Healthcare System: Choose A Type Of Healthcare Delivery Syst

Healthcare System Choose a Type Of Healthcare Delivery Sy

Choose a type of healthcare delivery system to study and prepare a 2-3 page paper about a specific hospital organization within that system. Explain why you selected this organization as the focus of your paper. Include information on the types of patients (consumers) who would use the services of this facility, how these individuals would access the healthcare system, and the impact and requirements of health insurance. Compare and contrast this healthcare delivery system with another type from the list, discussing the population it serves, how it is financed, and your opinions on its effectiveness. Additionally, provide your personal definition of "health" and explain how the chosen healthcare system would meet that definition. Use at least two authoritative references with proper in-text citations and a reference list.

Paper For Above instruction

Healthcare delivery systems are diverse, each designed to meet specific population needs and operational philosophies. For the purpose of this paper, I have selected the not-for-profit hospital system. This organizational choice allows for an exploration of primary healthcare services within a system that prioritizes community health, ethical standards, and reinvestment over profit-making motives. The specific hospital I focus on is the Massachusetts General Hospital (MGH), a distinguished not-for-profit institution renowned for its comprehensive medical services, research contributions, and community engagement.

I chose Massachusetts General Hospital as the core organization because it exemplifies the attributes and operational philosophy of not-for-profit hospitals. These hospitals are committed to providing accessible, high-quality care without the primary goal of generating profit. Their revenues are typically reinvested into the hospital to improve facilities, expand services, and support community health initiatives. MGH was selected because of its historic significance, reputation for excellence, and comprehensive service offerings that cater to diverse patient populations.

The primary consumers of services at MGH are a broad spectrum of individuals, including uninsured or underinsured patients, Medicaid beneficiaries, and those with private insurance. Patients access services through various means, such as referrals from primary care physicians, emergency room visits, or outpatient clinics. Accessibility is facilitated by a network of primary care providers, specialty clinics, and outreach programs designed to serve underserved communities. Insurance coverage plays a vital role, as the hospital works with multiple insurers to ensure financial stability and access to care. Nonetheless, uninsured patients often face barriers, which the hospital addresses through sliding scale fees or charity care programs aligned with its community mission.

Comparatively, the health maintenance organization (HMO) represents a different delivery model. HMOs are typically for-profit or non-profit entities that focus on preventive care and cost containment through specific networks of providers. Population-wise, HMOs often serve insured populations who are enrolled for managed care plans. Financing in HMOs is predominantly through prepaid premiums, with emphasis on regular, proactive care to prevent costly hospitalizations. In contrast, not-for-profit hospitals like MGH are funded through a mix of patient revenue, government grants, and donations, focusing on community service rather than profit.

Both systems aim to improve health outcomes; however, their approaches differ. Not-for-profit hospitals are driven by community health priorities, aiming to serve all individuals regardless of ability to pay, and are heavily involved in research and education. HMOs emphasize cost-efficiency and preventive care, promoting regular health monitoring and early intervention to reduce overall expenses. While HMOs may restrict provider choice within their networks, not-for-profit hospitals often provide a broader range of services and serve as safety-net institutions for vulnerable populations.

My personal definition of "health" aligns with the World Health Organization's perspective, describing health as "a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity" (WHO, 1948). The not-for-profit hospital system, with its comprehensive services, patient-centered care, and focus on community health, is well-suited to fulfill this definition. It strives to address social determinants of health, provide preventive care, and facilitate access to services for diverse populations—elements essential to achieving holistic well-being.

In conclusion, the not-for-profit hospital system exemplified by Massachusetts General Hospital offers a community-centric approach focused on equitable access and comprehensive care. Comparing it with HMOs highlights different priorities—community service versus cost management—yet both aim to enhance health outcomes effectively. Understanding these differences informs better policy-making and health system reform to meet the varied needs of populations. Overall, ensuring access, affordability, and quality remains central to effective healthcare delivery, whether through hospital-based or managed care models.

References

• World Health Organization. (1948). Constitution of the World Health Organization. Official Records of the World Health Organization, 2, 100.
• Blendon, R. J., & Benson, J. M. (2017). Understanding the US Health System. Journal of Health Politics, Policy and Law, 42(1), 57-73.
• Hood, L. J. (2019). Nonprofit Hospitals and Community Benefit: Evolving the Business Model. Health Affairs, 38(2), 199-205.
• Long, S. K., & Van der Klis, M. (2019). The Future of the American Health System. Milbank Quarterly, 97(1), 21-46.
• Rosenau, P. V., et al. (2020). Managed Care and the American Health System. Medical Care Research and Review, 77(3), 245-251.
• Hadley, J. (2017). Insurance Coverage and Health Care Access and Utilization: The Current Situation. Annual Review of Public Health, 38, 353-369.
• Immergut, E. M. (2018). Diverging Paths in Healthcare Systems: A Cross-National Perspective. International Journal of Health Services, 48(3), 558-567.
• Sutherland, K., et al. (2021). The Impact of Insurance Status on Hospital Utilization. Health Services Research, 56(2), 227-245.
• Zuckerman, S., et al. (2016). How US Health Care Payment Systems Impact the Quality of Care. JAMA, 316(8), 816-826.
• Fronstin, P. (2019). The Evolution of Managed Care in the United States. Employee Benefits Research Institute.