Health Care Systems Introduction to Systems Theory n

Health Care Systems

Introduction to Systems Theory n System – A group of individual parts that work together to form a unified whole. n Systems Theory – A way of studying a system as one unit, instead of individual parts.

Components of the Systems Theory n n n n Input Throughput Output Feedback Loop Controls Environment Goals Mission

Inputs, Throughputs, and Outputs n Input – Anything that enters a system, including money, resources, materials, or effort. n Throughput – A process that converts the input into a final product or service. n Output – The final product of service that is provided by a system.

Feedback Loop n Feedback Loop – A process of monitoring outputs to determine whether or not the system is working. n Feedback should be evaluated and then put back into the system to improve future outputs.

Controls and Environment n Environment – The circumstance in which the system exists. The system relies on the environment for resources.

Goals and Mission n Goals – A measurable activity that must be completed to ensure that the mission is accomplished. n Mission – The specific, stated purpose of a system.

Evaluate the System n The key to evaluating a system is to determine if the mission is fulfilled. n To evaluate a system, look at the “big picture. ”

Examples of other systems Physiological Systems: The digestive system, neurological system, circulatory system

Compare n Health care providers within a system must do their part to ensure that every patient receives the best care possible.

Interdependence n All members of the health care team are dependent on each other. n If one worker does not fulfill the required duties, the entire team is hindered.

Government Programs n In the 20 th century, the United States government began to realize the need for public medical assistance. n In 1965, President Lyndon B. Johnson instituted two medical assistance programs to help those without health insurance. ▫ Medicaid ▫ Medicare

Medicaid n Need-based program n Designed by the federal government, but administered by state governments n Provides medical assistance to individuals and families who are determined by the state to be “needy. ” Each state must determine its own definition of “needy. ”

Medicaid Service n Services typically include: ▫ Hospital services ▫ Prenatal care ▫ Child vaccines ▫ Pediatric services ▫ Physician services ▫ Diagnostic testing and Xrays ▫ Rehabilitation and physical therapy ▫ Prescription drugs ▫ Home health care

Medicaid Limits n Medicaid is not guaranteed to every low-income individual. n If a low-income individual does not have children or is not disabled, this person may be unable to receive any medical insurance.

Medicare n Entitlement program for any citizen age 65 or older n Administered by the federal government n After an individual pays a deductible, Medicare will cover 80% of all medical expenses.

Medicare Services n Part A: Hospital Care ▫ ▫ ▫ Hospitalization Skilled nursing facilities Home health care Hospice care Long-term care facilities n Part B: Outpatient Services ▫ Medical expenses, including therapy, medical equipment, and testing ▫ Preventive Care

Input--Entry point n An efficient healthcare delivery system must have a well defined entry point. n Triage (screening to determine priority of treatment) n Timely entry into the system

Throughput n Throughput is the step where the patient is treated n Educational resources n Treatment resources n Financing mechanism n Information and feedback systems

Services provided in throughput n Preventive - healthcare services designed to keep the student well n Diagnostic - healthcare services to find out what is wrong with the patient n Treatment - healthcare services to cure the patient n Patient education

Output n is the product of the system n A healthy patient? n A healthy community? n Some other definition?

n Movement or pressure on one component exerts pressure on others.