Health care extends beyond the delivery of services to patients,
encompassing many related sectors, and is set within a bigger picture of financing and governance structures.
Health system
Main articles: Health system and Health care systems by country
A health system, also sometimes referred to as health care system or healthcare system is the organization of people, institutions, and resources that deliver health care services to populations in need.
Health care industry
See also: Health care industry and Health economics
The health care industry incorporates several sectors that are dedicated to providing health care services and products. As a basic framework for defining the sector, the United Nations' International Standard Industrial Classification categorizes health care as generally consisting of hospital activities,
medical and dental practice activities, and "other human health activities." The last class involves activities of, or under the supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratories, pathology clinics, residential health facilities, patient advocates[22] or other allied health professions.
In addition, according to industry and market classifications, such as the Global Industry Classification Standard and the Industry Classification Benchmark, health care includes many categories of medical equipment, instruments and services including biotechnology, diagnostic laboratories and substances, drug manufacturing and delivery.
For example, pharmaceuticals and other medical devices are the leading high technology exports of Europe and the United States.[23][24] The United States dominates the biopharmaceutical field, accounting for three-quarters of the world's biotechnology revenues.[23][25]
Health care research
Main articles: Medical research and Nursing research
For a topical guide to this subject, see Healthcare science.
The quantity and quality of many health care interventions are improved through the results of science, such as advanced through the medical model of health which focuses on the eradication of illness through diagnosis and effective treatment. Many important advances have been made through health research, biomedical research and pharmaceutical research, which form the basis for evidence-based medicine and evidence-based practice in health care delivery.
Health care research frequently engages directly with patients, and as such issues for who to engage and how to engage with them become important to consider when seeking to actively include them in studies. While single best practice does not exist, the results of a systematic review on patient engagement suggest that research methods for patient selection need to account for both patient availability and willingness to engage.[26]
Health services research can lead to greater efficiency and equitable delivery of health care interventions, as advanced through the social model of health and disability, which emphasizes the societal changes that can be made to make populations healthier.[27] Results from health services research often form the basis of evidence-based policy in health care systems. Health services research is also aided by initiatives in the field of artificial intelligence for the development of systems of health assessment that are clinically useful, timely, sensitive to change, culturally sensitive, low-burden, low-cost, built into standard procedures, and involve the patient.[28]
Health care financing
See also: Health care system, Health policy, and Universal health care
See or edit source data.
Total health spending as a % of GDP.[29]
There are generally five primary methods of funding health care systems:[30]
general taxation to the state, county or municipality
social health insurance
voluntary or private health insurance
out-of-pocket payments
donations to health charities
In most countries, there is a mix of all five models, but this varies across countries and over time within countries. Aside from financing mechanisms, an important question should always be how much to spend on healthcare. For the purposes of comparison, this is often expressed as the percentage of GDP spent on healthcare.
In OECD countries for every extra $1000 spent on healthcare, life expectancy falls by 0.4 years.[citation needed] A similar correlation is seen from the analysis carried out each year by Bloomberg.[31] Clearly this kind of analysis is flawed in that life expectancy is only one measure of a health system's performance, but equally, the notion that more funding is better is not supported.
In 2011, the health care industry consumed an average of 9.3 percent of the GDP or US$ 3,322 (PPP-adjusted) per capita across the 34 members of OECD countries. The US (17.7%, or US$ PPP 8,508), the Netherlands (11.9%, 5,099), France (11.6%, 4,118), Germany (11.3%, 4,495), Canada (11.2%, 5669), and Switzerland (11%, 5,634) were the top spenders, however life expectancy in total population at birth was highest in Switzerland (82.8 years), Japan and Italy (82.7), Spain and Iceland (82.4), France (82.2) and Australia (82.0), while OECD's average exceeds 80 years for the first time ever in 2011: 80.1 years, a gain of 10 years since 1970. The US (78.7 years) ranges only on place 26 among the 34 OECD member countries, but has the highest costs by far. All OECD countries have achieved universal (or almost universal) health coverage, except the US and Mexico.[32][33] (see also international comparisons.)
In the United States, where around 18% of GDP is spent on health care,[31] the Commonwealth Fund analysis of spend and quality shows a clear correlation between worse quality and higher spending.[34]
Administration and regulation
See also: Health professional requisites
The management and administration of health care is vital to the delivery of health care services. In particular, the practice of health professionals and the operation of health care institutions is typically regulated by national or state/provincial authorities through appropriate regulatory bodies for purposes of quality assurance.[35]
Most countries have credentialing staff in regulatory boards or health departments who document the certification or licensing of health workers and their work history.[36]
Health information technology
Further information: Health information technology, Health information management, Health informatics, eHealth, and Health technology
Health information technology (HIT) is "the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication and decision making."[37]
Health information technology components:
Electronic Health Record (EHR) - An EHR contains a patient's comprehensive medical history, and may include records from multiple providers.[38]
Electronic Medical Record (EMR) - An EMR contains the standard medical and clinical data gathered in one's provider's office.[38]
Personal Health Record (PHR) - A PHR is a patient's medical history that is maintained privately, for personal use.[39]
Medical Practice Management software (MPM) - is designed to streamline the day-to-day tasks of operating a medical facility. Also known as practice management software or practice management system (PMS).
Health Information Exchange (HIE) - Health Information Exchange allows health care professionals and patients to appropriately access and securely share a patient's vital medical information electronically.[40]
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