Healthcare System Models: A Comparative Overview
Conclusion
Key Takeaways from Hospital Espases
Our work at Hospital Espases highlights crucial factors for effective task management, quality care, and efficiency. These include strong leadership, a dedicated staff, and collaborative teamwork. Addressing challenges promptly is vital for smooth unit operation. The participatory, democratic leadership model, inspired by Toyota’s ‘5 zeros’ approach, resonates with our commitment to quality care. This model emphasizes staff involvement, fosters creativity, and aligns with the collaborative decision-making and shared values practiced in our NICU. Importantly, it prioritizes human needs, a cornerstone of our work.
Intervention and the Nurse’s Role
Introduction and Initial Assessment
As the patient’s reference nurse, introduce yourself and explain your role to both the patient and their family. Confirm the admission process, ensuring they received the informational brochure and satisfaction survey. Assess their understanding of the center and unit, addressing any questions. Review the nursing assessment, interdisciplinary assessment, pressure ulcer risk evaluation, and care management plan, supplementing as needed. Check prescriptions and indications from other professionals.
Developing the Care Plan
Collaboratively establish care priorities with the patient and family. Define objectives, timelines, and nursing activities. Determine how the patient and family will contribute to achieving these objectives and outline information management and education strategies.
Healthcare System Models
Understanding Health Systems
Health systems are organizational and financial frameworks designed to protect community health. They form the foundation of the health sector, reflecting societal values and serving collective and individual interests.
The Mixed Model
The mixed model characterizes most Western European health systems, blending public and private sector involvement in financing, provision, and management. These systems have two key components:
- Structural Components:
- Primary Care (e.g., health center physicians)
- Specialist Care (e.g., hospitals, diagnostic centers)
- Public Health (e.g., sanitation, hygiene, prevention, education)
- Planning and Management
- Socioeconomic Components: Factors like GDP, health expenditure, and societal structures.
Two prominent hybrid models influence European health systems:
The Bismarck Model
Originating in Germany, the Bismarck model mandates contributions to guarantee healthcare. The state manages the public health network and acts as the health authority. Initially covering only contributing workers, it necessitates parallel welfare networks for non-contributors. Countries influenced by this model include France, Germany, Austria, Belgium, Luxembourg, and the Netherlands.
The Beveridge Model
Established in 1948, the Beveridge model underpins the NHS in countries like the UK, Sweden, Finland, Norway, Denmark, Italy, Spain, and Portugal. Public health funding comes from the general state budget, ensuring universality, equity, and free access. The state and decentralized communities handle planning and public health, developing mandatory health plans with clear, measurable objectives.
The Liberal Model (Friedman)
Prevalent in the United States, the liberal model, also known as the free market model, views healthcare as a commodity. Key characteristics include:
- Limited government intervention in healthcare.
- Prioritization of health problems often driven by patient demand and resources.
- Minimal state contribution to healthcare.
- Reliance on direct payment or private insurance, primarily for middle and upper classes.
- Regulation focused on professional licensing.
- Service utilization based on supply and demand.
Benefits:
- Promotes competition, driving advancements in technology and medical research.
- Emphasizes cost analysis systems for efficiency.
- Attracts top medical talent due to higher earning potential.
Cons:
- High societal cost, exceeding 12% of GDP in the USA.
- Reliance on charitable networks for the uninsured, leading to inequity and discrimination.
- Prioritizes healthcare over prevention and health education.
The Socialist Model
Characterized by full state funding, the socialist model provides universal, free access to a comprehensive range of health benefits. Private insurance is incompatible with this model.
Advantages:
- Focus on preventive medicine and health education to minimize costly healthcare services.
- Emphasis on public health initiatives like sanitation and occupational health.
Disadvantages:
- Potential limitations in access to advanced treatments and technologies.
- Risk of undervaluing healthcare due to its free provision.