A health care system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations.
There is a wide variety of health care systems around the world, with as many histories and organizational structures as there are nations. In some countries, health care system planning is distributed among market participants. In others, there is a concerted effort among governments, trade unions, charities, religious, or other co-ordinated bodies to deliver planned health care services targeted to the populations they serve. However, health care planning has been described as often evolutionary rather than revolutionary.
The explosive growth of managed care has led to an increased role for general internists and other primary care physicians in the American health care system. This change is welcome in many respects, since generalists have perennially been undervalued by health care institutions, payers, and even patients. The greater prominence of generalism has led to an increase in the number of medical students who choose careers in primary care, expanded job opportunities for generalists, and a modest increase in the incomes of primary care physicians.
Two of the principles underlying generalism, whether in the form of internal medicine, pediatrics, or family medicine, have been comprehensiveness and continuity. Ideally, the primary care physician would provide all aspects of care, ranging from preventive care to the care of critically ill hospitalized patients. This approach, argued the purists, would result in medical care that was more holistic, less fragmented, and less expensive. To its proponents, the notion was so attractive — the general internist admits the patient to the hospital, directs the inpatient workup, and arranges for a seamless transition back to the outpatient setting — that questioning it would have seemed sacrilegious merely a few years ago.
There is a wide variety of health care systems around the world, with as many histories and organizational structures as there are nations. In some countries, health care system planning is distributed among market participants. In others, there is a concerted effort among governments, trade unions, charities, religious, or other co-ordinated bodies to deliver planned health care services targeted to the populations they serve. However, health care planning has been described as often evolutionary rather than revolutionary.
The explosive growth of managed care has led to an increased role for general internists and other primary care physicians in the American health care system. This change is welcome in many respects, since generalists have perennially been undervalued by health care institutions, payers, and even patients. The greater prominence of generalism has led to an increase in the number of medical students who choose careers in primary care, expanded job opportunities for generalists, and a modest increase in the incomes of primary care physicians.
Two of the principles underlying generalism, whether in the form of internal medicine, pediatrics, or family medicine, have been comprehensiveness and continuity. Ideally, the primary care physician would provide all aspects of care, ranging from preventive care to the care of critically ill hospitalized patients. This approach, argued the purists, would result in medical care that was more holistic, less fragmented, and less expensive. To its proponents, the notion was so attractive — the general internist admits the patient to the hospital, directs the inpatient workup, and arranges for a seamless transition back to the outpatient setting — that questioning it would have seemed sacrilegious merely a few years ago.
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