Healthcare Systems Vocabulary

Flashcards about Healthcare Systems

Providers

Doctors, nurses, hospitals, pharmacies, and all individuals or entities providing healthcare services.

Patients/Population

Individuals or the general public receiving healthcare services.

Insurers (Payors)

Entities, like insurance companies or government programs, responsible for covering healthcare costs.

Payors

A general term for anyone paying for healthcare services, including insurance companies and government entities.

Health Plans

Organizations that arrange for healthcare services, often used synonymously with payors or insurers.

HMO (Health Maintenance Organization)

A type of health insurance that combines the insurance company and provider into a single package.

Well-Functioning Health System

A system that responds to a population’s needs, improves health, defends against threats, protects financially, provides equitable care, and enables participation in health decisions.

Six Main Components of a Health Care System (WHO)

1) Health care services, 2) Health care workers, 3) Information and knowledge system, 4) Medical products, vaccines and technologies, 5) Financing, 6) Leadership and management

Key Goals of Healthcare System Functioning

Quality and accessibility of care, guided by established policies.

Key Principles of Healthcare System

Priority of patient interests, child health, social security, public authority responsibility, availability/quality of care, impossibility of care denial, prevention priority, and medical confidentiality.

Health System Defined

All organizations, people, and actions intended to promote, restore, or maintain health, including efforts to influence health determinants.

Overall Health System Goals (World Health Report 2000)

Improving health and health equity in ways that are responsive, financially fair, and efficient.

Six Building Blocks of a Health System

1) Health services, 2) Health workforce, 3) Health information system, 4) Medical products/vaccines/technologies, 5) Health financing, 6) Leadership and governance.

Good Health Services

Effective, safe, and quality health interventions delivered when and where needed with minimal waste.

Well-Performing Health Workforce

Responsive, fair, and efficient workers achieving the best health outcomes with available resources.

Well-Functioning Health Information System

Ensures the production, analysis, dissemination, and use of reliable and timely health information.

Well-Functioning Health System (Medical Products)

Equitable access to essential medical products, vaccines, and technologies of assured quality, safety, efficacy, and cost-effectiveness.

Good Health Financing System

Raises adequate funds for health, protects people from financial catastrophe, and incentivizes efficient provider and user behavior.

Leadership and Governance

Ensuring strategic policy frameworks, oversight, coalition-building, regulation, system design, and accountability.

Health System Functions

Providing services, developing health workers, mobilizing finances, and ensuring leadership/governance.