Availability of Medical Care: Getting from Volume to Value

The availability of health care is a multidimensional concept that includes a balance of many factors within the framework of severe practical constraints caused by the characteristics of a country’s resources and capabilities. These factors include human resources, funding, vehicles, freedom of choice, public education, quality and distribution of technical resources. The balance of these elements, which maximize the quantity and quality of aid actually received by the population, determines the nature and degree of its availability.

Quality and availability of medical care in the USA

In the modern concept, the availability of medical care means unhindered access to all services in the health care system, regardless of geographical, economic, social, cultural, organizational or linguistic barriers, which must be ensured and conditioned by the balance of the state’s capabilities and the country’s medical resources, including the presence and the level of qualifications of medical personnel; adequate funding for the industry; transport accessibility, the ability to freely choose a doctor and a medical organization, as well as the quality of medical care.

The general criteria for the quality of medical care are the correctness of the implementation of medical technologies, the reduction of the risk to the patient’s condition, the optimal use of resources and the satisfaction of consumers of medical care.

The law provides guarantees to citizens for the provision of affordable and high-quality medical care. Some of the first guarantees outlined in the law are:

• organization of the provision of medical care according to the principle of proximity to the place of residence, place of work or training;
• ensuring the availability of the required number of medical workers and the level of their qualifications;
• ensuring the possibility of choosing a medical organization and a doctor.

According to the law, when providing medical care to a citizen within the framework of the program of state guarantees of free provision of medical care to citizens, he or she has the right to choose a medical organization in the manner approved by the authorized federal executive body, and to choose a doctor, taking into account the consent of the doctor. Features of the choice of a medical organization by citizens living in closed administrative-territorial formations, in territories with physical, chemical and biological factors hazardous to human health, included in the corresponding list, as well as by employees of organizations included in the list of organizations of certain industries with particularly hazardous working conditions, are established by the US Government.

When choosing a doctor and a medical organization, a citizen has the right to receive information in a form accessible to him/her, including posted on the information and telecommunication network of the Internet, about a medical organization, about its medical activities and about doctors, about their level of education and qualifications.

To solve the personnel issue in the field of health care, a strategy has been developed and is being implemented, which is aimed primarily at the correct distribution of personnel and the elimination of imbalances in staffing, at eliminating imbalances. So, at present, large state hospitals, university and academic clinics do not experience a shortage of personnel; and in the primary care, which ensures the maximum accessibility of citizens to medical care, there are not always enough medical workers. Another imbalance is observed in the distribution of doctors by specialties: in some medical specialties there is a shortage of personnel by almost half, while in others there is a surplus.

The solution of personnel issues is also facilitated by additional measures of social support for medical workers working in rural areas, employed in positions in federal-state institutions.

Other measures of personnel policy are being taken – to increase the average salary of doctors and improve working conditions, to optimize the number of medical workers, etc.

Ensuring the availability and quality of health care is also facilitated by the application of health care procedures and standards of care.

In accordance with the law, medical care is organized and rendered in accordance with the procedures for the provision of medical care that are binding on the territory of the United States by all medical organizations, as well as on the basis of standards of medical care. In accordance with the law, the procedures for the provision of medical care and standards of medical care are approved by the authorized federal executive body – U.S. Department of Health & Human Services.

The availability and quality of medical care is ensured by the provision of a guaranteed volume of medical care by a medical organization in accordance with the program of state guarantees of free provision of medical care to citizens.

The quality and availability of medical care is ensured by the fulfillment of the requirements established by the US legislation for the placement of medical organizations of the state healthcare system and the municipal healthcare system and other infrastructure in the healthcare sector based on the needs of the population, transport accessibility of medical organizations for all groups of the population, including the disabled and other groups population with limited mobility, as well as the possibility of unimpeded and free use of communication means or vehicles by a medical worker to transport a patient to the nearest medical organization in cases that threaten his life and health.

The availability of medical care is also ensured by the legal opportunity for a medical worker to freely and free of charge use communication means or vehicles to transport a patient to the nearest medical organization in cases that threaten his/her life and health. This right of medical workers often helps to save the patient’s life.

Fast and timely transportation to a medical institution is sometimes the only way to save a person since his or her life depends on how quickly he or she will be delivered to a medical institution and how quickly effective treatment can be started, and delay can cause irreparable harm. For the exercise of this right, vehicles and communication means belonging to enterprises, organizations, as well as individuals can be used.

The availability and quality of medical care are also ensured by equipping medical organizations with equipment for the provision of medical care, taking into account the special needs of people with disabilities and other groups of the population with disabilities.