Introduction
Healthcare delivery systems are organizations of people, institutions, and resources to deliver health care services to meet the health needs of the target population, whether a single provider practice or an extended care system(Piña, Cohen, Larson, Marion, Sills, Solberg, & Zerzan, 2015). The effective healthcare stakeholders group (SG) under the Agency of Healthcare Research and Quality (AHRQ) formed the Delivery Systems Committee (DSC) consisting of clinicians, policymakers, patient advocates, and researchers to develop a framework to characterize healthcare delivery systems. This paper summarizes the article produced by the DSC categorizing healthcare delivery systems.
According to the article, there are many innovations in healthcare delivery systems in the United States.The innovations result in a need for standardization of ways to describe, measure, compare, and evaluate healthcare delivery systems. A standardized system results in improved communication and quality of care given to patients. Common taxonomy was essential to enhance Comparative Effectiveness Research (CER), which relies on a standardized framework to compare the benefits and harms of healthcare delivery methods.
The article states that there was a lack of a common and standard way of describing healthcare delivery units, thus hindering the stakeholders from determining whether a study or innovation applied to the different healthcare settings. The proposal of the healthcare delivery description framework enables a better understanding, evaluation, and implementation of innovations and easier comparisons between healthcare delivery systems.
The DSC started categorization by first considering the existing descriptions present in the United States healthcare. The AHRQ had funded research that had resulted in the classification of most of the healthcare networks. However, continued innovation resulted in increased complexity of the healthcare system giving rise to a need for standardization.The complexity of the healthcare systems was further enhanced by the addition of public healthcare agencies, which are dynamic organizations.
The system used to characterize healthcare systems resulted in fragmented systems.A new categorization was needed because the standards for small systems were not applicable to multihospital systems. Fragmentation of healthcare delivery systems contributes to the unnecessary application of resources and results in a poor quality of care.
A new approach to defining healthcare delivery systems was conceived. The original method used domains and elements to describe healthcare delivery systems, even when they are different in size. There were various members to provide a diversity of perspectives. The final framework consisted of six domains and 26 elements.
The committee went through three phases during the development of the framework. Members of the committee reviewed the available literature, discussed in groups, and synthesized individual written feedback. The physical assets, personnel and the organizational characteristic that determine the number of patients able to receive care and the scope of conditions which can be treated in a facility define the capacity of an institution(Piñaet al., 2015). The capacity domain has elements that are best suited for it.
Other domains used in the system are the organizational structure domain, finance domain, patient's domain, care domain, and culture domain. The various fields provide a comprehensive system of describing and comparing healthcare delivery systems. Elements that define similar features are grouped in one domain.
Assessment and Reflection
The article provides a framework of domains and elements that can be used to categorize the healthcare delivery systems in the United States. The report presents the methods used to develop the structure as well as examples of possible applications.
The framework given in this article is essential in healthcare since it is used in comparative effectiveness research to determine the effectiveness of new methods of prevention, diagnosing, and treating medical conditions. The framework was needed since there was a lack of standardized system which described all healthcare delivery systems, both small local systems, and large healthcare systems. The proposed framework allows healthcare stakeholders to understand and evaluate healthcare delivery systems.
Implementation of healthcare innovations is more straightforward when healthcare systems can be quickly evaluated and compared with each other regardless of their size. The proposed framework provides a common taxonomy that enables communication and transparency. The system also considers the role of public health agencies as well as the individual needs giving rise to a patient-centered framework.
However, the proposed system has domains with elements that are not tangible and are impossible to quantify, therefore making them more susceptible to bias. The culture domain contains elements that cannot be objectively measured, thus giving the system a possible source of bias. The system also lacks boundaries to easily describe when people are subject to rules and culture of a healthcare system.
Conclusion
In conclusion, the article provides a framework for the categorization of healthcare delivery systems. The system of categorizing healthcare systems provides standard taxonomy that can be used to compare the effectiveness of various healthcare procedures. The framework can be used to understand and study the healthcare delivery system in the United States.
