, income, and geography. Certain populations face higher rates of diseases and have less access to quality healthcare services.
  6. Focus on Treatment over Prevention:
    • The healthcare system often emphasizes treating illnesses rather than preventing them. Greater emphasis on preventive care could potentially reduce the need for costly interventions.
  7. Opioid Epidemic:
    • The U.S. is grappling with a significant opioid epidemic, leading to widespread addiction and overdose deaths. Addressing this crisis requires a comprehensive approach involving healthcare providers, policymakers, and communities.
  8. Health Information Technology Challenges:
    • While there has been progress in adopting electronic health records (EHRs), challenges remain, including interoperability issues, concerns about data security, and the need for better integration of technology to improve patient care.
  9. Aging Population:
    • The aging population poses challenges in terms of increased demand for healthcare services, long-term care, and managing chronic conditions. This demographic shift puts additional strain on the healthcare system.
  10. Mental Health Services Gap:
    • There is a significant gap in the provision of mental health services. Access to mental health care is often limited, leading to untreated mental health conditions and their potential impact on overall health.

4 functions of health system

Health systems serve multiple functions to promote and maintain the health and well-being of individuals and communities. Here are four key functions of a health system:

  1. Health Promotion and Disease Prevention:
    • One primary function of a health system is to promote health and prevent diseases. This involves implementing strategies to educate individuals and communities about healthy behaviors, providing vaccinations, conducting screenings, and promoting lifestyle changes that contribute to overall well-being.
  2. Medical Treatment and Care Delivery:
    • A fundamental role of a health system is to provide medical treatment and care for individuals who are sick or injured. This includes a range of services, from primary care and emergency care to specialized treatments delivered by various healthcare professionals and institutions.
  3. Rehabilitation and Chronic Disease Management:
    • Health systems are responsible for supporting individuals in their recovery from illnesses or injuries, including rehabilitation services. Additionally, they play a crucial role in managing chronic conditions, such as diabetes, heart disease, and respiratory disorders, by offering ongoing care and support to improve quality of life.
  4. Health System Governance and Regulation:
    • Governance and regulation are essential functions of a health system to ensure its effective operation and the delivery of high-quality care. This involves developing and enforcing policies, regulations, and standards that govern healthcare providers, facilities, and overall system performance. It also includes overseeing ethical considerations and patient safety.

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