U.S. Health Services Systems Framework

Instructor: Alexandra Unfried

Alexandra earned her master's degree in nursing education and is currently a hospital supervisor/administrator.

A systems framework is being used when several different components are integrated to accomplish common goals. This lesson will discuss the U.S. Health Services Systems Framework.

Health Services Systems Framework in the United States

Rebecca has just started her new job at a community hospital in the billing and medical records department. She is going through her orientation process and learning how the health services systems are organized.

The U.S. health services systems framework is made up of several different components that are incorporated together to accomplish common goals such as providing organized health care delivery. The components that work together for the U.S. health services include system foundations, resources, processes, outcomes, and outlooks. The foundation is created by merging these elements together through input and output progressions.

Rebecca finds it interesting that so many factors work together to make the hospital organization run efficiently according to U.S. health services demands. She decides to look into each component to see how they contribute to the systems framework.

System Foundations

System foundations for U.S. health services are formed using cultural, historical, economic, social, and political factors. These factors help develop and introduce new trends but may also hinder progress. The foundations based on these factors support the interest to promote, repair, or preserve health.

System Resources

System resources or inputs play a large role in the development of health services. Resources can be both human and nonhuman entities. Human resources include personnel working directly with patient care and other ancillary departments to coordinate various health care services. Direct patient care personnel may consist of:

  • Doctors
  • Nurses
  • Pharmacists
  • Dentists

Ancillary departments that play a role in patient care consist of:

  • Marketing and public relations
  • Building maintenance
  • Billing and collection
  • Health care managers

A staff in Billing and Collection is an example of a human system resource
Billing and collection is an example of a human system resource

Nonhuman resources contain other aspects of health care such as technology, health service financing, reimbursement rates, medications, and medical equipment. Each of these resources helps create accessibility for the patient to receive adequate health care. Some areas or organizations may lack one or more resource which makes it difficult to offer well-rounded health care services. For example, a hospital may not have enough nurses to adequately care for patients in the emergency room, so waiting times are longer.

Rebecca has just learned that she is a member of an ancillary department that is part of a human resource system. She is working with billing and medical records which make sure that the patients are being charged the correct amount, the insurance companies are being contacted, and the hospital is billing for the correct procedures. Rebecca continues to review the components of health care systems foundations.

System Processes

System processes are made up of the physical structures that offer medical care and are responsible for how care is given and coordinated. Examples of process structures include hospitals, nursing homes, clinics, and outpatient services. Managed care combines these processes with resources to help with continuity of care, finances, and quality of services.

A hospital is categorized under system processes since it is where health care is delivered
A hospital is a system processes structure

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