Effective Healthcare Management: Ways to Solve Problems

Despite the variety of forms of medical care organization at the present time, apparently, there is not a single country that would be completely satisfied with the state of its own health care. The necessary conditions for the functioning of health systems are the availability of medical services, efficient use of resources, cost containment, control over prices for medical services while respecting human rights. In all countries, the search continues for effective ways to reform health care systems aimed at increasing the availability of high-quality and optimal medical care for the population. Since the 1980s, decision-makers in healthcare have started asking specialists the question: “Does too many expensive diagnostic procedures lead to overly intensive, sometimes expensive unnecessary therapy?” Whole guides have emerged to conserve resources and manage the quality of care. In terms of access to health care, two types of health care systems have emerged:

1. a system built on the principle of predominantly self-sufficiency of the population in case of illness;
2. a system where health services are provided largely from public funds.

The systems of the first type contribute to the development of paid medical care and voluntary medical insurance, the system of the second type contributes to the development of compulsory medical and social insurance with sufficiently significant state control.

Quality and accessibility of medical care in the USA

For the USA, it is considered a traditional question-address: “What quality and accessibility of medical care can we talk about if we have so little funds allocated for health care? Give more money, appropriate material and technical support, new equipment, raise salaries – then there will be quality.” It should be said that over the past 10 years, the material and technical base has significantly improved in the health care of the USA (although unevenly), for example, due to the acquisition of modern expensive equipment.

Has the quality of medical care improved in the USA, and has the country’s population become more satisfied with the healthcare system? Even the top management of the health care system and the compulsory medical insurance system notes the absence of clear and unambiguous positive dynamics. According to a sociological survey, when asked how the quality of medical care has changed after the compulsory medical insurance system was introduced? 50% of the respondents answered: “It has worsened” and 42%: “It has not changed.”

How did the health care reform affect the rates of morbidity, disability and mortality of the population? Until now, there has been no decrease in morbidity or mortality in the USA – the highest indicators of average life expectancy (70 years) in the USA were registered in 1987. It is obvious that a high increase in mortality, high rates of disability, morbidity, registration of advanced cases of the disease depend only on the development of new medical technologies but also on many factors external to the health service (biological, mental, social, cultural and other factors).

Factors such as the socio-economic, demographic situation in the country and the policy of the state are closely interrelated and affect both public and personal health of citizens. The final result is also influenced by such individual characteristics as the patient’s willingness to cooperate with doctors, the propensity to follow the doctor’s recommendations, and the way of life. An illustration of this influence can be the different life expectancies in the USA for men (59 years) and women (72.2 years) according to the state report on the state of health of the population for 2000.

According to the WHO, only a few rules are considered that ensure the reduction of morbidity and mortality in developed countries, in their most general form they can be formulated as follows: avoid overeating, alcohol abuse, do not smoke, do not use drugs, observe safety rules when driving a car, remember “safe sex”, to have active rest (physical activity) and if symptoms of ill health appear, contact your doctor.

It is impossible to guarantee a radical change in the situation with mortality and morbidity in the USA only by increasing funding for health care and improving medical technologies. For an effective solution to the problem, it is necessary to change the reasons that make up 80% at the level of the population or public health, that is, to change social policy at the state level, so the formation of an attitude to preserve health in the population, and not just in a particular patient, is a difficult task, the solution of which the state should be engaged in the person of a team of professionals: politicians, clinicians, specialists in the field of public health.

The contribution of health care and compulsory medical insurance to the state of health of the population reflects not generalized indicators of health but the quality of medical care for a specific patient who seeks medical care in the health care system.