Health Systems Thinking

Health Systems Thinking
Systems thinking (ST), a subset of to complexity theory (CT), is a potentially transformational way
to view and approach health. It draws on many academic traditions to describe the processes, actors,
and dynamics that shape systems like the health system(1). It is more than simply considering the
bigger picture. Approaching a problem from a ST perspective involves examining interrelationships,
considering all perspectives, and understanding the role of boundaries (Williams and van 't Hof
2014:8).
A system consists of interacting, connected parts that operate towards a purpose; changing one
connection necessarily affects other parts of the system. A complex adaptive system (CAS) is a type
of system that consists of interacting, nonlinear ... Show more content on Helpwriting.net ...
Despite growing evidence for the benefits of applying systems thinking, most health programs
continue to primarily apply a reductionist approaches that haves dominated for decades(9). The lack
of a comprehensive review of application limits the ability of planners to synthesize existing
literature and apply innovative–practices to emerging development challenges such as the post–
MDG agenda.
Case studies are of value to illustrate the range of applications of systems thinking terms, methods,
and tools. With a clearer understanding of real world approaches approaches based on ST, the global
health community will be better equipped to understand and address key health challenges. This
paper reports on findings from case studies extracted from a previous systematic review (cite the
systematic review). This systematic review of systems thinking case studies seeks to:
– Provide practitioners and planners with a reference for ST/CT application cases,
– Review the frequency and nature of key systems thinking terms, tools and methods in the health
literature
– Analyze and extract longitudinal themes across cases.
– Indicate the practical implications of these cases for changing organizational form/function and
post–MDG
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Health Insurance And The Health Care System
According to Martocchio (2014), health insurance covers the costs of a variety of services that
promote sound physical and mental health, including physical examinations, diagnostic testing,
surgery, dental treatments, and corrective prescription lenses for vision deficiencies. More than two
centuries ago, the presence of the health care system emerged when mining and railroad companies
hired doctors to provide medical services to their employees. As a result of the catastrophic World
War I, many health providers were left providing services with the prospect of not receiving
payments for the services being rendered and many Americans faced with the financial burdens of
these escalating health care costs. The essential for the development of a health care system was not
established for no apparent reason. The health care system was developed due to the staggering
number of Americans whom where unable to pay soaring medical bills.
With no government intervention, the private sector of health insurance was established as a means
for Americans to pay medical expenses. "In 1927, the American Medical Association (AMA)
formed a Committee on the Costs of Medical Care to report on options for helping Americans pay
for their medical services. The Committee concluded that private insurance was the best solution"
("HNN's History of Healthcare Reform", 2012). This empirical succession is what commenced the
evolution of health care in the United States.
For the next decade and

Health Informatics And The Health System
What is health informatics in Canadian health system? Health informatics transforms health care by
assessing, analyzing, integrating, and applying health communication and informational systems
(Anderson, 2007). Health informatics schemes are funded federally and implemented provincially in
Canada with each province creating its own dynamic programs to help improve both the population
and individuals health outcomes, enhance patient's care and to strengthen the patients–caregiver
relationship (Anderson, 2007) . Such programs are Ehealth Ontario, and Alberta Netcare. Electron
Health Records (EHR) and Electronic Medical Records are usually used exchangeable (Gartee,
2011). EMR servers as a data source for EHR; it usually contains patient's medical records and
usually found in an ambulatory or acute health facilities. While EHR is the sum of the entire
patient's life history of his or her health records from different sources, which is usually kept in an
institution such as an integrated delivery network facility where most health care providers can
guarantee access (Gartee, 2011). This literature review is intended to amalgamate the key barriers of
electronic health records in the Canadian healthcare system and to overcome these barriers for a
successful implementation among the public and policy makers.
Electronic health record is literally defined as "An aggregation of patient–centric health data that
originates in the patient record system of multiple independent

Health Information System
PRPOSED WORKING TITLE
Health Information System: A Repository Bank for Modelling and Simulating Health Outcomes for
Chronic Obstructive Pulmonary Disease
Rationale
Over the years, much advancement in different spheres of life has been achieved using information
technology. Man has been able to go to the moon, heavy objects have been able to fly and go deep
into the oceans without sinking, communication across the planets has been made possible and the
world has become a global village where everything seems in the reach of everyone.
In health and medicine, the advancement that has been accomplished in recent years with the benefit
of information technology is highly significant. The growing influence of ICT in health has also led
to the development of vibrant and robust health information systems and their management. As time,
distance and place are becoming less relevant among individuals and institutions', having a robust
health information system is a crucial part of a modern healthcare system and facilitates the
discovery and sharing of enormous amount of data for different people, places events and
conditions. Among several conditions for which health information system data can and have been
shared is chronic obstructive pulmonary disease (COPD), a disease which affects an estimated 15%
of New Zealand people who are above 45yrs old.[1]
In an environment like New Zealand that is prone to natural disasters such as earthquakes; where
construction, rebuilding and

Uk Health System vs Aus Health System Essay
Introduction All people across the globe are entitled to the health attention they require. The World
Health Organization has identified five elements to achieve this goal. These include reducing social
disparities in health, providing services that meet clients' expectations, altering public policies to
address health, leadership reforms and increasing stakeholder participation (WHO, 2013). With the
focus on these five areas, Governments in each country are creating health systems that aim to
provide services that are affordable, equitable and accessible. To achieve a sustainable health
system, cooperation and participation of all health care providers is vital. This will work towards
WHO's goal of achieving "better health for all" ... Show more content on Helpwriting.net ...
al., 2011). Health service accessibility by individuals in rural and remote areas is a problem central
to both countries. Reports indicate that compared with metropolitan populations, non–metropolitan
populations, in both Australia and the UK, experience poor access to health services (Watt, Franks,
Sheldon, 1994, p. 16). As in the primary care sector of the UK, majority of the doctors in Australia
are self–employed and reimbursed on a fee–for–service approach (Gillies, 2003, p. 77). GP's are the
initial point of contact for patients in both Australia and the UK. Additional specialist medical
services such as physiotherapy and optometry are only available when patients are provided with a
formal referral from their GPs (Piterman, Koritsas, 2005). Although the NHS is similar to the
Australian health system in certain ways, both systems also possess some differences. Strengths and
Weaknesses of the United Kingdom's National Health Service The NHS provides many benefits to
its residents in the UK. Specific benefits include the cost, care and coverage of the system. Cost:
Health care in the UK relies heavily on a public market rather than a private driven market; thus,
giving free care to its people. NHS services are free of charge to patients in England unless stated
(Department of Health, 2013). Free health care in the UK aim to prevent ill health and

Health System in Finland
At the start of 2007 the population of Finland was 5.3 million. Average life expectancy is 76 years
for men and 83 years for women in 2005. The health of the Finnish population has considerably
improved, but socioeconomic inequality in mortality is increasing. The most important public health
problems are circulatory diseases, malignant tumours, musculoskeletal diseases, diabetes and mental
health problems. Health problems are obesity, chronic lung diseases and diabetes, particularly type 2
diabetes. (Vuorenkoski L. 2008 )
`The foundation of the health services is laid down in the constitution of Finland . According to the
constitution: Everyone shall be guaranteed by an act the right to basic subsistence in the event of
unemployment, ... Show more content on Helpwriting.net ...
Principal health–related provisions are all people are entitled to protection of their health and genetic
identity (Article 5.5) and the state cares for the health of citizens and adopts special measures for the
protection of youth, old age, disability and for the relief of the needy (Article 21.3). (Charalambos
Economou 2010)
3.1. Health system in Greece
The health system have public integrated, public contract and public reimbursement models,
comprising elements from both the public and private sectors and incorporating principles of
different organizational patterns. Health care services have public and private providers. Private
providers are more primary care, especially in diagnostic technologies, private physicians' practices
and pharmaceuticals. (Charalambos Economou 2010) Primary health care services are through rural
health centres and provincial surgeries in rural areas, the outpatient departments of regional and
district hospitals, the polyclinics of the social insurance institutions and specialist in urban areas.
Secondary care is provided by public hospitals, private for–profit hospitals and clinics or hospitals
owned by social insurance funds. There are various social insurance funds co–exist with the
National Health System of Greece (ESY). For examples Institute of Social

Brazil Health System
Federative Republic of Brazil has an area of 8.5 million square–kilometers, which is slightly smaller
than the US, and makes it the fifth largest country in the world (The World FactBook [WFB],
2015a). It has a population of about 204.3 million (WFB, 2015a). As the South America's largest
economy, the gross domestic product (GDP) of Brazil is about $2.353 trillion and the GDP per
capita is around $16,100 in 2014 (WFB, 2015a).
In Brazil, the health expenditures, which is the total expenditure on health as a percentage of GDP is
9.7%, ranking 31 in the whole world in 2013 (WFB, 2015a). There are 1.89 physicians per 1,000
population, and 2.3 beds per 1,000 population (WFB, 2015a). Brazilian's life expectancy at birth is
73.53 years and their infant mortality rate is 18.6 deaths per 1,000 live births (WFB, 2015a).
The present Brazilian health system is made up of three subsectors: the public subsector, which is
called the Unified Health System (SUS), where state at municipal levels provides and finances the
services; the private subsector, where public or private funds finance the services in various ways;
and the private health insurance subsector, including different forms of health plans, various
insurance premiums, ... Show more content on Helpwriting.net ...
Municipalities are granted the independence to provide and manage care while the federal
government provides resources and oversees the implementation (Paim et al., 2011). The SUS
provides primary care and preventive care to all Brazilian citizens through Family Health Programs
(PSF) (Paim et al., 2011). Brazilian citizens are assigned to family health–care teams in local PSF
clinics, who provide health services at health facilities, in patients' homes, and in the community and
these teams also work closely with specialized services (Paim et al., 2011). The SUS is funded by
tax revenues and social contributions, and it is universal and free for Brazilian citizens (Paim et al.,

Health Care System Essay
The Trinidad health care system operates under two tier system which consist of both public and
private health care facilities, the main responsibility of the ministry of health is the overseeing of the
health care sector, although this agency does not directly run the public health care facilities, the
responsibility of this office is to set policies, goal and targets areas based on the assessment of the
community health needs, as well as to allocate funds to the regional health authorities to finance the
various health needs of the community.
The public health the care system which includes four main hospital that helps to facilities the
country medical needs, and can be access by the entire population of Trinidad and is offered free ...
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In the case of serious medical emergency, a medical evacuation is needed to transport the individual
to the closest health care facility that offers sufficient medical care, which may be located in another
country, such as Miami in the United States.
The private medical sector in Trinidad is very small comprising of four facilities which include:
St Augustine private hospital
Southern medical clinic
West shore private medical hospital
Adventist hospital
These facilities are located either in Port of Spain, San Fernando and the West Mooring area, they
are sufficient enough to treat most health problems but offer only a slightly better treatment than that
of the public health care systems. Although the private sector is considered better than the public
sector it is still incapable of handling serious illness and injuries especially those that require long
term care.
The health care system in Trinidad is not considered the best especially is seeking care at the public
facilities according to article written by Akilah Holder who writes for the Trinidad guardian
concerning the death of pregnant women who have had C– section at the hospital these are some of
story.
"Juliet Primus will never again hold her baby girl in her arms. She will not be around when baby
Chasarah takes her first steps or says her first words.
She will not be there to answer her questions when

Health System Ethics
Issue
In support of the board of directors' commitment to an IT initiative for the health system, we are
evaluating different vendors for the selection of an innovative health system that:
Includes a CEHRT (Certified Electronic Health Record technology).
Allows for structured data that complies with established government standards and requirements to
qualify for use in Medicare and Medicare EHR incentive programs.
Flexibility for implementation of national incentives, government requirements or future provisions
that might affect the purchase, features or use of the new system.
We have evaluated implications and present some recommendations for your consideration of
qualifying IT Health Systems as part of your initiatives ... Show more content on Helpwriting.net ...
o One of the main components for the HITECH is the Medicare and Medicaid EHR Incentive
Programs. These programs give incentive payments to eligible professionals, hospitals, and critical
access hospitals (CAHs) that implement or upgrade to a certified EHR (Wager 8). An additional
incentive is received if we can demonstrate "Meaningful Use" of interoperable electronic medical
records. The concept of electronic health records–meaningful use (EHR–MU) [8] implements the
provisions of the ARRA (American Recovery and Reinvestment Act) of 2009 that provide these type
of incentives.
Other regulations related to Health Information Technology that we will need to consider for this
memo are:
o The CLIA (Clinical Laboratory Improvement Amendments) program ensure quality laboratory
testing. All clinical laboratories must be properly certified to receive Medicare or Medicaid
payments (CMS.gov). o The FDASIA (Food and Drug Administration Safety and Innovation Act)
[6] is a risk–based regulatory framework for health IT. It includes medical mobile applications that
promote innovation, protects patient safety, and avoids regulatory duplication. o HIPAA (Health
Insurance Portability and Accountability Act). HIPAA was intended primarily to make insurance
more affordable and accessible for the consumers. Later on, it included provisions to simplify
administrative processes, provide patients with certain rights concerning

Health System in Mauritius
ANALYSE THE HEALTH SYSTEM IN MAURITIUS Mauritius, being a welfare state, has to
make sure that all the inhabitants are living in good conditions. The most important that has to be
taken into consideration is the health of the people. Health is a greatest gift, contentment the greatest
wealth, faithfulness the best relationship, said Buddha. The role of the Ministry of Health is to
ensure that all the medical facilities are available to the population and improvements are being
made as it is the main objective of the health system and there have been progressions in the health
system over the past decades. Access to health services is easy in Mauritius. Government hospitals
were opened to serve the people. Millions of ... Show more content on Helpwriting.net ...
Nowadays, people don't have time for themselves nor they are taking care of their health. Busy with
loads of work, the people most of the time consume fast food, which have a negative impact on their
health. Moreover, the amount of smokers and alcoholic are increasing at a high rate in the country.
People are starting to smoke at very young age and are also becoming drug addicts. Regardless of
the fact excessive alcohol is harmful, drugs and smoking kill, the people are still not leaving that bad
habit. In order to create awareness, increases knowledge, changes attitudes and moves people to
change their behaviour and to adopt a healthier lifestyle, sensitisation campaigns like Anti–Smoking,
Anti–Alcohols, having a balanced diet and practising exercises daily are being held. Whether on tv,
radio or magazines, we are being made conscious about the importance of our health. . Apart from
having the public sector, we also have a well established private sector The private sector absorbs
32% of the total expenditure on health in the country. . In a year, the private sector has 27, 000
admissions for in–patient treatment, undertakes 13,000 surgical operations and delivers over 2,000
babies. Some people choose private hospitals instead of public hospitals due to better service quality
and admission procedures. There are reliable doctors and nursing officers and their attitude are
courteous and they are more hospitable and are ready to help.

The Healthcare System And Samaritan Health System
Introduction "Banner Health is considered one of the nations ' largest secular, non–profit health care
organization operating 29 acute care facilities in seven western states" (Kash, 2016). It is known and
recognized nationally. It unites with Lutheran Health System and Samaritan Health System which
started in 1991 with the mission of making differences in people 's lives such as rendering perfect
patient care. This exellent mission of health care earned them good standing that help the
"organization to develop and manage 29 acute care facilities in seven states with the magnitude of
about 4,000 beds" (BANNER HEALTH, 2016). These States of networking health care of Banner in
America are Arizona, Colorado,Wyoming, ... Show more content on Helpwriting.net ...
All surplus made in this organization is used in maintaining the copany making then up to date by
purchasing the most contemporary equipment, preserving the facilities, buying most recent
technologies, get more physician services, widening current physisian services, after all these,
whatever money is left goes to the charities. The medical screening only (MSO) of Banner Health is
only meant to exclude life frightening situation. This procedure is followed up with a discussion by
financial services that notify the patients of the copays needed by their insurance companies before
moving to a comprehensive care at the emergency departments. "Banner healthy has come up with
organizational efforts of approaching health care quality and safety, reduction of patient errors, and
patients contentments while continuoesly rolling its operating cost" (Kirkman–Liff, 2004). In the
facilty that I work, Patients care depents on the type of insurance they have. Some pay copay out of
pocket, some are not. The type of room a patient stays on admission depends on the type of
insurance. Strategic plan for network growth The Banner Health system is addressing network
growth by increasing the size of health care distribution places all over their regions. They are
preparing for future healthcare desired suply of the communities by starting many critical care,

Peru Health System
Presentation Health System in Peru (South America)
How is the health system in Peru?
The health system of Peru has two sectors, public and private.
In the public sector the government provides health services to the population secured on payment
of a fee recovery of variable amounts subject to the discretion of organizations and through the
Comprehensive Health Insurance (SIS), which subsidizes the provision of services to the population
living in poverty and extreme poverty . The provision of services for the subsidized regime open or
secured toSIS population is carried out through the network of establishments of the Ministry of
Health (MOH), hospitals and specialized institutes that are located in the regions and in the capital
of the

The Interdependence Of The Health System
Health system is defined as "all activities whose primary purpose is to promote, restore, and
maintain health" (WHO, 2000). All activities in the "system" can be assumed as an organization of
components and their interconnections that work together for a purpose, which is concerned with
people's health. In other words, a system has many parts as a set of interrelated components to
achieve a common goal (Shi & Singh, 2014). The interdependence of the health system can be
regarded as the functions and roles played by these components (The World Bank, 2007).
Describing the components, interdependence, and purpose, Roemer (1991) defined a health system
as "the combination of resources, organization, financing and management that culminate in ...
A strong belief in capitalism has led to health care being viewed as an economic good or service, not
as a public resource. In other words, health is viewed as a privilege, not as a right. This has led to the
fee–for–service being the principal model of payment, which has uncontrolled utilization,
uncontrolled prices and payments. Capitalism has also led to the belief that each individual and
business particularly in private sectors try to manipulate financial incentives for their own benefits
without considering the effect on the system (Shi & Singh, 2014).
Values and beliefs do not only influence in shaping the entire health system, but they also influence
the other system within the systems framework such as system resources especially human
resources (health service professionals) and system processes especially the way of healthcare
delivered to people. For instance, health service professionals' cultural and value backgrounds may
affect the way they perform health care services. Part of their values as professionals is shaped not
only by their academic experiences, but also by their cultures and beliefs. Since cultural and social
factors between patients and health service professionals are not always the same, it is important to
take into

U.s. Health Care System
The U.S. health care system is perhaps one of the most complex and plastic industries present within
the current world economy. With a projected market sector value of $3,455.1 billion by the end of
2016 the U.S. health care providers market represents a significant portion of the economy
("Research and Markets; Healthcare Providers in the United States," 2012). For someone that finds
themselves in the position of management it is certainly an orthodox presumption that they
incorporate into their repertoire the tools necessary to survive in a constantly evolving workplace.
The purpose of this paper is to examine several emerging influences on the U.S. healthcare system
and what they mean for managers in the workplace. Specifically, ... Show more content on
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Statistically better risk–adjusted outcomes for the elderly are associated with better–performing
teams with regard to interdisciplinary health care management when considering a program. This of
course means that implementing such teams is not as much of a principle importance as making sure
those teams are performing well. This includes providing a robust program with diverse services in
place at elderly care centers to meet the many multifaceted healthcare demands of the elderly
population. While less progressive, PACE programs when compared to less restrictive designs are
associated with significantly less utilization of hospitals and emergency rooms (Mukamel et al.,
2007). Simply put, if a healthcare organization utilizes PACE as part of their healthcare management
for the elderly population they will reduce healthcare costs on their health system by reducing the
number of admissions to the emergency room and hospital respectfully. This saves money by
reducing the likelihood of null reimbursement for hospital acquired conditions in elderly patients
that may occur during their hospital stay. Recently, Medicare stopped reimbursing hospitals for
avoidable conditions that can occur while a patient is admitted to a hospital. This can include things
like foreign objects left inside patients after surgery, various infections, falls, pressure ulcers, and
traumas.

The Integration Of Health Systems
Integration of Health Systems
Marquetta Wiggins
Walden University
We first have to define what horizontal integration is? "According to Shi and Singh (2015) is a
growth strategy in which a healthcare extends its delivery core product or service". The way
horizontal integration is obtained by is internal development, acquisition or merger. Organization
can be linked horizontally closely, through ownership or alliances. Horizontal integration mainly
focuses on controlling the distribution of certain type of health services in an area. Some examples
of the focus are multihospital chains, nursing facilities chains or chains of drug stores all under the
same name and management. Diversification of new products or services is not reaching within
horizontal integration Shi & Singh (2015).
An example of horizontal integration is the Carolina's Health Care Systems. This was founded in
1940. It is the nation's leading and most innovative healthcare organization. They provide a full
variety of healthcare and wellness programs throughout North Carolina and South Carolina. They
have more than 900 care locations that include academic medical center, hospital healthcare
pavilion, and physician's practices. It has 60,000 full–time and part–time employees with more than
7,460 licensed bed and an annual budget that exceeds $7.7 billion. The premier facilities include
Levine Center Institutes and Levine Children's Hospital and Sanger Heart and Vascular Institutes.
Carolina's

Health Disparities And Health System Barriers
Dr Ananya Mandal a N ews
Medical.net author defines Health Disparities as "the inequalities that
occur in the provision of health care and access to health care across different racial, ethnic and
socioeconomic groups." This means Health disparities are essentially discrepancies in the servicing
of Healthcare as well as in access to healthcare amongst people of different racial, cultural, and
socioeconomic groups. Health Disparities has many underlying factors that impact it, a factor in
particular is Health system barriers. Health system barriers are critical problems such as Access,
Utilization, or Quality that serve to obstruct the passage towards proper Health. Health system
barriers are one of the many factors that contribute to Health Disparities, health system barriers are
composed of three major barriers; Access, Utilization, and Quality. These barriers all greatly impact
Health Disparities and impact the path toward achieving quality health, with that in mind, the
question of is one of these barriers more responsible for Health Disparities than the other? And the
answer is yes, and the health system barrier that is most responsible for Health Disparities. Although
many people believe that there is not one barrier that is more responsible for Health disparities, there
is one barrier that is more responsible and that is on the account of the other barriers being the
results of the one barrier.
1. Understanding the Three Major Barriers
Granted that there is one health

Operation Of Health Care System
OPERATION OF HEALTH CARE SYSTEM
The medical system in Cuba is a national priority, it provides care to every citizens. It is primary
care based, which means that team of doctors and nurses are in every part of the country and are
responsible for the health of a geographically defined population of 800–1800 people. Most of the
frequent visitors and people with chronic diseases, usually they spent half the day consulting people
in office and other half for the home visit. They are expected to be available for the patients in their
community 24 – 7 for any urgent cases. Some of the doctors in these settings are residents in the
second of their two–year FM residency, and they include those from other countries whose
governments permit ... Show more content on Helpwriting.net ...
Health care system is structured on two levels.
Level 1: Primary health care
Family doctor unit
Polyclinics (includes dental care)
Specialty institution
Mother's home
Grandparents home
Community mental health clinic
Level 2: Secondary health care
Inpatient hospital
Inpatient nursing homecare
One of the key differences between the US health system and Cuba health system is that Cuba
focuses on preventing diseases rather than treating the diseases. And everyone will be having family
physician and nurses. For the Cuba health system there are no private hospitals, all hospitals and
clinics are controlled by the government and people are given access to the system without any cost.
Every patient are visited by the family physician at home once in a year, one with chronic disease
will be visited frequently. If it is necessary patients are referred for specialty evaluation, but after the
evaluation they will come back to the community team for ongoing treatment.
This prevention orientation structure has produced positive result for the Cuba. Vaccination rates in
Cuba is the highest in world. The infant mortality rate fallen from 80 per 1000 live births to 5 per
1000, lower than US.
PRINCIPLE OF THE HEALTH SYSTEM
The principle that govern the public health system in Cuba are:
The public and social nature of the medicine
Access to services at no cost
Preventive

Essay On Health Systems
Comparative Health Systems
We have covered a total of 21 national health systems and have learned some unique systems on
each of them. We have learned some fascinating things for example, Japan having the highest life
expectancy than any other country at birth, or France being nominated the number health care
system in 2000 by the World Health Organisation, or Has a universal system that is facing
challenges from aging population and an increase in prevalence for behavior based conditions, but
my favorite system was india! I was amazed by how far their system has come and how good they're
doing. Their system had success in the 20th century with communicable diseases, which has resulted
in a population explosion which they are currently ... Show more content on Helpwriting.net ...
("Mali Health Insurance", 2017, Para. 2). The country became independent of France in 1960. Being
present day french colony, many diplomatic affairs exist between Mali and France as Mali is
dependant of France since colonial years. Mali and France enjoy close relations of confidence, not
only for historical and cultural reasons but also because of the large Malian diaspora in France. Mali
is dependent on a lot of international development. Mali accounts for over 50 Ethnologue languages,
then speak French as the official language and Bambara which I also speak is the most widely
spoken. The According to the French diplomatie, "During the early 2000s, Mali enjoyed a major
influx of FDI; french diplomatic influx, which increased more than twenty–fold, making it the third–
largest recipient country in the sub–region, with a stock of $3.4 billion (31% of GDP) in 2013".
(France Diplomatie. 2016). Now let's find out how how health is managed in Mali, one of the 10th
poorest countries in the world. Mali's health care system is slowly evolving but not nearly
comparable to those in developed countries, for example, life expectancy at birth is only 55 years in
Mali while there is over a 30 year difference in developed countries like in america where it's 89 and
expected get even higher by 2020 according to the world health organisation. (WHO, year).

The And Health Care System
Imagine you are a soldier named Connor who spends many years fighting to protect the lives of
Americans. When you retire from service you continue to fight, this time for your own life. When
veterans come home some of them suffer from mental illnesses, infectious diseases, or hearing loss
just to name a few. You are a veteran that suffers from an infectious disease called leishmaniasis, it
is fatal if untreated. You wait for numerous months to get care from the V.A. medical center. Once it
is time for your appointment the parasitic disease leishmaniasis has already spread through most of
the body. A few weeks later doctors declare you dead, your family is angry at the V.A. health care
system because you did not receive health care sooner. The U.S. veteran's health care system fails
veterans due to their long wait times but can be fixed by applying the triage system.
In the current system, you are given an appointment based on which patient schedules their
appointment first. Some veterans die before they even attend an appointment, causing other veterans
to wait in vain. The reason why some veterans die before their appointment is because they do not
receive care quickly. This is due to the system not taking into consideration the patient's condition
when scheduling appointments. For example, if there are two patients, one with a life threating
condition and one with a minor injury. If the patient with a minor injury schedules an appointment
first, the patient with a life

Health Information Systems And Systems
To successfully implement health information systems, it is important that the health care
organizations have access to appropriate IT staff and resources to support the new systems and
system users. IT staff perform several common functions and have several common roles. In large
organizations, the IT department often has a management team comprising the chief information
officer, chief technology officer, chief security officer, and chief medical information officer, who
provide leadership to ensure that the organization fulfills its IT strategies and goals (Wager, Lee, &
Glaser, 2010, p. 434). Health information systems' leaders understand that predicting gaps and
promoting parities in an effort to reduce data security risks, costs, and liabilities can only lead to
long–term profitability. The aims of this paper are to discuss five health information system's leaders
and their roles; to examine the stake holders health information systems' implementation; to analyze
the limitations and opportunities in health information systems' data analysis, to explain what the
literature suggests; and to summarize the impact of predicting gaps and parities on quality
improvement as it relates to the situation of my final proposal/project. List five health information
systems' leaders, and define their roles. Chief Information Officer (CIO) CIO is the one who
manages the Information Technology department and an executive who can successfully lead the
organization in its effort to

Health Insurance System
In the United States, there are three basic systems in which healthcare are financed: private
insurance, public insurance, and uninsured. Within private and public insurance, there are several
different types of plans that assist in financing health care. Private health insurance utilizes various
healthcare providers to provide cost–sharing in receiving healthcare services through benefits
provided by employers or for premiums (Shi & Singh, 2015). Some examples of healthcare
providers are commercial insurance companies, self–insured businesses, and managed care
organizations (Shi & Singh, 2015). Each healthcare provider outlines the coverage benefits,
individual out–of–pocket requirements, and limitations through an insurance contract or plan ...
This type of insurance is financed through governmental entities for the elderly, disabled
individuals, low income individuals or families, underprivileged children, Native Americans, and
military members and their families (Shi & Singh, 2015). Depending on the services, individuals
may be required to pay a co–payment dependent on the program and the financial abilities of the
individual or family (Shi & Singh, 2015). The advantage of public health insurance is providing
high–risk individuals and their families or veterans and their families with health insurance plans for
health care services at a discount or gratis. Many high–risk individuals and their families would not
be able to afford health care services because of the lack of income or ability to work. Also, one of
the benefits of serving in the military is the health care supported by the government for protecting
the country. The disadvantage of public health insurance is the limitation of funds and services
subsidized by the government. Each of these programs are limited by eligibility requirements,
approved health care services, and the budget sustained by governmental

The On The Health Care System
For my training project, I decided to train one of my co–workers. I decided to ask Danny if I could
train him because he is young like me and I know that it has been extremely beneficial to me, to be
aware about the health care system. The importance of understanding how we are insured and what
our rights are, has never been more prominent. With the introduction of the Affordable Care Act or
"Obamacare," in 2010, there were many changes to our health care system. The changes apply to
everyone and I felt that it was my duty as a Public Health student to spread what I have learned to
further engage my peers and allow them to take an active role. I gave Danny a short survey before I
trained him to understand what he was interested in and ... Show more content on Helpwriting.net ...
I used this to set the base for why there has been a big push back to have a universal health care
system. I also included that there was a big influence from the American Medical Association and
the Republican party. There was also mention of how ideas of socialism and communism were very
real for the United States and any idea that stemmed from this was not accepted. I then took this
opportunity to talk abou the technological advances we have made and how that has contributed to
the rise of health care. I made a note that just because we have the best technology, we are not
showing the best health outcomes and are spending about $9,000 per person on health care yearly.
Second, I gave a detailed explanation of Medicaid and the program's role in our health care system.
This was something that my co–worker was interested because he probably qualifies for Medicare. I
decided to start by showing a video I found on YouTube that talked about Medicare and Medicaid. It
did a great job at explaining that Medicaid is a needs based program that is determined by income.
Medicaid covers the basic things that we need to keep healthy like, hospital services, doctor visits,
prescriptions and nursing home care. In order to qualify, New Jersey is using data sources like the
Social Security Administration and the Department of Homeland Security and Labor. It covers
people with incomes up to 133% of the Federal Poverty Line. It also covers

Health Systems And The Health System
From my point of view, I believe that the health system is facing a hindrance in providing value to
the patient. The inability to provide high quality, low cost health care is now a double edged sword
in our industry. In a time where reimbursements are made on the patients perceived quality of their
treatment, the organization can no longer afford to run the business off of the volume of patients
seen. Moving forward, I believe that there are many changes that can be made, both internally and
externally, throughout the health system to successfully implement patient centered care, which
would enhance our value chain. Based on the following recommendations, I believe that the cost
savings, or revenue generated, would impact the health system substantially. Currently we are
receiving a 1% penalty on a section of outpatient physician practices. This proposal would allow for
us to cease paying a 1% penalty, and also allow for us to receive possible incentive payments for
striving to create a high quality at a low cost. To fulfill my proposal, the entire health system would
need to be educated, and willing, to make changes in their daily routines. In a small community
hospital where culture and politics often predict outcomes, this would have to be a task that
bypassed these factors. The clinical staff will have will impact the most change, but all of the
support staff will need to take action for the plan to be successful. Although initially the proposed
action to increase

Systems Thinking And The Health Care System
Systems thinking was developed during this SMAC by learning to identify the connections of
Information tecnology and the health care system. This SMAC involved the understand of the health
care system and the service they provide and how they operates. As a result, while systems thinking
allows new and useful methods to improve patient safety, it comes with it its own intangible
challenges that, if not documented and addressed, will both slow improvement and present new
harm. This SMAC allowed us to see the challenges that healthcare system faces and how they
analyzed and apply systems thinking in assessing them. Understanding the challenges by completion
of a SWOT analysis. Which required the development of an action plan of improvement for patient
safety by implementing and maintaining new processes and practices such has how can the
functions of each component be optimized so that the results of the system are maximized? How can
we identify and monitor for unintended consequences? How can we intervene to prevent harm from
unintended consequences. It required the development of an action plan of improvement for the
future. We have improved our ability to understand how health care system achieve the
organizational goal of safe and excellent patient care by developing my ability at systems thinking.
The contributions to this SMAC display both the complexity of a systems method to patient safety,
and the promise of new ways in thinking about the systems within

The Canadian Health Care System
The Canadian healthcare system is currently ranked in the top 11 OECD countries making the
Canadian healthcare system one of the best in the world, although like all perfect systems, there are
always uncovered flaws within. When examining certain attributes and traits within the system, such
as accessibility and the general quality of healthcare performance is considered to be low ranking
amongst international practices, thus improvements are needed. More importantly, the Canadian
health care system contains many different attributes and qualities differentiating it from any other
system in the world. This can be seen when examining the systems' orientation and design, and
service delivery. Health inequalities is another impacting factor on our health care system, this
becomes clear when examining Aboriginal people's health.
The Canadian healthcare system has been lagging behind other westernized countries except the
United States in terms of quality, access, efficiency, and equity. According to a study by the CHSRF
(Canadian Health Services Research Foundation), findings suggest substantially worse performance
in Canada for: wait times for diagnostic tests, discharge reports, and being consulted in emergency
departments. These issues are a generic sign of lack of system organization and support in Canada
compared with other international jurisdictions (Katz, 2009). When searching for differences
between different provinces in Canada in regards to access to a family doctor,

The Malawi Health System
There are a number of challenges exerting increasing pressure on Malawi's ability to fully adopt
HSS approach. These include: Demographic trends, While the population has grown from10.6
million in 1990, to approximately 17 million the Malawi health system has struggled to maintain
and provide adequate health care to the people Malawi's population is growing. Increasing fertility
rates has led to a significant increase in the population projection, which has grown from XXXX
million people in 2051 (2004 estimates) to 34.2 million people (2006 estimates). This, together with
demographic trends, suggests that while there will be a growing need for health services targeted at
children, teenagers and young families, the predominant influence will remain xxxxxx, which will
cause most change in the use of resources. burden of disease The prevalence and burden of chronic
disease is significant and will place increasing pressure on health expenditure. Chronic diseases,
including xxxxxxx, are estimated to be responsible for more than 80% of the burden of disease.12
The WHO warns that the global burden of chronic disease is increasing rapidly and predicts by the
year 2020 that chronic disease will account for almost three quarters of all deaths.13 uneven access
to health. The WHO has identified the inverse care law as one of the common shortcomings of
health care delivery. Inverse care suggests that people with the most means – whose needs for health
care are often less – consume

Health Care System
Health Care System Health Services Organization Health Care System In this paper there will be a
brief discussion of three forces that have affected the development of the U.S healthcare system. It
will observe whether or not these forces will continue to have an effect on the U.S healthcare system
over the next decade. This paper will also include an additional force, which may be lead to believe
to have an impact on the health care system of the nation. And lastly this paper will evaluate the
importance of technology in healthcare. There are three major forces that have affected the
development of the health care system within the U.S. and these forces include social, political and
economic. The first force is defined as a social ... Show more content on Helpwriting.net ...
Examples of this would be not having access to a vehicle or public transportation if the nearest
hospital is located farther away from the home, no cellular device to remind them of important
appointment dates and other find it very difficult to wait in long lines to receive services that are
offered to them. An additional force that could have an effect on the health care system of the nation
would be the Obama care. This is a Universal health care reform that would benefit everyone across
the nation, including those with pre–existing conditions and those that have difficulty obtaining the
proper medical attention that they need. I believe that with this type of health care it could save
many more lives and lessen the financial worries of families who have love ones that are in need of
a special procedure who may have to travel across that the states to have the procedure done. "A
week prior to July 3rd of 2012 "the Supreme Court decided in favor of the universal healthcare
statute that was passed under the Obama administration and upheld the individual mandate. But
surprisingly no one of the conservatives decried the decision as contributing to the downfall of
society, evidence that President Obama is a socialist, and generally anti–American. But
conservatives

Health Care Delivery System Us Public Health System
Title US Health Care Delivery System US Public Health System
Mission Achieving universal access, delivering services that are cost–effective, and meeting pre–
established standards of quality. Ensuring conditions in which the entire population can be healthy
by protecting, promoting, and advancing the health and safety of the nation.
Structure –There are four functional components of health care delivery system. 1–Financing: to
purchase insurance or to pay for health care services consumed. 2–Insurance: to protect against
catastrophic risk
3–Delivery: to provide health care services. 4–Payment: to reimburse providers for services
rendered.
–The subsystems of US Health Care Delivery includes: Managed Care (HMOs and PPOs), Military,
Vulnerable Populations, and Integrated Delivery. The entities Comprising the Public Health
Infrastructure include: County and city health departments and local boards of health – State,
territorial, and island nation health departments – Various U.S. Public Health Service agencies in the
Department of Health and Human Services (HHS) – Tribal health agencies coordinated at HHS by
the Indian Health Service – Public and private laboratories – Hospitals and other private–sector
healthcare providers – Volunteer organizations, such as the American Red Cross, American Diabetes
Association, American Cancer Society.
Workforce Employs approximately 10 million people:
850,000 doctors
3 million nurses
168,000 dentists
208,000 pharmacists
700,000

Healthcare System ( Shs ) Is A Not For Profit Health System
Smithson Healthcare System (SHS) is a not–for–profit health system which serves the greater
community of Newland County and other rural satellite counties within the state. In 2013, SHS
unfolded a new heart clinic located at their Smithson East hospital as a tactical response to some
disturbing outcome data and the evolving healthcare environment. The clinic's purpose was to
improve outcomes for patients with a primary diagnosis of heart failure and respond to
reimbursement changes associated with the Affordable Care Act (ACA). After three years of
aggregating data on the operating performance of the heart clinic, an evaluation of the impact and
success of the clinic is required. This analysis will offer conclusions and suggestions that will
influence the future of the heart clinic's vitality for consideration to Smithson East's Chief Operating
Officer (Chelsea Rigland) and its senior staff. Financial Information: The document severely lacks
pertinent financial information for the three years of operation of the heart clinic. Besides some
minimal information of mean revenue and expenses for 2011, the document neglects to offer any
other valuable financial information for consideration. This section can be further expanded with
details of an income statement, balance sheet and current statement of cash flows. Financial
statements can be a healthy management tool to illustrate the success of operating performance to
appropriate stakeholders and their constituents.

Health Care System : Health Is My Right, Health System
Health is my Right, Health System Health care system is the organization of people, institutions and
it resources to meet and deliver the health care needs of the targeted population (Welcome, M. O.
(2011). Health care is delivered differently in every country and every individual wish for a better
quality of care and health care system in their country. We always want to be in that position where
we can make our own health care decisions without someone telling us what to do. The purpose of
this paper is to discuss the health system of two countries such as Cuba and Nigeria by comparing
their health care system, the system building block, goals or outcome and how the system impact
individual's right to healthcare. Nigeria uses a healthcare system known as the pluralistic system
where there is the involvement of both the public and the private sector (Skolnik, Richard L (2016).
The federal government takes charge of mostly university Teaching Hospital and Federal Medical
Center while the State and Local Government is responsible for Dispensaries or Primary health care
regulated by federal government. The private sectors in the country are largely involved in
delivering health care services as well. Looking into the healthcare system building block, Nigeria
healthcare system is poorly build with no developed, adequate and functional health system to
achieve success in their healthcare system in this modern era (Welcome, M. O. (2011). The country
is underserved when it comes

Health System In Australia
There is an old joke about one fish asking another about the state of the water and the other
answering "what's water?" When one is immersed in something and that is his daily experience he is
not able to step outside it – all you sees is what he knows.
With all the talk about Australia's health system being untenable, it's useful to step back and look at
the Australian health system in an international context.
Australia's health system is complex, and best described as a web of services, providers, recipients
and organizational structures. And they all seem to be doing a good job because research conducted
by Grattan Institute/OECD shows that. Australia sits above average in life expectancy when
compared to other countries. This is good ... Show more content on Helpwriting.net ...
Australian Nobel Laureates Sir Frank Macfarlane Burnet and Professor Peter Doherty, were the first
to change scientists' basic understanding of the function of the immune system, as well as the way
infectious diseases and autoimmune diseases (A disease in which the body produces antibodies that
attack its own tissues, leading to the deterioration and in some cases to the destruction of such
tissue) are diagnosed and treated. Another Australian Nobel Laureate Sir Howard Florey developed
the first antibiotic, penicillin, for use in humans.
Due to all these discoveries Australia has been fortunate in its experience with infectious diseases
over the past century. By the 1960s, many communicable diseases were controlled. Australia is the
leader of world immunology.
At present scientists from CSIRO research institute are studying mosquitoes and other insects that
carry and transmit disease causing viruses in order to gain knowledge on the viruses they carry, how
they develop immunity against them and how to best prevent or manage these animal and human
health

The Health Of The Canadian Health System
Oral health is not considered an integral part of Canada 's universal, publicly–funded health care
regime. Dental care, outside of a hospital setting, does not constitute a 'medically necessary' service
for the purpose of maintaining health as per the Canada Health Act (1964). There are three
components to the Canadian health system that exist today: universal, publicly–funded coverage for
physician and hospital services (known as Medicare); goods and services such as home care, long–
term care, and prescription drugs which are funded either privately (through insurance or out–of–
pocket), or publicly (through targeted subsidies or direct delivery programs); and finally, private
health care services which include dental care.1 Costs for ... Show more content on Helpwriting.net
...
in Finland, where up to 79 per cent of dental care is publicly–funded.3 A report issued by the
Canadian Academy of Health Sciences states that six million Canadians per year avoid visiting a
dental professional for cost reasons.2 While the private sector provides excellent quality of oral
health care for its patients, many vulnerable groups have difficulty with access.2 It is also these
vulnerable groups who demonstrate extremely high levels of oral health disease. According to a
2014 report issued by the Canadian Academy of Health Services (CAHS), the following represent
Canada's most vulnerable groups: individuals with low incomes; younger age children living in
low–income families; individuals working without dental insurance; elderly populations with low
incomes and/or living in institutions; aboriginal people, immigrants/refugees; people with
disabilities; and, populations living in rural/remote communities.2 The CAHS authors report that
increasingly and in light of challenging economic times, families from lower–middle income strata
are also demonstrating difficulty with accessing oral health care (this is partially attributable to an
increasing tendency toward part–time employment rather than full–time employment with benefits).
Oral health has many

An Integrated Health System
Integrated health systems talk to each other about their patients or constituents thereby providing the
best care possible. Understanding racial, ethnic and other global disparities helps provide a balanced
care. Health care providers and public health professionals who understand "ways in which race,
ethnicity, and SES" combine and influence health outcomes is important in addressing health
disparities across the "socioeconomic spectrum" and among minority groups ( Williams, Priest,
Anderson (2016). Health systems and services should be integrated with available community
services like mental health, nutritional health, counseling, day care centers, and public health
education programs. Providers should think of providing complete services

The Health Of A Health Care System
A health care system is a framework of interrelated, interacting, and interdependent descriptions of
human development in a given country, region, or community. This system of human development
functions as an organized measure to promote and provide treatment in which individuals reach their
highest attainable level of physical, mental, and social well–being. All health care systems are
grounded in the concept that genetic and biological factors must be taken into account to understand
the problems and behaviors of a specific population. The interconnected factors that determine an
individual's health status includes personal features, social status, culture, environment, educational
attainment, health behaviors, childhood development, access to care, and government policy.
International collaboration of ideas on the progression of transnational health is greatly endorsed for
the benefit of complete global health care. Health care has social, governmental, and financial
implications that affect all members of the health care system and in countries within the Central
American region specially, citizens have fallen victim to health disparities that have resulted from
long–term neglect of the underlying factors that perpetuate this issue. It is imperative for children to
develop with healthy nutrition during their first five years of life in order to sustain a healthy well
being. When a child experiences stunted growth, they often have difficulties learning and

Assessment Of The Health System
Assessment of the Health System in the Philippines : an analysis of Out– of– Pocket Expenditure
INTRODUCTION The World Health Organization's (WHO) Commission on Macroeconomics and
Health stated that "the wisdom of every culture teaches that health is wealth" (p21). In fact,
developing a strong health system has emerged as a priority for many countries. Furthermore,
understanding the major components of the health system, and identifying main constraints, are two
crucial steps in attaining key health outcomes. This paper discusses the health system of the
Philippines using the WHO's Building Blocks. The Philippines is a group of islands located in
Southeast Asia with a total population of 96 million. The Life expectancy of male is 69 and female
is 72 years, with significant variations between regions. The leading causes of deaths include
communicable diseases such as pneumonia and tuberculosis, and non–communicable diseases like
heart conditions. The total expenditure on health per capita is US$ 202 while the gross domestic
product (GDP) is US$ 159.3 billion. (Romualdez, 2011). The country's health reforms have had
some success, notably a reduction in maternal and child mortality. Nevertheless, the country
continues to register poor health status, and registers significantly high out–of–pocket (OOP) health
expenditures. We examine OPP spending as one of the main health issues in the country. This paper
is organized in five major sections. In the first section, we

Health Service System : A Market Based Health System
Background
Health service system as defined by "Roemer" in the text is the pooling of resources, organizations,
financing, and management that aggregates to the delivery of health services to the needs of a
population (Barton, p.3).
Demographics
Health service in most cases is crafted by the economic and social values systems of each respective
country . It contributes to a countries economic GDP(gross domestic product), by creating various
areas of employment opportunities, examples including and not limited to the delivery of medical
services, research and development of new drugs for the treatment of various ailments, insurance
services to name a few (Barton, p.3).
Statistics
As stated in the text, the United States provides a market based health system. Not until recently, the
majority of the population could only access the insurance market through an employer based
system. The ability to acquire insurance or gain access into the market outside of this medium was,
in most cases, exorbitant for the average citizen. Nevertheless, government assistance programs like
Medicare and Medicaid were made available to certain demographics of the population who
qualified for these programs, such as citizens from the age of 65 and above, expecting mothers, as
well as newly born infants. The rest of the population demographic 18–44 which consist of the
highest number of uninsured, is left to either attain insurance through their employers after gaining
full–time employee

The Health Information System
Abstract: The Health Information System (HIS), an health organization with many departments and
functional units, facing trends in changes of an overall work processes. The principles of goal setting
sees the departments restructuring and re–engineering strategy implementation towards achievable
goal. The work design onlook the departments effort in making sustainable health services. The job
redesign had set modification and re–arrangement of task structure and processes of work
administered through the principles of job enrichment. Keywords: electronic environment, rate of
workdone, limits complexity, managerial tools. Introduction Due to growing trends and changes in
the processes organization experienced, the Health Information Services (HIS) stepped up its
organizational design in its strategy formulated. Introducing the efficacy of electronic health records
that also overhaul changes in the health care delivery system in various department, enabling task
variety among professionals. Challenges of job enlargement, as insinuated to become alternatives in
complementing the changes in experiencing in the departments. Employees and professionals in the
organization seemed vested with accomplishment of their assigned tasks, assignments, works and
responsibilities towards the achieving organisation's goal setting. Leaders in the all departments tend
to plan, organize, and controls the goal set with the four different strategic model– re–engineering,
restructuring,

Health Care System
Given the fact that the United states of America and Canada are linked together sharing a border
which is open basically to and from both sides, their health care systems are highly different from
each other and how the services are financed, organized and given to the citizens.
In Canada, healthcare comes from the 'Single payer system' (Canadian health care system, 2013).
Single payer is known to be quite normal in many other countries, for example, New Zealand. It is
basically a publically funded system that is provided by the provincial governments through taxes
with guidance and some funds from the federal government (Canadian health care system, 2013).
This health system covers Canadian citizens, permanent residents and temporary ... Show more
content on Helpwriting.net ...
Most of all the U.S. citizens need a more privately owned insurance to cover the cost of medical
care services. Group health insurance purchased by employers were introduced originally during
World War II, when wages froze it caused employers to offer benefits such as a way to compete for
workers. Nearly every amend since the early 1970s has desired to grow this concept of things. There
are now currently more than 1200 privately owned insurance companies in America. Public
insurance is provided for the poor that can't afford good healthcare (Medicaid) and for those over
age sixty–five (Medicare). The Medicare system administers medical coverage for those who are at
the age 65 and older. In addition, younger people with disabling illnesses or injuries are suitable for
Medicare coverage. Those who are under age 65, but do not have health insurance are too poor to
afford it and are eligible for medical coverage through Medicaid. Medicare is financed by federal
income taxes, while Medicaid is funded by a blend of state and federal taxes. Medical insurance for
those who can't seem to get it anywhere else is actually paid for by the more prosperous citizens,
basically the rich and well paid citizens. It is paid not directly, but through work and taxes that they
pay

Health System Formations
4. Methods
Data and Study Sample
This study examined whether the two health system formations analyzed in the previous essay,
Health System A and Health System B, can pass the antitrust safety zone test for horizontal hospital
mergers and acquisitions. The main data source for this essay is MarketScan® Commercial Claims
and Encounters Database, which is a unique private insurance claims database that includes 23
million employees, dependents and retirees from around 100 large private employers (Adamson,
Chang & Hansen, 2008). This study collected patient flow information from this detailed database,
which includes patient and hospital characteristics. The AHAAnnual Survey Database™ is another
source used in this study. Comprehensive hospital ... Show more content on Helpwriting.net ...
The MarketScan database includes patient zip code information but it only covers a sub–sample of
the total hospital admissions. This study used patient admission distribution from MarketScan as a
proxy for actual patient admission distribution across zip code areas. Table A1 and A2 show the
patient zip code distributions of Health System B. Figure A1 and A2 show PSA 3 for Hospital B1
and PSA 4 for Hospital B2.
Herfindahl–Hirschman Index
The Herfindahl–Hirschman Index (HHI), one of the most frequently used market concentration
measures, defined as the sum of squared market shares of a firm in the relevant market (Rhoades,
1993). The Antitrust Agencies recommend HHI to assess market concentration of a market for
antitrust analysis (Department of Justice and Federal Trade Commission, 1992). The HHI is
calculated by
where N refers total number of hospitals in a market, and xi refers market share for a hospital i.
Holding the market shares of other hospitals equal, the change in HHI when hospital j and k would
merge into a health system is calculated

Health Systems Thinking

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