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Health CareHealth Care
DeliveryDelivery
SystemSystem
Evolution of Healthcare System
How Do You Define
HEALTHHEALTH
? ? ?
How Can You Define
SYSTEMSYSTEM
? ? ?
Did You Exposed to a Prior
Discussion about
HEALTH CARE DELIVERYHEALTH CARE DELIVERY
? ? ?
Let us have a discussion about this …
Health
A state of complete physical, mental, and
social well-being and not merely the absence
of disease or infirmity
Health Care System
A collection of people and organizations
working together to provide health care to the
population
Organization
Two or more people working together within
identifiable boundariesboundaries to accomplishedaccomplished a
common goal.
Any organization has an INTERNALINTERNAL and
EXTERNALEXTERNAL environment
External Environment
All activities that are outsideoutside an organization
and have the potential to influence the
organization
System
A set of interrelated componentsof interrelated components that serve a
greater purpose than the singular
components
Systems either be OpenOpen or ClosedClosed
Open System
System that interactinteract with its environment
Closed System
System that DONOTDONOT interactinteract with its
environment
SystemSystem
ComponentsComponents
What are the components of the
SYSTEMSYSTEM
??????
System Components
feedback
feedback
feedbackfeedback
System ComponentsSystem Components
• Input - - - - Resources.
• Throughput - - - - transforming process.
• Output - - - - the product (desired Vs undesired)
(intended Vs unintended)
(primary or secondary)
• Feedback - - - - communication and control
mechanism in and between systems
• Boundaries - - - - point of interaction b/w system and
environment
Example:Example:
FIGURE 1-1 Characteristics of a system
Evolution of HCSsEvolution of HCSs
• Before 1900Before 1900 … private physicians & medics.
charitable hospitals, NO insurance companies.
• Early 1900sEarly 1900s … public hospitals for poor ppl.
• In the 1980sIn the 1980s … many models established due
to economic constrains.
Characteristics of HCS:Characteristics of HCS:
TWO general types of services:
Illness (restorative).(restorative).
Wellness (preventive).(preventive).
Characteristics of Healthcare SystemCharacteristics of Healthcare System
TaxesTaxes TaxesTaxes
ControllerControllerControllerController
Healthcare perspectivesHealthcare perspectives
TWO perspectives on healthcare industry:
Government Vs Taxes (Horizontal axis)(Horizontal axis)
Who control how healthcare is delivered
(Vertical axis)(Vertical axis)
Healthcare perspectivesHealthcare perspectives (Cont.)(Cont.)
• Free market medicine,Free market medicine,
Where doctors determine who and how to
treat, and patients pay for their treatment
either directly or through private insurance
plans.
• The upper left contains single payerThe upper left contains single payer
health insurance,health insurance,
In which medical services are still provided
by the private sector, but the government
pays for the health care costs of its citizens
with taxes.
• In the lower left is socialized medicine,In the lower left is socialized medicine,
Where the government controls delivery of
health care, either through direct
employment of health care providers or
through heavy regulation, and pays for the
associated costs with taxes.
• In the lower right is governmentIn the lower right is government
monopoly,monopoly,
Which no implemented health care systems
currently emulate, but has been used in other
industries, such as the US postal service.
HealthcareHealthcare
SystemSystem
inin
Saudi ArabiaSaudi Arabia
Healthcare system in Saudi ArabiaHealthcare system in Saudi Arabia
The healthcare system in Saudi Arabia can
be classified as a nationalnational health carehealth care
systemsystem in which the governmentgovernment provides
health care services through a number of
government agencies. The Ministry of HealthThe Ministry of Health
(MOH)(MOH) is the National Health Service (NHS)
for the entire population
Ministry of Health (MOH)Ministry of Health (MOH)
1. The Ministry of Health (MOH) is the major government
agency which provides preventive, curative and
rehabilitative health care for the Kingdom’s population.
2. The (MOH) provides primary health careprimary health care (PHC) services
through a network of health care centers.
Ministry of Health (MOHMinistry of Health (MOH))
3. The (MOH) applies the referral systemapplies the referral system which provides
curative carecurative care for all members of society from the level of
– General practitionersGeneral practitioners at health centers to advanced
technology specialist curative services through a broad
base of general and specialist hospitals.
4. The MOH is considered the lead government agency
responsible for the management, planning, financing and
regulating of the health care services.
Ministry of Health (MOH)Ministry of Health (MOH)
5. The MOH is responsible for the overall supervision and
follow-up of health care related activities carried out by the
private sector.
6. There are three other mini-NHS which finance and deliver
primary, secondary and tertiary care to specific security and
armed forces populations:
Ministry of Defense and Aviation (MODA)Ministry of Defense and Aviation (MODA)
Ministry of Interior (MOI)Ministry of Interior (MOI)
National Guard (SANG)National Guard (SANG)
Ministry of Health (MOH)Ministry of Health (MOH)
7. There are several independent government agenciesindependent government agencies which
are responsible for the delivery and financingdelivery and financing of health care
services in the KSA:
• Ministry of EducationMinistry of Education provides immediate primary health
care to students
• The Ministry of Labor and Social AffairsMinistry of Labor and Social Affairs provides long term
care for the mentally retarded and custodial homes for
orphans
• The General Organization for Social Insurance and GeneralGeneral Organization for Social Insurance and General
Presidency of Youth WelfarePresidency of Youth Welfare provide health services for the
population in connection with sport facilities
• The Royal Commission for Jubail and YanbuRoyal Commission for Jubail and Yanbu provides health
services for employees and residents at the two industrial
cities (Jubail and Yanbu).
• The Saudi Arabian AirlinesSaudi Arabian Airlines provides health services to its
employees
• The Kingdom’s universitiesKingdom’s universities provide health care to its
employees and students, through their medical colleges or
hospitals. They also provide specialist curative services and
medical education and training programs, while they also
conduct health research in collaboration with other research
centers
8. The Government also finances and provides care on a
referral basis in its major specialized national tertiary care
referral hospitals:
• King Faisal Specialist Hospital and Research Center:King Faisal Specialist Hospital and Research Center: uses highly
advanced technologies and is a reference hospital for cases that
require advanced and specialist treatment , while it also conducts
research on health issues
• King Khalid Eye Specialist Hospital:King Khalid Eye Specialist Hospital: is a large health facility offering
high quality specialized services for ophthalmology and eye surgery
and medicine. It’s also a regional research center in the area of
ophthalmology. The hospital also has a cornea bank.
9. The Saudi Red Crescent SocietySaudi Red Crescent Society provides emergency
services at the pre-hospital stage, either at the scene of
accidents or during the transportation of patients to
hospitals. The society also provides these services for
pilgrims during Hajj and Umrah at the Holy Places of Mecca
and Medina
10. The private sectorprivate sector provides health services through its
health facilities including hospitals, dispensaries,
laboratories, pharmacies and physiotherapy centers
throughout the kingdom.
Coverage and eligibility of healthCoverage and eligibility of health
care in KSAcare in KSA
• Saudi Arabia has universal health care coverage. Free
health care is a right for all Saudi citizens and expatriates
working in the public sector. There are two different
coverage groups:
– Saudis and expats working in the public sector.
– Expatriates working in the private sector.
• Generally, Saudi Health System law established a national
Health Services Council for the coordination of health
services to be responsible for the following tasks:
• Coordinating with educational and training institutionsinstitutions to
meet the need for Saudi workers in the health fields
• Coordinating and integratingintegrating all health system elements in
the kingdom iincludingncluding the private sector
• Ensuring optimal utilizationEnsuring optimal utilization of health facilities and available
resources in the Kingdom
• Selecting adequate alternativesSelecting adequate alternatives for the operation of hospitals
and financing health care services
• Developing specific criteria for the establishment of new
health facilities.
• Ensuring regional balanceregional balance regarding health care services
• Selecting adequate alternatives in the field of health
insurance
• Conducting studies and research in the health services at
the national level
Health Manpower in Saudi HeathHealth Manpower in Saudi Heath
CareCare
To meet the challenge imposed by the shortage of
qualified health personnel, the Labor Force Council
in Saudi Arabia adopted on 1/12/1423H a strategy
for the development of labor force in the health
sector containing short and long term goals to be
achieved through the following policies:
• Encourage the private sector to invest in the establishment
of medical schools and health colleges
• Increase capacity level in established health colleges and
institutes
• Increase opportunities for scholarships in health specialties
• Encourage hospitals to establish their own training centers
• Establish more teaching/training hospitals
• Use non-conventional educational systems
• Enlarge the base of medical postgraduate studies
• Strengthen the role of the Saudi council for Health
Specialties
Evolution of healthcare_delivery

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Evolution of healthcare_delivery

  • 2. How Do You Define HEALTHHEALTH ? ? ?
  • 3. How Can You Define SYSTEMSYSTEM ? ? ?
  • 4. Did You Exposed to a Prior Discussion about HEALTH CARE DELIVERYHEALTH CARE DELIVERY ? ? ?
  • 5. Let us have a discussion about this …
  • 6. Health A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity
  • 7. Health Care System A collection of people and organizations working together to provide health care to the population
  • 8. Organization Two or more people working together within identifiable boundariesboundaries to accomplishedaccomplished a common goal. Any organization has an INTERNALINTERNAL and EXTERNALEXTERNAL environment
  • 9. External Environment All activities that are outsideoutside an organization and have the potential to influence the organization
  • 10. System A set of interrelated componentsof interrelated components that serve a greater purpose than the singular components Systems either be OpenOpen or ClosedClosed
  • 11. Open System System that interactinteract with its environment
  • 12. Closed System System that DONOTDONOT interactinteract with its environment
  • 14. What are the components of the SYSTEMSYSTEM ??????
  • 16. System ComponentsSystem Components • Input - - - - Resources. • Throughput - - - - transforming process. • Output - - - - the product (desired Vs undesired) (intended Vs unintended) (primary or secondary) • Feedback - - - - communication and control mechanism in and between systems • Boundaries - - - - point of interaction b/w system and environment
  • 19. Evolution of HCSsEvolution of HCSs • Before 1900Before 1900 … private physicians & medics. charitable hospitals, NO insurance companies. • Early 1900sEarly 1900s … public hospitals for poor ppl. • In the 1980sIn the 1980s … many models established due to economic constrains.
  • 20. Characteristics of HCS:Characteristics of HCS: TWO general types of services: Illness (restorative).(restorative). Wellness (preventive).(preventive).
  • 21. Characteristics of Healthcare SystemCharacteristics of Healthcare System TaxesTaxes TaxesTaxes ControllerControllerControllerController
  • 22. Healthcare perspectivesHealthcare perspectives TWO perspectives on healthcare industry: Government Vs Taxes (Horizontal axis)(Horizontal axis) Who control how healthcare is delivered (Vertical axis)(Vertical axis)
  • 24. • Free market medicine,Free market medicine, Where doctors determine who and how to treat, and patients pay for their treatment either directly or through private insurance plans.
  • 25. • The upper left contains single payerThe upper left contains single payer health insurance,health insurance, In which medical services are still provided by the private sector, but the government pays for the health care costs of its citizens with taxes.
  • 26. • In the lower left is socialized medicine,In the lower left is socialized medicine, Where the government controls delivery of health care, either through direct employment of health care providers or through heavy regulation, and pays for the associated costs with taxes.
  • 27. • In the lower right is governmentIn the lower right is government monopoly,monopoly, Which no implemented health care systems currently emulate, but has been used in other industries, such as the US postal service.
  • 29. Healthcare system in Saudi ArabiaHealthcare system in Saudi Arabia The healthcare system in Saudi Arabia can be classified as a nationalnational health carehealth care systemsystem in which the governmentgovernment provides health care services through a number of government agencies. The Ministry of HealthThe Ministry of Health (MOH)(MOH) is the National Health Service (NHS) for the entire population
  • 30. Ministry of Health (MOH)Ministry of Health (MOH) 1. The Ministry of Health (MOH) is the major government agency which provides preventive, curative and rehabilitative health care for the Kingdom’s population. 2. The (MOH) provides primary health careprimary health care (PHC) services through a network of health care centers.
  • 31. Ministry of Health (MOHMinistry of Health (MOH)) 3. The (MOH) applies the referral systemapplies the referral system which provides curative carecurative care for all members of society from the level of – General practitionersGeneral practitioners at health centers to advanced technology specialist curative services through a broad base of general and specialist hospitals. 4. The MOH is considered the lead government agency responsible for the management, planning, financing and regulating of the health care services.
  • 32. Ministry of Health (MOH)Ministry of Health (MOH) 5. The MOH is responsible for the overall supervision and follow-up of health care related activities carried out by the private sector. 6. There are three other mini-NHS which finance and deliver primary, secondary and tertiary care to specific security and armed forces populations: Ministry of Defense and Aviation (MODA)Ministry of Defense and Aviation (MODA) Ministry of Interior (MOI)Ministry of Interior (MOI) National Guard (SANG)National Guard (SANG)
  • 33. Ministry of Health (MOH)Ministry of Health (MOH) 7. There are several independent government agenciesindependent government agencies which are responsible for the delivery and financingdelivery and financing of health care services in the KSA: • Ministry of EducationMinistry of Education provides immediate primary health care to students • The Ministry of Labor and Social AffairsMinistry of Labor and Social Affairs provides long term care for the mentally retarded and custodial homes for orphans • The General Organization for Social Insurance and GeneralGeneral Organization for Social Insurance and General Presidency of Youth WelfarePresidency of Youth Welfare provide health services for the population in connection with sport facilities
  • 34. • The Royal Commission for Jubail and YanbuRoyal Commission for Jubail and Yanbu provides health services for employees and residents at the two industrial cities (Jubail and Yanbu). • The Saudi Arabian AirlinesSaudi Arabian Airlines provides health services to its employees • The Kingdom’s universitiesKingdom’s universities provide health care to its employees and students, through their medical colleges or hospitals. They also provide specialist curative services and medical education and training programs, while they also conduct health research in collaboration with other research centers
  • 35. 8. The Government also finances and provides care on a referral basis in its major specialized national tertiary care referral hospitals: • King Faisal Specialist Hospital and Research Center:King Faisal Specialist Hospital and Research Center: uses highly advanced technologies and is a reference hospital for cases that require advanced and specialist treatment , while it also conducts research on health issues • King Khalid Eye Specialist Hospital:King Khalid Eye Specialist Hospital: is a large health facility offering high quality specialized services for ophthalmology and eye surgery and medicine. It’s also a regional research center in the area of ophthalmology. The hospital also has a cornea bank.
  • 36. 9. The Saudi Red Crescent SocietySaudi Red Crescent Society provides emergency services at the pre-hospital stage, either at the scene of accidents or during the transportation of patients to hospitals. The society also provides these services for pilgrims during Hajj and Umrah at the Holy Places of Mecca and Medina 10. The private sectorprivate sector provides health services through its health facilities including hospitals, dispensaries, laboratories, pharmacies and physiotherapy centers throughout the kingdom.
  • 37. Coverage and eligibility of healthCoverage and eligibility of health care in KSAcare in KSA • Saudi Arabia has universal health care coverage. Free health care is a right for all Saudi citizens and expatriates working in the public sector. There are two different coverage groups: – Saudis and expats working in the public sector. – Expatriates working in the private sector. • Generally, Saudi Health System law established a national Health Services Council for the coordination of health services to be responsible for the following tasks:
  • 38. • Coordinating with educational and training institutionsinstitutions to meet the need for Saudi workers in the health fields • Coordinating and integratingintegrating all health system elements in the kingdom iincludingncluding the private sector • Ensuring optimal utilizationEnsuring optimal utilization of health facilities and available resources in the Kingdom • Selecting adequate alternativesSelecting adequate alternatives for the operation of hospitals and financing health care services
  • 39. • Developing specific criteria for the establishment of new health facilities. • Ensuring regional balanceregional balance regarding health care services • Selecting adequate alternatives in the field of health insurance • Conducting studies and research in the health services at the national level
  • 40. Health Manpower in Saudi HeathHealth Manpower in Saudi Heath CareCare To meet the challenge imposed by the shortage of qualified health personnel, the Labor Force Council in Saudi Arabia adopted on 1/12/1423H a strategy for the development of labor force in the health sector containing short and long term goals to be achieved through the following policies:
  • 41. • Encourage the private sector to invest in the establishment of medical schools and health colleges • Increase capacity level in established health colleges and institutes • Increase opportunities for scholarships in health specialties • Encourage hospitals to establish their own training centers • Establish more teaching/training hospitals • Use non-conventional educational systems • Enlarge the base of medical postgraduate studies • Strengthen the role of the Saudi council for Health Specialties