Health care: Difference between revisions
Wikipedian2 (talk | contribs) m Reverted edits by 199.219.138.254 (talk) to last revision by Versageek (HG) |
Timeshifter (talk | contribs) m (GR) File renamed: File:Health spending. OECD countries. US dollars per capita (using economy-wide PPPs).png → File:Average annual health spending. US dollars (PPP) per person. OECD countries and more.png |
||
Line 1: | Line 1: | ||
{{Short description|Prevention of disease and promotion of well-being}} |
|||
{{For|The Office episode|Health Care (The Office)}} |
|||
{{cs1 config|name-list-style=vanc}} |
|||
{{other uses}} |
|||
{{Use dmy dates|date=April 2023}} |
|||
[[File:Global physician density map - WHO 2010.png|thumb|upright=1.6|Global concentrations of health care resources, as depicted by the number of physicians per 10,000 individuals, by country. Data is sourced from a World Health Statistics 2010, a [[World Health Organization|WHO]] report.{{old|2022|4|19}}]] |
|||
{{multiple image |
|||
| align = right |
|||
| direction = vertical |
|||
| image1 = Hospital-beds-per-1000-people.png |
|||
| width1 = 350 |
|||
| caption1 = |
|||
| image2 = NewYorkPresbyterian-Cornell.jpg |
|||
| width2 = 350 |
|||
| caption2 = Graphic of hospital beds per 1,000 people globally in 2013, at top;<ref>{{cite web |title=Hospital beds per 1,000 people |url=https://ourworldindata.org/grapher/hospital-beds-per-1000-people?year=2013 |website=Our World in Data |access-date=7 March 2020 |archive-date=12 April 2020 |archive-url=https://web.archive.org/web/20200412185105/https://ourworldindata.org/grapher/hospital-beds-per-1000-people?year=2013 |url-status=live }}</ref> [[NewYork-Presbyterian Hospital]] in [[New York City]], a hub for health care and [[life sciences]],<ref name=NYCHealthCareLifeSciencesHub>{{cite web|url=https://www.governor.ny.gov/news/governor-hochul-mayor-adams-announce-plan-sparc-kips-bay-first-its-kind-job-and-education-hub|title=Governor Hochul, Mayor Adams Announce Plan for SPARC Kips Bay, First-of-Its-Kind Job and Education Hub for Health and Life Sciences Innovation|publisher=[[State of New York]]|date=October 13, 2022|access-date=October 13, 2022|archive-date=1 November 2022|archive-url=https://web.archive.org/web/20221101195547/https://www.governor.ny.gov/news/governor-hochul-mayor-adams-announce-plan-sparc-kips-bay-first-its-kind-job-and-education-hub|url-status=live}}</ref> is one of the world's busiest [[hospital]]s, below. Pictured is its [[Weill Cornell Medical Center|Weill Cornell]] facility (white complex at the center). |
|||
}} |
|||
'''Health care''', or '''healthcare''', is the improvement of [[health]] via the [[preventive healthcare|prevention]], [[diagnosis]], [[therapy|treatment]], [[wikt:amelioration|amelioration]] or [[cure]] of [[disease]], [[illness]], [[injury]], and other [[disability|physical and mental impairments]] in people. Health care is delivered by [[health professional]]s and [[allied health professions|allied health fields]]. [[Medicine]], [[dentistry]], [[pharmacy]], [[midwifery]], [[nursing]], [[optometry]], [[audiology]], [[psychology]], [[occupational therapy]], [[physical therapy]], [[athletic training]], and other [[health profession]]s all constitute health care. The term includes work done in providing [[primary care]], [[wikt:secondary care|secondary care]], [[tertiary care]], and [[public health]]. |
|||
Access to healthcare may vary across countries, communities, and individuals, influenced by social and economic conditions and [[health policy|health policies]]. Providing health care services means "the timely use of personal health services to achieve the best possible health outcomes".<ref name="NAP2009">{{Cite book|url=https://www.nap.edu/read/2009/chapter/2|title=Access to Health Care in America|publisher=The National Academies Press, US National Academies of Science, Engineering and Medicine|date=1993|doi=10.17226/2009|pmid=25144064|isbn=978-0-309-04742-5|author1=Institute of Medicine (US) Committee on Monitoring Access to Personal Health Care Services|last2=Millman|first2=M.|access-date=14 June 2019|archive-date=11 February 2021|archive-url=https://web.archive.org/web/20210211044453/https://www.nap.edu/read/2009/chapter/2|url-status=live}}</ref> Factors to consider in terms of healthcare access include financial limitations (such as insurance coverage), [[Geography|geographical]] and [[Logistics|logistical]] barriers (such as additional transportation costs and the ability to take paid time off work to use such services), [[sociocultural]] expectations, and personal limitations (lack of ability to communicate with health care providers, poor [[health literacy]], low income).<ref name=RHI2021>{{Cite web|url=https://www.ruralhealthinfo.org/topics/healthcare-access|title=Healthcare Access in Rural Communities Introduction|publisher=Rural Health Information Hub|date=2019|access-date=2019-06-14|archive-date=11 February 2021|archive-url=https://web.archive.org/web/20210211044452/https://www.ruralhealthinfo.org/topics/healthcare-access|url-status=live}}</ref> Limitations to health care services affect negatively the use of medical services, the efficacy of treatments, and overall outcome (well-being, mortality rates). |
|||
'''Health care''' is the diagnosis, treatment and prevention of [[disease]], [[illness]], injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in [[medicine]], [[chiropractic]], [[dentistry]], [[nursing]], [[pharmacy]] and [[allied health]]. The exact configuration of [[health care system]]s varies from country to country, but in all cases requires a robust financing mechanism; a well-trained and adequately paid [[Health Human Resources|workforce]]; reliable information on which to base decisions and policies; and well maintained facilities and logistics to deliver quality medicines and technologies.<ref>[http://www.who.int/topics/health_systems/en/ World Health Organization: ''Health systems'']</ref> |
|||
[[Health system]]s are the [[organization]]s established to meet the health needs of targeted populations. According to the [[World Health Organization]] (WHO), a well-functioning healthcare system requires a financing mechanism, a well-trained and adequately paid [[Health Human Resources|workforce]], reliable information on which to base decisions and [[health policy|policies]], and well-maintained [[health facilities]] to deliver quality medicines and technologies. |
|||
==Health care industry== |
|||
{{Main|Health care industry}} |
|||
{{See also|Health care providers}} |
|||
An efficient healthcare system can contribute to a significant part of a country's [[Economic system|economy]], development, and [[industrialization]]. Health care is an important determinant in promoting the general [[physical health|physical]] and [[mental health]] and [[well-being]] of people around the world.<ref name="WHO">{{cite web |url= https://www.who.int/topics/health_systems/en/ |title= Health Topics: Health Systems |publisher= World Health Organization |website= www.who.int |access-date= 2013-11-24 |archive-date= 2019-07-18 |archive-url= https://web.archive.org/web/20190718195540/https://www.who.int/topics/health_systems/en/ |url-status= live }}</ref> An example of this was the worldwide [[Eradication of infectious diseases|eradication]] of [[smallpox]] in 1980, declared by the WHO, as the first [[disease]] in human history to be eliminated by deliberate healthcare interventions.<ref>World Health Organization. ''Anniversary of smallpox eradication''. Geneva, 18 June 2010.</ref> |
|||
The delivery of modern health care depends on an expanding group of trained [[professional]]s coming together as an [[interdisciplinary team]].<ref name=PrincetonDef>[[Princeton University]]. (2007). Health profession. Retrieved June 17, 2007, from [http://wordnet.princeton.edu/perl/webwn?s=health%20profession Princeton University]</ref><ref name=USDL>United States Department of Labor. (February 27, 2007). Health Care Industry Information. Retrieved June 17, 2007, from [http://www.doleta.gov/BRG/Indprof/Health.cfm Employment & Training Administration (ETA) - U.S. Department of Labor]</ref> |
|||
==Delivery== |
|||
The health-care [[industry]] incorporates several sectors that are dedicated to providing health care services and products. According to industry and market classifications, such as the [[Global Industry Classification Standard]] and the [[Industry Classification Benchmark]], the health-care industry includes health care equipment and services as well as pharmaceuticals, [[biotechnology]] and life sciences. The particular sectors associated with these groups are: biotechnology, diagnostic substances, drug delivery, drug manufacturers, hospitals, medical equipment and instruments, diagnostic laboratories, n |
|||
{{See also|Health professionals}} |
|||
[[File: Jericho Health Centre 20050326.jpg|thumb|Primary care may be provided in community health centers.]] |
|||
The delivery of modern health care depends on groups of trained [[professional]]s and [[paraprofessional]]s coming together as [[interdisciplinary team]]s.<ref name=USDL>United States Department of Labor. [https://www.dol.gov/agencies/eta/ ''Employment and Training Administration: Health care''] {{Webarchive|url=https://web.archive.org/web/20120129005204/http://www.doleta.gov/BRG/Indprof/Health.cfm |date=2012-01-29 }}. Retrieved June 24, 2011.</ref> This includes professionals in [[medicine]], [[psychology]], [[physiotherapy]], [[nursing]], [[dentistry]], [[midwifery]] and [[allied health]], along with many others such as [[public health|public health practitioners]], [[community health worker]]s and [[unlicensed assistive personnel|assistive personnel]], who systematically provide personal and population-based preventive, curative and [[Physical medicine and rehabilitation|rehabilitative]] care services.{{cn|date=June 2022}} |
|||
While the definitions of the various types of health care vary depending on the different [[Culture|cultural]], political, organizational, and disciplinary perspectives, there appears to be some consensus that primary care constitutes the first element of a continuing health care process and may also include the provision of secondary and tertiary levels of care.<ref name="Cookie">Thomas-MacLean R et al. [http://www.uwo.ca/fammed/csfm/tutor-phc/documentation/trainingpapers/TUTOR_Definitio_%20of_primar_%20health_care.pdf ''No Cookie-Cutter Response: Conceptualizing Primary Health Care.''] {{Webarchive|url=https://web.archive.org/web/20190412075131/https://www.uwo.ca/fammed/csfm/tutor-phc/documentation/trainingpapers/TUTOR_Definitio_%20of_primar_%20health_care.pdf |date=2019-04-12 }} Retrieved 26 August 2014.</ref> Health care can be defined as either [[Public health care|public]] or [[Private healthcare in the United Kingdom|private]].{{cn|date=June 2022}} |
|||
According to the United Nations system, the [[International Standard Industrial Classification]], health care generally consists of hospital activities, medical and dental practice activities, and other human health activities. The last class consists of all activities for human health not performed by hospitals, physicians or dentists. This involves activities of, or under the supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratories, pathology clinics, home, or other para-medical practitioners in the field of optometry, hydrotherapy, medical massage, yoga therapy, music therapy, occupational therapy, speech therapy, chiropody, homeopathy, chiropractics, acupuncture, etc.<ref name="UNclass">[http://unstats.un.org/unsd/cr/registry/regcst.asp?Cl=2 Welcome to the United Nations: It's Your World]</ref> |
|||
[[File: FEMA - 18213 - Photograph by Robert Kaufmann taken on 10-25-2005 in Louisiana.jpg|thumb|The [[emergency room]] is often a frontline venue for the delivery of primary medical care.]] |
|||
=== |
===Primary care=== |
||
{{Main|Primary care}} |
|||
{{see|Philosophy of healthcare}} |
|||
{{See also|Primary health care|Ambulatory care|Urgent care}} |
|||
The philosophy of healthcare attempts to synthesize the general meaning of the healthcare industry as a [[institution|social institution]]. Through the study of people, processes, [[politics]], and [[ethics]] in the healthcare industry, a workable philosophy of healthcare develops. And as a [[social philosophy]], healthcare represents the primary means by which people improve the overall quality of their daily lives. The ultimate purpose of healthcare philosophy is to provide an [[analytic frame|analytic framework]] for the collection and analysis of all pertinent data in the healthcare industry, especially for fields like [[biotechnology]], [[chiropractic]], [[medicine]], and [[nursing]]. |
|||
[[File:Terapevt Mudrov train.JPG|thumb|[[Hospital train]] "Therapist Matvei Mudrov" in [[Khabarovsk]], [[Russia]]<ref>{{cite web|url=https://www.nationalgeographic.com/magazine/2014/06/|title=June 2014|website=Magazine|access-date=9 March 2019|archive-date=22 December 2020|archive-url=https://web.archive.org/web/20201222160425/https://www.nationalgeographic.com/magazine/2014/06/|url-status=dead}}</ref>]] |
|||
'''Primary care''' refers to the work of [[health professionals]] who act as a first point of consultation for all [[patients]] within the [[health care system]]. The primary care model supports first-contact, accessible, continuous, comprehensive and coordinated person-focused care.<ref>{{cite web |title=Primary care |url= https://www.who.int/teams/integrated-health-services/clinical-services-and-systems/primary-care |access-date=21 June 2024 |website=World Health Organization}}</ref> Such a professional would usually be a [[primary care physician]], such as a [[general practitioner]] or [[Family medicine|family physician]]. Another professional would be a licensed independent practitioner such as a [[physiotherapist]], or a non-physician primary care provider such as a [[physician assistant]] or [[nurse practitioner]]. Depending on the locality and health system organization, the patient may see another health care professional first, such as a [[pharmacist]] or [[nurse]]. Depending on the nature of the health condition, [[patient]]s may be [[Referral (medicine)|referred]] for secondary or tertiary care.{{cn|date=June 2022}} |
|||
==Research== |
|||
{{See also|List of health care journals|List of medical journals|List of pharmaceutical sciences journals|List of bioinformatics journals|Medical literature}} |
|||
Primary care is often used as the term for the health care services that play a role in the local community. It can be provided in different settings, such as [[Urgent care]] centers that provide same-day appointments or services on a walk-in basis.{{cn|date=April 2024}} |
|||
Top [[impact factor]] [[academic journals]] in the health care field include ''[[Health Affairs]]'' and ''[[Milbank Quarterly]]''. The ''[[New England Journal of Medicine]]'', ''[[British Medical Journal]]'', and the ''[[Journal of the American Medical Association]]'' are more general journals. |
|||
Primary care involves the widest scope of health care, including all ages of patients, patients of all [[socioeconomic]] and geographic origins, patients seeking to maintain optimal [[health]], and patients with all types of acute and chronic physical, [[mental health|mental]] and social health issues, including [[Polypharmacy|multiple chronic diseases]]. Consequently, a primary care practitioner must possess a wide breadth of knowledge in many areas. [[Transitional care#continuity|Continuity]] is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine check-ups and [[preventive medicine|preventive care]], [[health education]], and every time they require an initial consultation about a new health problem. The [[International Classification of Primary Care]] (ICPC) is a standardized tool for understanding and analyzing information on interventions in primary care based on the reason for the patient's visit.<ref>World Health Organization. [https://www.who.int/classifications/icd/adaptations/icpc2/en/index.html ''International Classification of Primary Care, Second edition (ICPC-2)''.] {{Webarchive|url=https://web.archive.org/web/20201222160335/https://www.who.int/classifications/icd/adaptations/icpc2/en/ |date=2020-12-22 }} Geneva. Accessed 24 June 2011.</ref> |
|||
[[Biomedical research]] (or [[experimental medicine]]), in general simply known as [[medical research]], is the [[basic research]], [[applied research]], or [[translational research]] conducted to aid the body of knowledge in the field of [[medicine]]. Medical research can be divided into two general categories: the evaluation of new treatments for both safety and efficacy in what are termed [[clinical trial]]s, and all other research that contributes to the development of new treatments. The latter is termed [[Pre-clinical development|preclinical research]] if its goal is specifically to elaborate knowledge for the development of new therapeutic strategies. A new paradigm to biomedical research is being termed [[translational research]], which focuses on iterative feedback loops between the basic and clinical research domains to accelerate knowledge translation from the bedside to the bench, and back again. |
|||
Common chronic illnesses usually treated in primary care may include, for example, [[hypertension]], [[Diabetes mellitus|diabetes]], [[asthma]], [[chronic obstructive pulmonary disease|COPD]], [[Major depressive disorder|depression]] and [[Anxiety disorder|anxiety]], [[back pain]], [[Osteoarthritis|arthritis]] or [[Thyroid disease|thyroid dysfunction]]. Primary care also includes many basic [[maternal health|maternal]] and child health care services, such as [[family planning]] services and [[vaccination]]s. In the United States, the 2013 [[National Health Interview Survey]] found that skin disorders (42.7%), osteoarthritis and joint disorders (33.6%), back problems (23.9%), disorders of lipid metabolism (22.4%), and upper respiratory tract disease (22.1%, excluding asthma) were the most common reasons for accessing a physician.<ref>{{cite journal |vauthors=St Sauver JL, Warner DO, Yawn BP, etal |title=Why patients visit their doctors: assessing the most prevalent conditions in a defined American population |journal=Mayo Clin. Proc. |volume=88 |issue=1 |pages=56–67 |date=January 2013 |pmid=23274019 |doi=10.1016/j.mayocp.2012.08.020 |pmc=3564521}}</ref> |
|||
In terms of pharmaceutical R&D spending, [[Europe]] spends a little less than the United States (€22.50bn compared to €27.05bn in 2006) and there is less growth in European R&D spending.<ref name="EFPIA">{{cite web|url=http://www.efpia.org/content/Default.asp?PageID=388|title=Europe’s competitiveness|work=[[European Federation of Pharmaceutical Industries and Associations]]|accessdate= February 15, 2010}}</ref><ref name="Europe">{{cite web|title=The Pharmaceutical Industry in Figures|year=2007|url=http://www.efpia.eu/Content/Default.asp?DocID=7024|accessdate=February 15, 2010|work=[[European Federation of Pharmaceutical Industries and Associations]]|format=pdf}}</ref> Pharmaceuticals and other medical devices are the leading high technology exports of Europe and the United States.<ref name="Europe"/><ref name="PHRMA">{{cite web |url=http://www.phrma.org/files/attachments/2008%20Profile.pdf|title=2008 Annual Report|accessdate= February 15, 2010|work=[[Pharmaceutical Research and Manufacturers of America]]}}</ref> However, the United States dominates the [[biopharmaceutical]] field, accounting for the three quarters of the world’s biotechnology revenues and 80% of world R&D spending in biotechnology.<ref name="EFPIA"/><ref name="Europe"/> |
|||
In the United States, primary care physicians have begun to deliver primary care outside of the managed care (insurance-billing) system through [[direct primary care]] which is a subset of the more familiar [[concierge medicine]]. Physicians in this model bill patients directly for services, either on a pre-paid monthly, quarterly, or annual basis, or bill for each service in the office. Examples of direct primary care practices include [[Foundation Health]] in Colorado and [[Qliance]] in Washington.{{cn|date=April 2024}} |
|||
===World Health Organization=== |
|||
{{Main|World Health Organization}} |
|||
{{See also|Global health}} |
|||
The [[World Health Organization]] (WHO) is a specialized [[United Nations]] agency which acts as a coordinator and researcher for [[public health]] around the world. Established on 7 April 1948, and headquartered in [[Geneva]], Switzerland, the agency inherited the mandate and resources of its predecessor, the Health Organization, which had been an agency of the [[League of Nations]]. The WHO's constitution states that its mission "is the attainment by all peoples of the highest possible level of health." Its major task is to combat disease, especially key infectious diseases, and to promote the general health of the peoples of the world. Examples of its work include years of fighting [[smallpox]], which the organization declared in 1979 had been eradicated - the first disease in history to be completely eliminated by deliberate human design. The WHO is nearing success through research activities in developing vaccines against [[malaria]] and [[schistosomiasis]]. |
|||
In the context of global [[population aging]], with increasing numbers of older adults at greater risk of chronic [[non-communicable disease]]s, rapidly increasing demand for primary care services is expected in both developed and developing countries.<ref>World Health Organization. [https://www.who.int/ageing/en/ ''Aging and life course: Our aging world.''] {{Webarchive|url=https://web.archive.org/web/20190611084251/https://www.who.int/ageing/en/ |date=2019-06-11 }} Geneva. Accessed 24 June 2011.</ref><ref>Simmons J. [http://www.healthleadersmedia.com/content/233658/topic/WS_HLM2_PHY/Primary-Care-Needs-New-Innovations-to-Meet-Growing-Demands.html ''Primary Care Needs New Innovations to Meet Growing Demands.''] {{Webarchive|url=https://web.archive.org/web/20110711160400/http://www.healthleadersmedia.com/content/233658/topic/WS_HLM2_PHY/Primary-Care-Needs-New-Innovations-to-Meet-Growing-Demands.html |date=2011-07-11 }} ''HealthLeaders Media'', May 27, 2009.</ref> The [[World Health Organization]] attributes the provision of essential primary care as an integral component of an inclusive [[primary health care]] strategy.<ref name="Cookie"/> |
|||
The WHO is financed by contributions from member states and from donors. In recent years the WHO's work has involved more collaboration, currently around 80 such partnerships, with [[Non-governmental organization|NGO]]s and the [[pharmaceutical industry]], as well as with foundations such as the [[Bill and Melinda Gates Foundation]] and the [[Rockefeller Foundation]]. Research programmes implemented or supported by the WHO include strengthening health systems research<ref>[http://www.who.int/alliance-hpsr/en/index.html WHO Alliance for Health Policy and Systems Research]</ref>, improving access to health research and literature in developing countries <ref>[http://www.who.int/hinari/en/ HINARI Access to Research in Health Programme]</ref>, as well as research on neglected tropical diseases <ref>[http://apps.who.int/tdr/svc/research WHO TDR Research on neglected priority needs]</ref>, women's reproductive health<ref>[http://www.who.int/hrp/en/index.html Special Programme of Research, Development and Research Training in Human Reproduction]</ref> and other priority areas. |
|||
===Secondary care=== |
|||
==Economics== |
|||
[[File:Aerial-Picture-of-Jackson-e1445995779731.jpg|thumb|upright=1.1|[[Jackson Memorial Hospital]] in [[Miami]], the primary teaching hospital of the [[University of Miami]]'s [[Miller School of Medicine]] and the largest hospital in the United States with 1,547 beds<ref>[https://www.beckershospitalreview.com/100-of-the-largest-hospitals-and-health-systems-in-america-2021.html "100 of the largest hospitals and health systems in America"] {{Webarchive|url=https://web.archive.org/web/20220602024829/https://www.beckershospitalreview.com/100-of-the-largest-hospitals-and-health-systems-in-america-2021.html |date=2 June 2022 }}, ''Becker's Hospital Review''</ref>]] |
|||
{{Main|Health economics}} |
|||
'''Secondary care''' includes [[acute care]]: necessary treatment for a short period of time for a brief but serious illness, injury, or other health condition. This care is often found in a [[hospital]] [[emergency department]]. Secondary care also includes skilled attendance during [[childbirth]], [[intensive care medicine|intensive care]], and [[medical imaging]] services.<ref>{{cite web|url=https://medical-dictionary.thefreedictionary.com/health+care+system|title=Health Care System|website=the Free Medical Dictionary|access-date=December 21, 2020|archive-date=5 February 2021|archive-url=https://web.archive.org/web/20210205030143/https://medical-dictionary.thefreedictionary.com/health%20care%20system|url-status=live}}</ref> |
|||
The term "secondary care" is sometimes used synonymously with "hospital care". However, many secondary care providers, such as [[psychiatrists]], [[clinical psychology|clinical psychologists]], [[occupational therapists]], most [[dental specialties]] or [[physiotherapist]]s, do not necessarily work in hospitals. Some primary care services are delivered within hospitals. Depending on the organization and policies of the national health system, patients may be required to see a primary care provider for a [[referral (medicine)|referral]] before they can access secondary care.<ref>{{cite web|url=https://mstrust.org.uk/a-z/care-in-the-nhs#:~:text=Secondary%20care%20refers%20to%20services,first%20contact%20with%20a%20patient.&text=Secondary%20care%20services%20are%20usually,services%20may%20be%20community%20based.|title=Secondary Care|website=MS Trust|access-date=December 22, 2020|archive-date=5 February 2021|archive-url=https://web.archive.org/web/20210205025603/https://mstrust.org.uk/a-z/care-in-the-nhs#:~:text=Secondary%20care%20refers%20to%20services,first%20contact%20with%20a%20patient.&text=Secondary%20care%20services%20are%20usually,services%20may%20be%20community%20based.|url-status=live}}</ref><ref>{{cite web|url=https://www.einsure.com/blog/the-difference-between-primary-secondary-and-tertiary-health-care/|title=Difference between primary, secondary and tertiary health care|website=EInsure|date=24 January 2017|access-date=December 21, 2020|archive-date=6 May 2021|archive-url=https://web.archive.org/web/20210506205753/https://www.einsure.com/blog/the-difference-between-primary-secondary-and-tertiary-health-care/|url-status=live}}</ref> |
|||
[[Health economics]] is a branch of [[economics]] concerned with issues related to scarcity in the allocation of [[health]] and health care. Broadly, health economists study the functioning of the health care system and the private and social causes of health-affecting behaviors such as smoking. |
|||
In countries that operate under a [[mixed market]] health care system, some [[physician]]s limit their practice to secondary care by requiring patients to see a primary care provider first. This restriction may be imposed under the terms of the payment agreements in private or group [[health insurance]] plans. In other cases, [[Medical specialty|medical specialists]] may see patients without a referral, and patients may decide whether self-referral is preferred.{{cn|date=April 2024}} |
|||
A seminal 1963 article by [[Kenneth Arrow]], often credited with giving rise to the health economics as a discipline, drew conceptual distinctions between health and other goals.<ref name=Arrow>Arrow, K. (1963) Uncertainty and the welfare economics of medical care. ''American Economic Review'', 53:941-73.</ref> |
|||
Factors that distinguish health economics from other areas include extensive [[government intervention]], intractable [[uncertainty]] in several dimensions, [[information asymmetry|asymmetric information]], and [[externalities]].<ref>Phelps, Charles E. (2002) Health Economics 3rd Ed. Addison Wesley. Boston, MA</ref> Governments tend to regulate the health care industry heavily and also tend to be the largest [[payer]] within the market. Uncertainty is intrinsic to health, both in patient outcomes and financial concerns. The knowledge gap that exists between a physician and a patient can prevent the patient from accurately describing his symptoms or enable the physician to prescribe unnecessary but profitable services; these imbalances lead to market failures resulting from [[asymmetric information]]. [[Externalities]] arise frequently when considering health and health care, notably in the context of infectious disease. For example, making an effort to avoid catching a cold, or practicing safer sex, affects people other than the decision maker. |
|||
In other countries patient self-referral to a [[medical specialist]] for secondary care is rare as prior referral from another physician (either a primary care physician or another specialist) is considered necessary, regardless of whether the funding is from [[Health insurance|private insurance schemes]] or [[national health insurance]].{{cn|date=April 2024}} |
|||
The scope of health economics is neatly encapsulated by Alan William's "plumbing diagram"<ref>Williams A (1987) "Health economics: the cheerful face of a dismal science" in Williams A (ed.) ''Health and Economics'', Macmillan: London</ref> dividing the discipline into eight distinct topics: |
|||
* What influences health? (other than health care) |
|||
* What is health and what is its value |
|||
* The [[Demand (economics)|demand]] for health care |
|||
* The [[Supply (economics)|supply]] of health care |
|||
* [[Micro-economic]] evaluation at [[therapy|treatment]] level |
|||
* [[Market equilibrium]] |
|||
* Evaluation at whole system level; and, |
|||
* Planning, [[budgeting]] and monitoring mechanisms. |
|||
[[Allied health professions|Allied health professionals]], such as [[physical therapy|physical therapists]], [[respiratory therapists]], [[occupational therapist]]s, [[Speech and language pathology|speech therapists]], and [[dietitians]], also generally work in secondary care, accessed through either patient self-referral or through physician referral.{{cn|date=May 2024}} |
|||
Consuming just under 10 percent of [[gross domestic product]] of most developed nations, health care can form an enormous part of a country's [[Economic system|economy]]. In 2008, health care consumed an average of 9.0 percent of GDP across the [[OECD]] countries<ref>[http://www.oecd.org/document/11/0,3343,en_21571361_44315115_45549771_1_1_1_1,00.html OECD data]</ref> with the United States (16.0%), [[France]] (11.2%), and [[Switzerland]] (10.7%)being the top three spenders. |
|||
===Tertiary care=== |
|||
The United States and Canada account for 48% of world pharmaceutical sales, while Europe, Japan, and all other nations account for 30%, 9%, and 13%, respectively.<ref name="Europe"/> United States accounts for the three quarters of the world’s biotechnology revenues. |
|||
[[File:NationalNeurologyHospital.jpg|thumb|right|upright=1.1|[[National Hospital for Neurology and Neurosurgery]] in [[London]], [[United Kingdom]] is a specialist neurological hospital.]] |
|||
'''Tertiary care''' is specialized consultative health care, usually for [[inpatient]]s and on referral from a primary or secondary health professional, in a facility that has personnel and facilities for advanced [[medicine|medical]] investigation and treatment, such as a [[tertiary referral hospital]].<ref>Johns Hopkins Medicine. [http://www.hopkinsmedicine.org/patient_care/pay_bill/insurance_footnotes.html ''Patient Care: Tertiary Care Definition''.] {{Webarchive|url=https://web.archive.org/web/20170711120409/http://www.hopkinsmedicine.org/patient_care/pay_bill/insurance_footnotes.html |date=2017-07-11 }} Accessed 27 June 2011.</ref> |
|||
Examples of tertiary care services are [[cancer]] management, [[neurosurgery]], [[cardiac surgery]], [[plastic surgery]], treatment for severe [[burn]]s, advanced [[neonatology]] services, palliative, and other complex medical and surgical interventions.<ref name="Emory">Emory University. [http://www.em.emory.edu/hospital_eu.html School of Medicine.] {{Webarchive|url=https://web.archive.org/web/20110423081310/http://www.em.emory.edu/hospital_eu.html |date=2011-04-23 }} Accessed 27 June 2011.</ref> |
|||
==Systems== |
|||
[[File:A group of Damas de Rojo.jpg|thumb|A group of [[Chile]]an 'Damas de Rojo' volunteering at their local hospital.]] |
|||
{{Main|Health care system}} |
|||
{{See also|Preventive medicine|Social medicine}} |
|||
=== Quaternary care === |
|||
[[Social health insurance]] is where a nation's entire population is eligible for health care coverage, and this coverage and the services provided are regulated. In almost every country, state or municipality with a government health care system a parallel private, and usually for-profit, system is allowed to operate. This is sometimes referred to as [[two-tier health care]]. The scale, extent, and funding of these private systems is variable. |
|||
The term '''quaternary care''' is sometimes used as an extension of tertiary care in reference to advanced levels of medicine which are highly [[Medical specialist|specialized]] and not widely accessed. [[Clinical research|Experimental medicine]] and some types of uncommon [[diagnosis|diagnostic]] or [[surgery|surgical]] procedures are considered quaternary care. These services are usually only offered in a limited number of regional or national health care centers.<ref name="Emory"/><ref>Alberta Physician Link. [http://www.albertaphysicianlink.ab.ca/orientation_guide/levels-of-care.html ''Levels of Care''.] {{Webarchive|url=https://web.archive.org/web/20140614134839/http://www.albertaphysicianlink.ab.ca/orientation_guide/levels-of-care.html |date=2014-06-14 }} Retrieved 26 August 2014.</ref> |
|||
===Home and community care=== |
|||
A traditional view is that improvements in health result from advancements in medical science. The [[medical model]] of health focuses on the eradication of [[illness]] through [[medical diagnosis|diagnosis]] and effective treatment. In contrast, the social model of health places emphasis on changes that can be made in society and in people's own lifestyles to make the population healthier. It defines ''illness'' from the point of view of the individual's functioning within their society rather than by monitoring for changes in [[biological]] or [[physiological]] signs.<ref>{{cite book | author=Bond J. & Bond S. | title=Sociology and Health Care| publisher=Churchill Livingstone| year=1994 | isbn=0-443-04059-1}}</ref> |
|||
{{See also|Public health}} |
|||
Many types of health care interventions are delivered outside of health facilities. They include many interventions of [[public health]] interest, such as [[food safety]] surveillance, distribution of [[condom]]s and [[needle-exchange programme|needle-exchange programs]] for the prevention of transmissible diseases.{{cn|date=April 2024}} |
|||
They also include the services of professionals in residential and community settings in support of [[self-care]], [[home care]], [[long-term care]], [[assisted living]], treatment for [[substance use disorder]]s among other types of health and social care services.{{cn|date=April 2024}} |
|||
The United States currently operates under a [[mixed market]] health care system. Government sources (federal, state, and local) account for 45% of U.S. health care expenditures.<ref>CMS Annual Statistics, [http://www.cms.hhs.gov/NationalHealthExpendData/downloads/proj2008.pdf United States Department of Health and Human Services]</ref> Private sources account for the remainder of costs, with 38% of people receiving health coverage through their employers and 17% arising from other private payment such as private insurance and out-of-pocket co-pays. Opponents of government intervention into the market generally believe that such intervention distorts pricing as government agents would be operating outside of the corporate model and the principles of [[market discipline]]; they have less short and medium-term incentives than private agents to make purchases that can generate revenues and avoid bankruptcy. Health system reform in the United States usually focuses around three suggested systems, with proposals currently underway to integrate these systems in various ways to provide a number of health care options. First is [[Single-payer health care|single-payer]], a term meant to describe a single agency managing a single system, as found in most modernized countries as well as some states and municipalities within the United States. Second are employer or individual insurance mandates, with which the state of Massachusetts has experimented. Finally, there is consumer-driven health, in which systems, consumers, and patients have more control of how they access care. This is argued{{By whom|date=September 2009}} to provide a greater incentive to find cost-saving health care approaches. Critics of consumer-driven health say that it would benefit the healthy but be insufficient for the chronically sick, much as the current system operates. Over the past thirty years, most of the nation's health care has moved from the second model operating with not-for-profit institutions to the third model operating with for-profit institutions; the greater problems with this approach have been the gradual deregulation of HMOs resulting in fewer of the promised choices for consumers, and the steady increase in consumer costs that have marginalized consumers and burdened states with excessive urgent health care costs that are avoided when consumers actually have adequate access to preventive health care. |
|||
Community [[Physical therapy|rehabilitation]] services can assist with mobility and independence after the loss of limbs or loss of function. This can include [[prosthesis|prostheses]], [[orthotics]], or [[wheelchair]]s.{{cn|date=April 2024}} |
|||
A few states have taken serious steps toward universal health care coverage, most notably [[Minnesota]], [[Massachusetts]] and [[Connecticut]], with recent examples being the [[Massachusetts 2006 Health Reform Statute]]<ref>[http://usliberals.about.com/od/healthcare/i/MassHealthIns.htm About.com's Pros & Cons of Massachusetts' Mandatory Health Insurance Program]</ref> and Connecticut's [[SustiNet]] plan to provide quality, affordable health care to state residents.<ref>http://www.aarp.org/states/ct/advocacy/articles/in_historic_vote_legislature_overrides_sustinet_veto.html</ref> |
|||
Many countries are dealing with aging populations, so one of the priorities of the health care system is to help seniors live full, independent lives in the comfort of their own homes. There is an entire section of health care geared to providing seniors with help in day-to-day activities at home such as transportation to and from doctor's appointments along with many other activities that are essential for their health and well-being. Although they provide home care for older adults in cooperation, family members and care workers may harbor diverging attitudes and values towards their joint efforts. This state of affairs presents a challenge for the design of ICT (information and communication technology) for home care.<ref>{{Cite conference |
|||
==Politics== |
|||
| last1 = Christensen |
|||
{{Main|Health policy}} |
|||
| first1 = L.R. |
|||
All countries have different [[health policy|policies and plans]] in relation to health care goals within their societies. The nature of these policies and the politics leading to the decisions taken depend on which country one is in. In the United States, the social and political issues surrounding [[US health care reform|access to health care]] have led to vigorous public debate and the almost colloquial use of terms such as health care (medical management of illness), [[health insurance]] (reimbursement of health care costs), and [[public health]] (the collective state and range of health in a population). In the United States 12% to 16% of the citizens do not have health insurance. State boards and the Department of Health regulate inpatient care to reduce the national health care deficit. To tackle the problems of the perpetually increasing number of uninsured, and costs associated with the US health care system, President [[Barack Obama]] says he favors the creation of a universal health care system.<ref>[http://obama.senate.gov/speech/070125-the_time_has_co/ The Time Has Come for Universal Health Care | U.S. Senator Barack Obama<!-- Bot generated title -->]</ref> However, ''[[New York Times]]'' opinion columnist [[Paul Krugman]] said that Obama's plan would not actually provide universal coverage,<ref>{{cite news|url=http://www.nytimes.com/2008/02/04/opinion/04krugman.html|title=Clinton, Obama, Insurance|first=Paul|last=Krugman|date=February 4, 2008 | work=The New York Times}}</ref> and [[Factcheck.org]] alleges that Obama's predicted savings were exaggerated.<ref>[http://www.newsweek.com/id/141829 Obama's Inflated Health Savings]</ref> In contrast, the state of Oregon and the city of San Francisco are both examples of governments that adopted universal healthcare systems for strictly fiscal reasons. |
|||
| last2= Grönvall |
|||
| first2= E. |
|||
| title = ECSCW 2011: Proceedings of the 12th European Conference on Computer Supported Cooperative Work, 24–28 September 2011, Aarhus Denmark |
|||
| chapter = Challenges and Opportunities for Collaborative Technologies for Home Care Work |
|||
|editor=S. Bødker |editor2=N. O. Bouvin |editor3=W. Letters |editor4=V. Wulf |editor5=L. Ciolfi |
|||
| book-title= ECSCW 2011: Proceedings of the 12th European Conference on Computer Supported Cooperative Work, 24–28 September 2011, Aarhus Denmark |
|||
|location=London |
|||
| pages = 61–80 |
|||
| publisher = Springer |
|||
| year = 2011 |
|||
| doi = 10.1007/978-0-85729-913-0_4 |
|||
| isbn = 978-0-85729-912-3 }}</ref> |
|||
Because statistics show that over 80 million Americans have taken time off of their primary employment to care for a loved one,<ref>{{Cite news|url=https://www.nytimes.com/2017/08/29/business/economy/home-health-care-work.html|title=Home Health Care: Shouldn't It Be Work Worth Doing?|last=Porter|first=Eduardo|date=2017-08-29|work=The New York Times|access-date=2017-11-29|language=en-US|issn=0362-4331|archive-date=2020-12-22|archive-url=https://web.archive.org/web/20201222160411/https://www.nytimes.com/2017/08/29/business/economy/home-health-care-work.html|url-status=live}}</ref> many countries have begun offering programs such as the Consumer Directed Personal Assistant Program to allow family members to take care of their loved ones without giving up their entire income.{{citation needed|date=November 2017}} |
|||
Current health care concerns in England revolve around the use of [[private finance initiative]]s to build hospitals which it is argued costs taxpayers more in the long run.<ref>[http://news.bbc.co.uk/2/hi/uk_news/england/norfolk/8077611.stm PFI hospital 'costing £20m more'] BBC report on research findings showing that PFI can cost taxpayers more in the long run</ref> In Germany and France, concerns are more based on the rising cost of drugs to the governments. In [[HIV/AIDS in Brazil|Brazil]], an important political issue is the breach of [[intellectual property]] rights, or [[patent]]s, for the domestic manufacture of [[antiretroviral drug]]s used in the treatment of HIV/AIDS. |
|||
With obesity in children rapidly becoming a major concern, health services often set up programs in schools aimed at educating children about nutritional eating habits, making physical education a requirement and teaching young adolescents to have a positive self-image.<ref>{{Cite journal |last1=Sanyaolu |first1=Adekunle |last2=Okorie |first2=Chuku |last3=Qi |first3=Xiaohua |last4=Locke |first4=Jennifer |last5=Rehman |first5=Saif |date=January 2019 |title=Childhood and Adolescent Obesity in the United States: A Public Health Concern |journal=Global Pediatric Health |language=en |volume=6 |pages=2333794X1989130 |doi=10.1177/2333794X19891305 |issn=2333-794X |pmc=6887808 |pmid=31832491}}</ref> |
|||
The [[HIV/AIDS in South Africa|South African]] government, whose population sets the record for HIV infections, came under pressure for its refusal to admit there is any connection with AIDS<ref>[http://news.bbc.co.uk/1/hi/world/africa/826742.stm BBC News: Controversy dogs Aids forum]</ref> because of the cost it would have involved. |
|||
===Ratings=== |
|||
==Health care by country== |
|||
{{Main|Health care |
{{Main|Health care ratings}} |
||
[[Health care ratings]] are ratings or [[evaluation]]s of health care used to evaluate the process of care and health care structures and/or outcomes of health care services. This information is translated into report cards that are generated by quality organizations, nonprofit, consumer groups and media. This evaluation of quality is based on measures of:{{cn|date=April 2024}} |
|||
Health care systems are composed of individuals and organizations that aim to meet the health care needs of target populations. There are a wide variety of health care systems around the world. In some countries, the health care system planning is distributed among market participants, whereas in others planning is made more centrally among governments, trade unions, charities, religious, or other co-ordinated bodies to deliver planned health care services targeted to the populations they serve. However, health care planning has been described as often evolutionary rather than revolutionary. |
|||
* [[health plan]] quality |
|||
* hospital quality |
|||
* of [[patient experience]] |
|||
* physician quality |
|||
* quality for other health professionals |
|||
==Access to health care== |
|||
==See also== |
|||
{{ |
{{main|Health equity}} |
||
Access to healthcare may vary across countries, communities, and individuals, influenced by social and economic conditions as well as [[health policy|health policies]]. Providing health care services means "the timely use of personal health services to achieve the best possible health outcomes".<ref name="NAP2009"/> Factors to consider in terms of healthcare access include financial limitations (such as insurance coverage), [[Geography|geographical]] and [[Logistics|logistical]] barriers (such as additional transportation costs and the ability to take paid time off work to use such services), [[sociocultural]] expectations, and personal limitations (lack of ability to communicate with health care providers, poor [[health literacy]], low income).<ref name=RHI2021/> Limitations to health care services affects negatively the use of medical services, the efficacy of treatments, and overall outcome (well-being, mortality rates).{{cn|date=April 2024}} |
|||
<!-- Please maintain in alphabetical order --> |
|||
* [[Acronyms in healthcare]] |
|||
* [[Health care providers]] |
|||
* [[Alliance for Healthy Cities]] |
|||
== |
==Related sectors== |
||
Health care extends beyond the delivery of services to patients, encompassing many related sectors, and is set within a bigger picture of financing and governance structures. |
|||
{{Reflist|2}} |
|||
== |
===Health system=== |
||
{{Main|Health system|Health care systems by country}} |
|||
{{Commons category}} |
|||
A '''health system''', also sometimes referred to as '''health care system''' or '''healthcare system''', is the organization of people, institutions, and resources that deliver health care services to populations in need.{{cn|date=April 2024}} |
|||
* [http://thomas.loc.gov/cgi-bin/bdquery/z?d111:H.R.3200: HR3200: America's Affordable Health Choices Act of 2009] |
|||
*{{WhoRunsGov|Issues/Health_Care|Health Care Policymakers}} |
|||
===Industry=== |
|||
{{See also|Healthcare industry|Health economics}} |
|||
The [[healthcare industry]] incorporates several sectors that are dedicated to providing health care services and products. As a basic framework for defining the sector, the United Nations' [[International Standard Industrial Classification]] categorizes health care as generally consisting of hospital activities, medical and dental practice activities, and "other human health activities." The last class involves activities of, or under the supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratories, pathology clinics, residential health facilities, patient advocates<ref>{{cite web | title=Patient advocacy services ensure optimum health outcomes | author=Dorothy Kamaker | date=2015-09-21 | url=http://www.smh.com.au/business/workplace-relations/patient-advocacy-20150920-gjr53j.html | access-date=2015-09-26 | archive-date=2017-12-20 | archive-url=https://web.archive.org/web/20171220213648/http://www.smh.com.au/business/workplace-relations/patient-advocacy-20150920-gjr53j.html | url-status=live }}</ref> or other [[allied health professions]]. |
|||
In addition, according to industry and market classifications, such as the [[Global Industry Classification Standard]] and the [[Industry Classification Benchmark]], health care includes many categories of medical equipment, instruments and services including [[biotechnology]], diagnostic laboratories and substances, drug manufacturing and delivery.{{cn|date=May 2024}} |
|||
For example, pharmaceuticals and other medical devices are the leading high technology exports of Europe and the United States.<ref name="Europe">{{cite web|title=The Pharmaceutical Industry in Figures|year=2007|url=http://www.efpia.eu/|access-date=February 15, 2010|work=[[European Federation of Pharmaceutical Industries and Associations]]|format=pdf|archive-date=December 22, 2020|archive-url=https://web.archive.org/web/20201222160435/https://www.efpia.eu/|url-status=live}}</ref><ref name="PHRMA">{{cite book |title=2008 Annual Report|publisher=[[Pharmaceutical Research and Manufacturers of America]]|year=2008}}</ref> The United States dominates the [[biopharmaceutical]] field, accounting for three-quarters of the world's biotechnology revenues.<ref name="Europe"/><ref name="EFPIA">{{cite web|url=http://www.efpia.org/content/Default.asp?PageID=388|archive-url=https://web.archive.org/web/20090823030103/http://www.efpia.org/content/Default.asp?PageID=388|archive-date=23 August 2009 |title=Europe's competitiveness|work=[[European Federation of Pharmaceutical Industries and Associations]]|access-date= February 15, 2010}}</ref> |
|||
===Research=== |
|||
{{main|Medical research|Nursing research}} |
|||
{{For outline|Healthcare science}} |
|||
The quantity and quality of many health care interventions are improved through the results of science, such as advanced through the [[medical model]] of health which focuses on the eradication of [[illness]] through [[medical diagnosis|diagnosis]] and effective treatment. Many important advances have been made through health research, [[biomedical research]] and [[pharmaceutical research]], which form the basis for [[evidence-based medicine]] and [[evidence-based practice]] in health care delivery. Health care research frequently engages directly with patients, and as such issues for whom to engage and how to engage with them become important to consider when seeking to actively include them in studies. While single best practice does not exist, the results of a systematic review on patient engagement suggest that research methods for patient selection need to account for both patient availability and willingness to engage.<ref>{{Cite journal|last1=Domecq|first1=Juan Pablo|last2=Prutsky|first2=Gabriela|last3=Elraiyah|first3=Tarig|last4=Wang|first4=Zhen|last5=Nabhan|first5=Mohammed|last6=Shippee|first6=Nathan|last7=Brito|first7=Juan Pablo|last8=Boehmer|first8=Kasey|last9=Hasan|first9=Rim|last10=Firwana|first10=Belal|last11=Erwin|first11=Patricia|date=2014-02-26|title=Patient engagement in research: a systematic review|journal=BMC Health Services Research|volume=14|issue=1|pages=89|doi=10.1186/1472-6963-14-89|pmid=24568690|pmc=3938901|issn=1472-6963|doi-access=free}}</ref> |
|||
[[Health services research]] can lead to greater efficiency and equitable delivery of health care interventions, as advanced through the [[social model of disability|social model of health and disability]], which emphasizes the societal changes that can be made to make populations healthier.<ref>{{cite book |author1=Bond J. |author2=Bond S. | title=Sociology and Health Care| publisher=Churchill Livingstone| year=1994 | isbn=978-0-443-04059-7}}</ref> Results from health services research often form the basis of [[evidence-based policy]] in health care systems. [[Health services research]] is also aided by initiatives in the field of artificial intelligence for the development of systems of health assessment that are clinically useful, timely, sensitive to change, [[culturally sensitive]], low-burden, low-cost, built into standard procedures, and involve the patient.<ref name = "campro"> |
|||
{{cite conference |
|||
| author = Erik Cambria |author2=Tim Benson |author3=Chris Eckl |author4=Amir Hussain |
|||
| title = Sentic PROMs: Application of Sentic Computing to the Development of a Novel Unified Framework for Measuring Health-Care Quality |
|||
| book-title = Expert Systems with Applications, Elsevier |
|||
| year = 2012 |
|||
|volume=39 |issue=12 |pages=10533–10543 | doi = 10.1016/j.eswa.2012.02.120 |
|||
}} |
|||
</ref> |
|||
===Financing=== |
|||
{{See also|Healthcare system|Health policy|Universal health care|Health spending as percent of gross domestic product (GDP) by country|List of countries by total health expenditure per capita}} |
|||
There are generally five primary methods of funding [[health care systems]]:<ref>World Health Organization. [http://whqlibdoc.who.int/searo/2004/SEA_HSD_274_eng.pdf "Regional Overview of Social Health Insurance in South-East Asia.'] {{Webarchive|url=https://web.archive.org/web/20120903195354/http://whqlibdoc.who.int/searo/2004/SEA_HSD_274_eng.pdf |date=2012-09-03 }} Retrieved December 02, 2014.</ref> |
|||
# General [[taxation]] to the state, county or municipality |
|||
# [[social insurance|Social health insurance]] |
|||
# Voluntary or private [[health insurance]] |
|||
# [[Out-of-pocket expenses|Out-of-pocket payments]] |
|||
# [[Donation]]s to health [[charities]] |
|||
[[File:Life expectancy vs healthcare spending.jpg|thumb|upright=1.4|Life expectancy vs healthcare spending of rich [[OECD]] countries. [[List of countries by total health expenditure per capita|US average of $10,447 in 2018]].<ref name="life">[https://ourworldindata.org/the-link-between-life-expectancy-and-health-spending-us-focus Link between health spending and life expectancy: US is an outlier] {{Webarchive|url=https://web.archive.org/web/20220311193123/https://ourworldindata.org/the-link-between-life-expectancy-and-health-spending-us-focus|date=11 March 2022}}. May 26, 2017. By [[Max Roser]] at [[Our World in Data]]. Click the sources tab under the chart for info on the countries, healthcare expenditures, and data sources. See the later version of the chart [https://ourworldindata.org/us-life-expectancy-low here] {{Webarchive|url=https://web.archive.org/web/20220305030958/https://ourworldindata.org/us-life-expectancy-low|date=5 March 2022}}.</ref>]] |
|||
In most countries, there is a mix of all five models, but this varies across countries and over time within countries. Aside from financing mechanisms, an important question should always be how much to spend on health care. For the purposes of comparison, this is often expressed as the percentage of GDP spent on health care. In [[OECD]] countries for every extra $1000 spent on health care, life expectancy falls by 0.4 years.<ref>{{Cite web|date=2021-03-02|title=Improve operational efficiency in healthcare with RPA|url=https://www.nuaig.ai/improve-operational-efficiency-in-healthcare-with-rpa/|access-date=2021-05-27|website=NuAIg|language=en-US|archive-date=27 May 2021|archive-url=https://web.archive.org/web/20210527055633/https://www.nuaig.ai/improve-operational-efficiency-in-healthcare-with-rpa/|url-status=live}}</ref> A similar correlation is seen from the analysis carried out each year by Bloomberg.<ref name="auto">{{Cite web|url=https://www.bloombergquint.com/global-economics/u-s-near-bottom-of-health-index-hong-kong-and-singapore-at-top|title=These Are the Economies With the Most (and Least) Efficient Health Care|website=BloombergQuint|date=19 September 2018 |access-date=2019-01-14|archive-date=2020-12-22|archive-url=https://web.archive.org/web/20201222160336/https://www.bloombergquint.com/global-economics/u-s-near-bottom-of-health-index-hong-kong-and-singapore-at-top|url-status=live}}</ref> Clearly this kind of analysis is flawed in that life expectancy is only one measure of a health system's performance, but equally, the notion that more funding is better is not supported.{{cn|date=April 2024}} |
|||
In 2011, the [[health care industry]] consumed an average of 9.3 percent of the [[gross domestic product|GDP]] or [[United States dollar|US$]] 3,322 ([[Purchasing power parity|PPP-adjusted]]) per capita across the 34 members of [[Organisation for Economic Co-operation and Development|OECD]] countries. The US (17.7%, or US$ PPP 8,508), the [[Netherlands]] (11.9%, 5,099), [[France]] (11.6%, 4,118), [[Germany]] (11.3%, 4,495), [[Canada]] (11.2%, 5669), and [[Switzerland]] (11%, 5,634) were the top spenders, however [[life expectancy|life expectancy in total population at birth]] was highest in Switzerland (82.8 years), [[Japan]] and [[Italy]] (82.7), [[Spain]] and [[Iceland]] (82.4), France (82.2) and [[Australia]] (82.0), while OECD's average exceeds 80 years for the first time ever in 2011: 80.1 years, a gain of 10 years since 1970. The US (78.7 years) ranges only on place 26 among the 34 OECD member countries, but has the highest costs by far. All OECD countries have achieved universal (or almost universal) health coverage, except the US and [[Mexico]].<ref name="OECDHealthGlance">{{cite web|url=http://www.oecd.org/els/health-systems/Health-at-a-Glance-2013-Chart-set.pdf|title=Health at a Glance 2013 – OECD Indicators|publisher=OECD|date=2013-11-21|id=([http://www.oecd.org/health/health-systems/health-at-a-glance.htm link])|pages=5, 39, 46, 48|access-date=2013-11-24|archive-date=2019-04-12|archive-url=https://web.archive.org/web/20190412075105/http://www.oecd.org/els/health-systems/Health-at-a-Glance-2013-Chart-set.pdf|url-status=live}}</ref><ref name="OECDLifeExpectancy">{{cite web |url= http://stats.oecd.org//Index.aspx?QueryId=51904 |title= OECD.StatExtracts, Health, Health Status, Life expectancy, Total population at birth, 2011 |publisher= OECD's iLibrary |year= 2013 |format= online statistics |website= stats.oecd.org/ |access-date= 2013-11-24 |archive-date= 2019-04-02 |archive-url= https://web.archive.org/web/20190402130935/https://stats.oecd.org/Index.aspx?QueryId=51904 |url-status= live }}</ref> (see also [[Health system#International comparisons|international comparisons]].) |
|||
In the [[United States]], where around 18% of GDP is spent on health care,<ref name="auto"/> the [[Commonwealth Fund]] analysis of spend and quality shows a clear correlation between worse quality and higher spending.<ref>{{Cite journal|url=https://www.commonwealthfund.org/health-care-quality-spending-interactive|title=Health Care Quality-Spending Interactive {{!}} Commonwealth Fund|website=www.commonwealthfund.org| year=2018 | doi=10.26099/bf4n-8j57 |language=en|access-date=2019-01-14|archive-date=2020-12-22|archive-url=https://web.archive.org/web/20201222160427/https://www.commonwealthfund.org/health-care-quality-spending-interactive|url-status=live| author1=Commonwealth Fund }}</ref> |
|||
Expand the [[OECD]] charts below to see the breakdown: |
|||
* "Government/compulsory": Government spending and compulsory health insurance. |
|||
* "Voluntary": Voluntary health insurance and private funds such as households' out-of-pocket payments, NGOs and private corporations. |
|||
* They are represented by columns starting at zero. They are not stacked. The 2 are combined to get the total. |
|||
* At the source you can run your cursor over the columns to get the year and the total for that country.<ref name=OECD-barcharts/> |
|||
* Click the table tab at the source to get 3 lists (one after another) of amounts by country: "Total", "Government/compulsory", and "Voluntary".<ref name=OECD-barcharts/> |
|||
<div style="display:inline-table; vertical-align:top;"> |
|||
[[File:Health spending by country. Percent of GDP (Gross domestic product).png|thumb|none|upright=1.4|[[Health spending as a percent of GDP by country (gross domestic product)|Health spending by country]]. Percent of GDP ([[Gross domestic product]]). For example: 11.2% for Canada in 2022. 16.6% for the United States in 2022.<ref name=OECD-barcharts>[[OECD]] Data. [https://data.oecd.org/healthres/health-spending.htm Health resources - Health spending] {{Webarchive|url=https://web.archive.org/web/20200412163054/https://data.oecd.org/healthres/health-spending.htm |date=12 April 2020 }}. {{doi|10.1787/8643de7e-en}}. 2 bar charts: For both: From bottom menus: Countries menu > choose OECD. Check box for "latest data available". Perspectives menu > Check box to "compare variables". Then check the boxes for government/compulsory, voluntary, and total. Click top tab for chart (bar chart). For GDP chart choose "% of GDP" from bottom menu. For per capita chart choose "US dollars/per capita". Click fullscreen button above chart. Click "print screen" key. Click top tab for table, to see data.</ref>]]</div> |
|||
<div style="display:inline-table; vertical-align:top;"> |
|||
[[File:Average annual health spending. US dollars (PPP) per person. OECD countries and more.png|thumb|none|upright=1.4|[[List of countries by total health expenditure per capita|Total healthcare cost per person]]. Public and private spending. US dollars [[Purchasing power parity|PPP]]. For example: $6,319 for Canada in 2022. $12,555 for the US in 2022.<ref name=OECD-barcharts/>]] |
|||
</div> |
|||
===Administration and regulation=== |
|||
{{See also|Health professional requisites}} |
|||
The [[Health administration|management and administration of health care]] is vital to the delivery of health care services. In particular, the practice of health professionals and the operation of health care institutions is typically [[Regulation|regulated]] by national or state/provincial authorities through appropriate regulatory bodies for purposes of [[quality assurance]].<ref>World Health Organization, 2003. ''Quality and accreditation in health care services''. Geneva http://www.who.int/hrh/documents/en/quality_accreditation.pdf {{Webarchive|url=https://web.archive.org/web/20201222160336/https://www.who.int/hrh/documents/en/quality_accreditation.pdf |date=2020-12-22 }}</ref> Most countries have credentialing staff in regulatory boards or [[health department]]s who document the [[Health professional requisites|certification or licensing of health workers]] and their work history.<ref>Tulenko et al., "Framework and measurement issues for monitoring entry into the health workforce." ''Handbook on monitoring and evaluation of human resources for health''. Geneva, World Health Organization, 2012.</ref> |
|||
===Health information technology=== |
|||
{{see|Health information technology|Health information management|Health informatics|eHealth|Health technology}} |
|||
Health information technology (HIT) is "the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication and decision making."<ref>{{cite web|title=Health information technology — HIT|url=http://www.healthit.gov/unintended-consequences/content/glossary.html#h|website=HealthIT.gov|access-date=5 August 2014|archive-date=22 December 2020|archive-url=https://web.archive.org/web/20201222160429/http://www.healthit.gov/unintended-consequences/content/glossary.html#h|url-status=live}}</ref> |
|||
Health information technology components: |
|||
* [[Electronic health record]] (EHR) – An EHR contains a patient's comprehensive medical history, and may include records from multiple providers.<ref name=":0">{{Cite web|url=https://www.healthit.gov/providers-professionals/electronic-medical-records-emr|title=Definition and Benefits of Electronic Medical Records (EMR) {{!}} Providers & Professionals {{!}} HealthIT.gov|website=www.healthit.gov|language=en|access-date=2017-11-27|archive-date=9 September 2017|archive-url=https://web.archive.org/web/20170909080734/https://www.healthit.gov/providers-professionals/electronic-medical-records-emr|url-status=live}}</ref> |
|||
* [[Electronic Medical Record]] (EMR) – An EMR contains the standard medical and clinical data gathered in one's provider's office.<ref name=":0" /> |
|||
* [[Health information exchange]] (HIE) – Health Information Exchange allows health care professionals and patients to appropriately access and securely share a patient's vital medical information electronically.<ref>{{Cite web|url=https://www.healthit.gov/HIE|title=Official Information about Health Information Exchange (HIE) {{!}} Providers & Professionals {{!}} HealthIT.gov|website=www.healthit.gov|language=en|access-date=2017-11-27|archive-date=2020-12-22|archive-url=https://web.archive.org/web/20201222160341/https://www.healthit.gov/topic/health-it-and-health-information-exchange-basics/health-information-exchange|url-status=live}}</ref> |
|||
* [[Medical practice management software]] (MPM) – is designed to streamline the day-to-day tasks of operating a medical facility. Also known as practice management software or practice management system (PMS).{{cn|date=May 2024}} |
|||
* [[Personal health record]] (PHR) – A PHR is a patient's medical history that is maintained privately, for personal use.<ref>{{Cite web|url=https://www.healthit.gov/providers-professionals/faqs/what-personal-health-record|title=What is a personal health record? {{!}} FAQs {{!}} Providers & Professionals {{!}} HealthIT.gov|website=www.healthit.gov|language=en|access-date=2017-11-27|archive-date=2020-12-22|archive-url=https://web.archive.org/web/20201222160342/https://www.healthit.gov/faq/what-personal-health-record-0|url-status=live}}</ref> |
|||
==See also== |
|||
* [[:Category:Health care by country]] |
|||
* [[Global health]] |
|||
* [[Health equity]] |
|||
* [[Health policy]] |
|||
* [[Healthcare system]] / [[Health professionals]] |
|||
* [[Tobacco politics|Tobacco control laws]] |
|||
* [[Universal health care]] |
|||
== References == |
|||
{{Reflist}} |
|||
== External links == |
|||
{{Library resources box}} |
|||
* {{Commons category-inline}} |
|||
* {{Wikivoyage-inline|Travel health}} |
|||
{{World topic|Healthcare in|title=Healthcare by country|noredlinks=yes|state=show}} |
|||
{{Health care}} |
{{Health care}} |
||
{{Articles of the Universal Declaration of Human Rights}} |
|||
{{Particular human rights}} |
{{Particular human rights}} |
||
{{Nursing}} |
|||
{{Medicine}} |
|||
{{Portal bar|Medicine|Society|Health care}} |
|||
{{Authority control}} |
|||
{{DEFAULTSORT:Health Care}} |
{{DEFAULTSORT:Health Care}} |
||
[[Category: |
[[Category:Health care| ]] |
||
[[Category:Primary care]] |
|||
[[Category:Public services]] |
[[Category:Public services]] |
||
[[Category: |
[[Category:Health care quality|*]] |
||
[[Category:Health]] |
|||
[[Category:Public health]] |
|||
[[ar:رعاية صحية]] |
|||
[[Category:Universal health care]] |
|||
[[az:Səhiyyə]] |
|||
[[Category:Health economics]] |
|||
[[bg:Здравеопазване]] |
|||
[[Category:Health sciences]] |
|||
[[cs:Zdravotnictví]] |
|||
[[da:Sundhedsvæsen]] |
|||
[[et:Tervishoid]] |
|||
[[es:Asistencia sanitaria]] |
|||
[[ko:의료]] |
|||
[[hi:स्वास्थ्य सेवा]] |
|||
[[io:Flegado]] |
|||
[[id:Perawatan kesehatan]] |
|||
[[it:Assistenza sanitaria]] |
|||
[[ja:医療]] |
|||
[[no:Helsevesen]] |
|||
[[pl:Opieka zdrowotna]] |
|||
[[pt:Assistência médica]] |
|||
[[ru:Здравоохранение]] |
|||
[[simple:Health care]] |
|||
[[sk:Zdravotníctvo]] |
|||
[[fi:Terveydenhuolto]] |
|||
[[sv:Sjukvård]] |
|||
[[ta:நலம் பேணல்]] |
|||
[[uk:Охорона здоров'я]] |
|||
[[vi:Y tế]] |
|||
[[yi:העלט קעיר]] |
|||
[[zh:医疗卫生]] |
Latest revision as of 18:00, 9 December 2024
Health care, or healthcare, is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health professionals and allied health fields. Medicine, dentistry, pharmacy, midwifery, nursing, optometry, audiology, psychology, occupational therapy, physical therapy, athletic training, and other health professions all constitute health care. The term includes work done in providing primary care, secondary care, tertiary care, and public health.
Access to healthcare may vary across countries, communities, and individuals, influenced by social and economic conditions and health policies. Providing health care services means "the timely use of personal health services to achieve the best possible health outcomes".[3] Factors to consider in terms of healthcare access include financial limitations (such as insurance coverage), geographical and logistical barriers (such as additional transportation costs and the ability to take paid time off work to use such services), sociocultural expectations, and personal limitations (lack of ability to communicate with health care providers, poor health literacy, low income).[4] Limitations to health care services affect negatively the use of medical services, the efficacy of treatments, and overall outcome (well-being, mortality rates).
Health systems are the organizations established to meet the health needs of targeted populations. According to the World Health Organization (WHO), a well-functioning healthcare system requires a financing mechanism, a well-trained and adequately paid workforce, reliable information on which to base decisions and policies, and well-maintained health facilities to deliver quality medicines and technologies.
An efficient healthcare system can contribute to a significant part of a country's economy, development, and industrialization. Health care is an important determinant in promoting the general physical and mental health and well-being of people around the world.[5] An example of this was the worldwide eradication of smallpox in 1980, declared by the WHO, as the first disease in human history to be eliminated by deliberate healthcare interventions.[6]
Delivery
[edit]The delivery of modern health care depends on groups of trained professionals and paraprofessionals coming together as interdisciplinary teams.[7] This includes professionals in medicine, psychology, physiotherapy, nursing, dentistry, midwifery and allied health, along with many others such as public health practitioners, community health workers and assistive personnel, who systematically provide personal and population-based preventive, curative and rehabilitative care services.[citation needed]
While the definitions of the various types of health care vary depending on the different cultural, political, organizational, and disciplinary perspectives, there appears to be some consensus that primary care constitutes the first element of a continuing health care process and may also include the provision of secondary and tertiary levels of care.[8] Health care can be defined as either public or private.[citation needed]
Primary care
[edit]Primary care refers to the work of health professionals who act as a first point of consultation for all patients within the health care system. The primary care model supports first-contact, accessible, continuous, comprehensive and coordinated person-focused care.[10] Such a professional would usually be a primary care physician, such as a general practitioner or family physician. Another professional would be a licensed independent practitioner such as a physiotherapist, or a non-physician primary care provider such as a physician assistant or nurse practitioner. Depending on the locality and health system organization, the patient may see another health care professional first, such as a pharmacist or nurse. Depending on the nature of the health condition, patients may be referred for secondary or tertiary care.[citation needed]
Primary care is often used as the term for the health care services that play a role in the local community. It can be provided in different settings, such as Urgent care centers that provide same-day appointments or services on a walk-in basis.[citation needed]
Primary care involves the widest scope of health care, including all ages of patients, patients of all socioeconomic and geographic origins, patients seeking to maintain optimal health, and patients with all types of acute and chronic physical, mental and social health issues, including multiple chronic diseases. Consequently, a primary care practitioner must possess a wide breadth of knowledge in many areas. Continuity is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine check-ups and preventive care, health education, and every time they require an initial consultation about a new health problem. The International Classification of Primary Care (ICPC) is a standardized tool for understanding and analyzing information on interventions in primary care based on the reason for the patient's visit.[11]
Common chronic illnesses usually treated in primary care may include, for example, hypertension, diabetes, asthma, COPD, depression and anxiety, back pain, arthritis or thyroid dysfunction. Primary care also includes many basic maternal and child health care services, such as family planning services and vaccinations. In the United States, the 2013 National Health Interview Survey found that skin disorders (42.7%), osteoarthritis and joint disorders (33.6%), back problems (23.9%), disorders of lipid metabolism (22.4%), and upper respiratory tract disease (22.1%, excluding asthma) were the most common reasons for accessing a physician.[12]
In the United States, primary care physicians have begun to deliver primary care outside of the managed care (insurance-billing) system through direct primary care which is a subset of the more familiar concierge medicine. Physicians in this model bill patients directly for services, either on a pre-paid monthly, quarterly, or annual basis, or bill for each service in the office. Examples of direct primary care practices include Foundation Health in Colorado and Qliance in Washington.[citation needed]
In the context of global population aging, with increasing numbers of older adults at greater risk of chronic non-communicable diseases, rapidly increasing demand for primary care services is expected in both developed and developing countries.[13][14] The World Health Organization attributes the provision of essential primary care as an integral component of an inclusive primary health care strategy.[8]
Secondary care
[edit]Secondary care includes acute care: necessary treatment for a short period of time for a brief but serious illness, injury, or other health condition. This care is often found in a hospital emergency department. Secondary care also includes skilled attendance during childbirth, intensive care, and medical imaging services.[16]
The term "secondary care" is sometimes used synonymously with "hospital care". However, many secondary care providers, such as psychiatrists, clinical psychologists, occupational therapists, most dental specialties or physiotherapists, do not necessarily work in hospitals. Some primary care services are delivered within hospitals. Depending on the organization and policies of the national health system, patients may be required to see a primary care provider for a referral before they can access secondary care.[17][18]
In countries that operate under a mixed market health care system, some physicians limit their practice to secondary care by requiring patients to see a primary care provider first. This restriction may be imposed under the terms of the payment agreements in private or group health insurance plans. In other cases, medical specialists may see patients without a referral, and patients may decide whether self-referral is preferred.[citation needed]
In other countries patient self-referral to a medical specialist for secondary care is rare as prior referral from another physician (either a primary care physician or another specialist) is considered necessary, regardless of whether the funding is from private insurance schemes or national health insurance.[citation needed]
Allied health professionals, such as physical therapists, respiratory therapists, occupational therapists, speech therapists, and dietitians, also generally work in secondary care, accessed through either patient self-referral or through physician referral.[citation needed]
Tertiary care
[edit]Tertiary care is specialized consultative health care, usually for inpatients and on referral from a primary or secondary health professional, in a facility that has personnel and facilities for advanced medical investigation and treatment, such as a tertiary referral hospital.[19]
Examples of tertiary care services are cancer management, neurosurgery, cardiac surgery, plastic surgery, treatment for severe burns, advanced neonatology services, palliative, and other complex medical and surgical interventions.[20]
Quaternary care
[edit]The term quaternary care is sometimes used as an extension of tertiary care in reference to advanced levels of medicine which are highly specialized and not widely accessed. Experimental medicine and some types of uncommon diagnostic or surgical procedures are considered quaternary care. These services are usually only offered in a limited number of regional or national health care centers.[20][21]
Home and community care
[edit]Many types of health care interventions are delivered outside of health facilities. They include many interventions of public health interest, such as food safety surveillance, distribution of condoms and needle-exchange programs for the prevention of transmissible diseases.[citation needed]
They also include the services of professionals in residential and community settings in support of self-care, home care, long-term care, assisted living, treatment for substance use disorders among other types of health and social care services.[citation needed]
Community rehabilitation services can assist with mobility and independence after the loss of limbs or loss of function. This can include prostheses, orthotics, or wheelchairs.[citation needed]
Many countries are dealing with aging populations, so one of the priorities of the health care system is to help seniors live full, independent lives in the comfort of their own homes. There is an entire section of health care geared to providing seniors with help in day-to-day activities at home such as transportation to and from doctor's appointments along with many other activities that are essential for their health and well-being. Although they provide home care for older adults in cooperation, family members and care workers may harbor diverging attitudes and values towards their joint efforts. This state of affairs presents a challenge for the design of ICT (information and communication technology) for home care.[22]
Because statistics show that over 80 million Americans have taken time off of their primary employment to care for a loved one,[23] many countries have begun offering programs such as the Consumer Directed Personal Assistant Program to allow family members to take care of their loved ones without giving up their entire income.[citation needed]
With obesity in children rapidly becoming a major concern, health services often set up programs in schools aimed at educating children about nutritional eating habits, making physical education a requirement and teaching young adolescents to have a positive self-image.[24]
Ratings
[edit]Health care ratings are ratings or evaluations of health care used to evaluate the process of care and health care structures and/or outcomes of health care services. This information is translated into report cards that are generated by quality organizations, nonprofit, consumer groups and media. This evaluation of quality is based on measures of:[citation needed]
- health plan quality
- hospital quality
- of patient experience
- physician quality
- quality for other health professionals
Access to health care
[edit]Access to healthcare may vary across countries, communities, and individuals, influenced by social and economic conditions as well as health policies. Providing health care services means "the timely use of personal health services to achieve the best possible health outcomes".[3] Factors to consider in terms of healthcare access include financial limitations (such as insurance coverage), geographical and logistical barriers (such as additional transportation costs and the ability to take paid time off work to use such services), sociocultural expectations, and personal limitations (lack of ability to communicate with health care providers, poor health literacy, low income).[4] Limitations to health care services affects negatively the use of medical services, the efficacy of treatments, and overall outcome (well-being, mortality rates).[citation needed]
Related sectors
[edit]Health care extends beyond the delivery of services to patients, encompassing many related sectors, and is set within a bigger picture of financing and governance structures.
Health system
[edit]A health system, also sometimes referred to as health care system or healthcare system, is the organization of people, institutions, and resources that deliver health care services to populations in need.[citation needed]
Industry
[edit]The healthcare industry incorporates several sectors that are dedicated to providing health care services and products. As a basic framework for defining the sector, the United Nations' International Standard Industrial Classification categorizes health care as generally consisting of hospital activities, medical and dental practice activities, and "other human health activities." The last class involves activities of, or under the supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratories, pathology clinics, residential health facilities, patient advocates[25] or other allied health professions.
In addition, according to industry and market classifications, such as the Global Industry Classification Standard and the Industry Classification Benchmark, health care includes many categories of medical equipment, instruments and services including biotechnology, diagnostic laboratories and substances, drug manufacturing and delivery.[citation needed]
For example, pharmaceuticals and other medical devices are the leading high technology exports of Europe and the United States.[26][27] The United States dominates the biopharmaceutical field, accounting for three-quarters of the world's biotechnology revenues.[26][28]
Research
[edit]The quantity and quality of many health care interventions are improved through the results of science, such as advanced through the medical model of health which focuses on the eradication of illness through diagnosis and effective treatment. Many important advances have been made through health research, biomedical research and pharmaceutical research, which form the basis for evidence-based medicine and evidence-based practice in health care delivery. Health care research frequently engages directly with patients, and as such issues for whom to engage and how to engage with them become important to consider when seeking to actively include them in studies. While single best practice does not exist, the results of a systematic review on patient engagement suggest that research methods for patient selection need to account for both patient availability and willingness to engage.[29]
Health services research can lead to greater efficiency and equitable delivery of health care interventions, as advanced through the social model of health and disability, which emphasizes the societal changes that can be made to make populations healthier.[30] Results from health services research often form the basis of evidence-based policy in health care systems. Health services research is also aided by initiatives in the field of artificial intelligence for the development of systems of health assessment that are clinically useful, timely, sensitive to change, culturally sensitive, low-burden, low-cost, built into standard procedures, and involve the patient.[31]
Financing
[edit]There are generally five primary methods of funding health care systems:[32]
- General taxation to the state, county or municipality
- Social health insurance
- Voluntary or private health insurance
- Out-of-pocket payments
- Donations to health charities
In most countries, there is a mix of all five models, but this varies across countries and over time within countries. Aside from financing mechanisms, an important question should always be how much to spend on health care. For the purposes of comparison, this is often expressed as the percentage of GDP spent on health care. In OECD countries for every extra $1000 spent on health care, life expectancy falls by 0.4 years.[34] A similar correlation is seen from the analysis carried out each year by Bloomberg.[35] Clearly this kind of analysis is flawed in that life expectancy is only one measure of a health system's performance, but equally, the notion that more funding is better is not supported.[citation needed]
In 2011, the health care industry consumed an average of 9.3 percent of the GDP or US$ 3,322 (PPP-adjusted) per capita across the 34 members of OECD countries. The US (17.7%, or US$ PPP 8,508), the Netherlands (11.9%, 5,099), France (11.6%, 4,118), Germany (11.3%, 4,495), Canada (11.2%, 5669), and Switzerland (11%, 5,634) were the top spenders, however life expectancy in total population at birth was highest in Switzerland (82.8 years), Japan and Italy (82.7), Spain and Iceland (82.4), France (82.2) and Australia (82.0), while OECD's average exceeds 80 years for the first time ever in 2011: 80.1 years, a gain of 10 years since 1970. The US (78.7 years) ranges only on place 26 among the 34 OECD member countries, but has the highest costs by far. All OECD countries have achieved universal (or almost universal) health coverage, except the US and Mexico.[36][37] (see also international comparisons.)
In the United States, where around 18% of GDP is spent on health care,[35] the Commonwealth Fund analysis of spend and quality shows a clear correlation between worse quality and higher spending.[38]
Expand the OECD charts below to see the breakdown:
- "Government/compulsory": Government spending and compulsory health insurance.
- "Voluntary": Voluntary health insurance and private funds such as households' out-of-pocket payments, NGOs and private corporations.
- They are represented by columns starting at zero. They are not stacked. The 2 are combined to get the total.
- At the source you can run your cursor over the columns to get the year and the total for that country.[39]
- Click the table tab at the source to get 3 lists (one after another) of amounts by country: "Total", "Government/compulsory", and "Voluntary".[39]
Administration and regulation
[edit]The management and administration of health care is vital to the delivery of health care services. In particular, the practice of health professionals and the operation of health care institutions is typically regulated by national or state/provincial authorities through appropriate regulatory bodies for purposes of quality assurance.[40] Most countries have credentialing staff in regulatory boards or health departments who document the certification or licensing of health workers and their work history.[41]
Health information technology
[edit]Health information technology (HIT) is "the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication and decision making."[42]
Health information technology components:
- Electronic health record (EHR) – An EHR contains a patient's comprehensive medical history, and may include records from multiple providers.[43]
- Electronic Medical Record (EMR) – An EMR contains the standard medical and clinical data gathered in one's provider's office.[43]
- Health information exchange (HIE) – Health Information Exchange allows health care professionals and patients to appropriately access and securely share a patient's vital medical information electronically.[44]
- Medical practice management software (MPM) – is designed to streamline the day-to-day tasks of operating a medical facility. Also known as practice management software or practice management system (PMS).[citation needed]
- Personal health record (PHR) – A PHR is a patient's medical history that is maintained privately, for personal use.[45]
See also
[edit]- Category:Health care by country
- Global health
- Health equity
- Health policy
- Healthcare system / Health professionals
- Tobacco control laws
- Universal health care
References
[edit]- ^ "Hospital beds per 1,000 people". Our World in Data. Archived from the original on 12 April 2020. Retrieved 7 March 2020.
- ^ "Governor Hochul, Mayor Adams Announce Plan for SPARC Kips Bay, First-of-Its-Kind Job and Education Hub for Health and Life Sciences Innovation". State of New York. 13 October 2022. Archived from the original on 1 November 2022. Retrieved 13 October 2022.
- ^ a b Institute of Medicine (US) Committee on Monitoring Access to Personal Health Care Services, Millman M (1993). Access to Health Care in America. The National Academies Press, US National Academies of Science, Engineering and Medicine. doi:10.17226/2009. ISBN 978-0-309-04742-5. PMID 25144064. Archived from the original on 11 February 2021. Retrieved 14 June 2019.
- ^ a b "Healthcare Access in Rural Communities Introduction". Rural Health Information Hub. 2019. Archived from the original on 11 February 2021. Retrieved 14 June 2019.
- ^ "Health Topics: Health Systems". www.who.int. World Health Organization. Archived from the original on 18 July 2019. Retrieved 24 November 2013.
- ^ World Health Organization. Anniversary of smallpox eradication. Geneva, 18 June 2010.
- ^ United States Department of Labor. Employment and Training Administration: Health care Archived 2012-01-29 at the Wayback Machine. Retrieved June 24, 2011.
- ^ a b Thomas-MacLean R et al. No Cookie-Cutter Response: Conceptualizing Primary Health Care. Archived 2019-04-12 at the Wayback Machine Retrieved 26 August 2014.
- ^ "June 2014". Magazine. Archived from the original on 22 December 2020. Retrieved 9 March 2019.
- ^ "Primary care". World Health Organization. Retrieved 21 June 2024.
- ^ World Health Organization. International Classification of Primary Care, Second edition (ICPC-2). Archived 2020-12-22 at the Wayback Machine Geneva. Accessed 24 June 2011.
- ^ St Sauver JL, Warner DO, Yawn BP, et al. (January 2013). "Why patients visit their doctors: assessing the most prevalent conditions in a defined American population". Mayo Clin. Proc. 88 (1): 56–67. doi:10.1016/j.mayocp.2012.08.020. PMC 3564521. PMID 23274019.
- ^ World Health Organization. Aging and life course: Our aging world. Archived 2019-06-11 at the Wayback Machine Geneva. Accessed 24 June 2011.
- ^ Simmons J. Primary Care Needs New Innovations to Meet Growing Demands. Archived 2011-07-11 at the Wayback Machine HealthLeaders Media, May 27, 2009.
- ^ "100 of the largest hospitals and health systems in America" Archived 2 June 2022 at the Wayback Machine, Becker's Hospital Review
- ^ "Health Care System". the Free Medical Dictionary. Archived from the original on 5 February 2021. Retrieved 21 December 2020.
- ^ "Secondary Care". MS Trust. Archived from the original on 5 February 2021. Retrieved 22 December 2020.
- ^ "Difference between primary, secondary and tertiary health care". EInsure. 24 January 2017. Archived from the original on 6 May 2021. Retrieved 21 December 2020.
- ^ Johns Hopkins Medicine. Patient Care: Tertiary Care Definition. Archived 2017-07-11 at the Wayback Machine Accessed 27 June 2011.
- ^ a b Emory University. School of Medicine. Archived 2011-04-23 at the Wayback Machine Accessed 27 June 2011.
- ^ Alberta Physician Link. Levels of Care. Archived 2014-06-14 at the Wayback Machine Retrieved 26 August 2014.
- ^ Christensen L, Grönvall E (2011). "ECSCW 2011: Proceedings of the 12th European Conference on Computer Supported Cooperative Work, 24–28 September 2011, Aarhus Denmark". In S. Bødker, N. O. Bouvin, W. Letters, V. Wulf, L. Ciolfi (eds.). ECSCW 2011: Proceedings of the 12th European Conference on Computer Supported Cooperative Work, 24–28 September 2011, Aarhus Denmark. London: Springer. pp. 61–80. doi:10.1007/978-0-85729-913-0_4. ISBN 978-0-85729-912-3.
- ^ Porter E (29 August 2017). "Home Health Care: Shouldn't It Be Work Worth Doing?". The New York Times. ISSN 0362-4331. Archived from the original on 22 December 2020. Retrieved 29 November 2017.
- ^ Sanyaolu A, Okorie C, Qi X, Locke J, Rehman S (January 2019). "Childhood and Adolescent Obesity in the United States: A Public Health Concern". Global Pediatric Health. 6: 2333794X1989130. doi:10.1177/2333794X19891305. ISSN 2333-794X. PMC 6887808. PMID 31832491.
- ^ Dorothy Kamaker (21 September 2015). "Patient advocacy services ensure optimum health outcomes". Archived from the original on 20 December 2017. Retrieved 26 September 2015.
- ^ a b "The Pharmaceutical Industry in Figures" (pdf). European Federation of Pharmaceutical Industries and Associations. 2007. Archived from the original on 22 December 2020. Retrieved 15 February 2010.
- ^ 2008 Annual Report. Pharmaceutical Research and Manufacturers of America. 2008.
- ^ "Europe's competitiveness". European Federation of Pharmaceutical Industries and Associations. Archived from the original on 23 August 2009. Retrieved 15 February 2010.
- ^ Domecq JP, Prutsky G, Elraiyah T, Wang Z, Nabhan M, Shippee N, Brito JP, Boehmer K, Hasan R, Firwana B, Erwin P (26 February 2014). "Patient engagement in research: a systematic review". BMC Health Services Research. 14 (1): 89. doi:10.1186/1472-6963-14-89. ISSN 1472-6963. PMC 3938901. PMID 24568690.
- ^ Bond J., Bond S. (1994). Sociology and Health Care. Churchill Livingstone. ISBN 978-0-443-04059-7.
- ^ Erik Cambria, Tim Benson, Chris Eckl, Amir Hussain (2012). "Sentic PROMs: Application of Sentic Computing to the Development of a Novel Unified Framework for Measuring Health-Care Quality". Expert Systems with Applications, Elsevier. Vol. 39. pp. 10533–10543. doi:10.1016/j.eswa.2012.02.120.
- ^ World Health Organization. "Regional Overview of Social Health Insurance in South-East Asia.' Archived 2012-09-03 at the Wayback Machine Retrieved December 02, 2014.
- ^ Link between health spending and life expectancy: US is an outlier Archived 11 March 2022 at the Wayback Machine. May 26, 2017. By Max Roser at Our World in Data. Click the sources tab under the chart for info on the countries, healthcare expenditures, and data sources. See the later version of the chart here Archived 5 March 2022 at the Wayback Machine.
- ^ "Improve operational efficiency in healthcare with RPA". NuAIg. 2 March 2021. Archived from the original on 27 May 2021. Retrieved 27 May 2021.
- ^ a b "These Are the Economies With the Most (and Least) Efficient Health Care". BloombergQuint. 19 September 2018. Archived from the original on 22 December 2020. Retrieved 14 January 2019.
- ^ "Health at a Glance 2013 – OECD Indicators" (PDF). OECD. 21 November 2013. pp. 5, 39, 46, 48. (link). Archived (PDF) from the original on 12 April 2019. Retrieved 24 November 2013.
- ^ "OECD.StatExtracts, Health, Health Status, Life expectancy, Total population at birth, 2011" (online statistics). stats.oecd.org/. OECD's iLibrary. 2013. Archived from the original on 2 April 2019. Retrieved 24 November 2013.
- ^ Commonwealth Fund (2018). "Health Care Quality-Spending Interactive | Commonwealth Fund". www.commonwealthfund.org. doi:10.26099/bf4n-8j57. Archived from the original on 22 December 2020. Retrieved 14 January 2019.
- ^ a b c d OECD Data. Health resources - Health spending Archived 12 April 2020 at the Wayback Machine. doi:10.1787/8643de7e-en. 2 bar charts: For both: From bottom menus: Countries menu > choose OECD. Check box for "latest data available". Perspectives menu > Check box to "compare variables". Then check the boxes for government/compulsory, voluntary, and total. Click top tab for chart (bar chart). For GDP chart choose "% of GDP" from bottom menu. For per capita chart choose "US dollars/per capita". Click fullscreen button above chart. Click "print screen" key. Click top tab for table, to see data.
- ^ World Health Organization, 2003. Quality and accreditation in health care services. Geneva http://www.who.int/hrh/documents/en/quality_accreditation.pdf Archived 2020-12-22 at the Wayback Machine
- ^ Tulenko et al., "Framework and measurement issues for monitoring entry into the health workforce." Handbook on monitoring and evaluation of human resources for health. Geneva, World Health Organization, 2012.
- ^ "Health information technology — HIT". HealthIT.gov. Archived from the original on 22 December 2020. Retrieved 5 August 2014.
- ^ a b "Definition and Benefits of Electronic Medical Records (EMR) | Providers & Professionals | HealthIT.gov". www.healthit.gov. Archived from the original on 9 September 2017. Retrieved 27 November 2017.
- ^ "Official Information about Health Information Exchange (HIE) | Providers & Professionals | HealthIT.gov". www.healthit.gov. Archived from the original on 22 December 2020. Retrieved 27 November 2017.
- ^ "What is a personal health record? | FAQs | Providers & Professionals | HealthIT.gov". www.healthit.gov. Archived from the original on 22 December 2020. Retrieved 27 November 2017.
External links
[edit]- Media related to Healthcare at Wikimedia Commons
- Travel health travel guide from Wikivoyage