This document discusses the history and definition of health systems. It begins by defining a health system as the organization of people and resources that deliver healthcare services. The document then discusses the origins of healthcare, including the establishment of hospital systems by the Catholic Church in medieval Europe. It emphasizes that understanding history is important to avoid repeating past mistakes and highlights how innovations were sometimes previously practiced, such as hand washing. The document concludes by discussing attributes of good health systems, including standards of education and evidence-based practice, and attributes of better health systems, focusing on continuous improvement built on past successes rather than new innovations alone.

1. “An Introduction to
Health Care System”
By: Christine R. Guerrero, RMT, MLS (ASCPi)CM
● Definition of Health System
● Health Care Reform
● History of Health System
● Why Health System History Matters
● Attributes of a Good Health System
● Attributes of a Better Health System

2. DEFINITIONS
A health system, also sometimes referred to as
health care system or as healthcare system, is the
organization of people, institutions, and resources
that deliver health care services to meet the health
needs of target populations.
Health care reform is a general rubric used
for discussing major health policy creation or
changes—for the most part, governmental
policy that affects health care delivery in a
given place.

3. History of Health Care - Origins
The Catholic Church established a hospital
system in Medieval Europe that vastly
improves from the merely reciprocal hospitality
of the [Jews and] Greeks and family-based
obligations of the Romans. These hospitals were
established to cater to "particular social groups
marginalized by poverty, sickness, and age,"
according to historian of hospitals, Guenter Risse.
[Risse, Guenter B (April 1999). Mending Bodies, Saving Souls: A History of Hospitals.
Oxford University Press. p. 59. ]

4. Sir William Osler (1849–1919) and a few
dozen other visionary clinicians (William
Halsted, Howard Kelly, Florence Nightingale,
William Welch, Harvey Cushing, etc.) laid the
foundation for modern clinical care. He has
frequently been described as the "Father of
Modern Medicine" and one of the "greatest
diagnosticians ever to wield a stethoscope".
He lived and practiced during a time of great
change in healthcare.
History of Health Care - Origins

5. Does history matter?
“All of this history is important because it
changes how we think about the present and
future.” (Healthcare: A Better Way, John L. Haughom, MD, © 2017
HealthCatalyst.com, p. 9)
“Progress, far from consisting in change, depends on
retentiveness. When change is absolute there
remains no being to improve and no direction is set
for possible improvement, and when experience is not
retained, as among savages, infancy is perpetual.
Those who cannot remember the past are
condemned to repeat it.” -George Santayana, 1905.
History of Health Care - Origins

6. In other words, the main point in
developing a good health system lies
NOT in mere innovation but in improving
what has already worked in the past.
“Read it up—you really should. There is
nothing new under the sun. It has all been
done before.” -Sherlock Holmes, quoting Ecclesiastes
Indeed, many so called “innovations” were
already done before.
History of Health Care - Origins

7. Hand washing, for example, was
practiced by Jewish rabbis and Catholic
priests alike before the advent of “modern
medicine” as a religious act.
This very religious act also helped prevent
the spread of disease in both Jewish
ghettos and Catholic monasteries.
Hand washing was already practiced
before the science of microbiology.
History of Health Care - Origins

8. Health System and
Health Care Reform
Often health system has been defined
with a reductionist perspective, for
example reducing it to healthcare system.
In many publications, for example, both
expressions are used interchangeably.
Some authors have developed arguments
to expand the concept of health systems,
indicating additional dimensions that
should be considered:

9. Health System and
Health Care Reform
● Health systems should not be expressed in terms of their
components only, but also of their interrelationships;
● Health systems should include not only the institutional or supply
side of the health system, but also the population;
● Health systems must be seen in terms of their goals, which include
not only health improvement, but also equity, responsiveness to
legitimate expectations, respect of dignity, and fair financing,
among others;
● Health systems must also be defined in terms of their functions,
including the direct provision of services, whether they are medical
or public health services, but also "other enabling functions, such
as stewardship, financing, and resource generation, including what
is probably the most complex of all challenges, the health
workforce."

10. ● New, high standards of clinical education
● Strict requirements for professional licensing
● Clinical practice founded on scientific research
● New internal organization for hospitals
● Creation of new, more modern nurse practices
● Implementation of more modern hygiene
techniques
● New public health policies and treatments
Attributes of a
Good Health System

11. ● New, high standards of clinical education
● Strict requirements for professional licensing
● Clinical practice founded on scientific research
● New internal organization for hospitals
● Creation of new, more modern nurse practices
● Implementation of more modern hygiene
techniques
● New public health policies and treatments
Attributes of a
Good Health System

12. LET US REMEMBER THAT MERE
INNOVATION IS NOT SYNONYMOUS
WITH IMPROVEMENT.
Sir Isaac Newton is known to have said,
“If I have seen further it is by standing on the
shoulders of giants.”
Just because something is new does NOT
mean that it is better.
Attributes of a
Good Health System

13. ● New, high standards of clinical education
● Strict requirements for professional licensing
● Clinical practice founded on scientific research
● New internal organization for hospitals
● Creation of new, more modern nurse practices
● Implementation of more modern hygiene
techniques
● New public health policies and treatments
Attributes of a
Good Health System

14. ● Better standards of clinical education
● Rational requirements for professional licensing
● Clinical practice founded on scientific principles
● Effective internal organization for hospitals
● Creation of better medical practices
● Implementation of successful hygiene techniques
● Efficient public health policies and treatments
Attributes of a
BETTER Health System

15. The thing that hath been, it is that which
shall be; and that which is done is that
which shall be done: there is no new thing
under the sun. Is there anything that may
be said, “See, this is new”? It hath been
already of old time, which was before us.
Ecclesiastes i. 9­10