Question

Discuss how organizational and operational models vary among three different health care organizations (e.g., transitional care, home health, long-term care). Provide examples to support your response.

Answer 1

Many organizational blueprints have been submitted as the basis for restructuring the United States health system, but only three basic models have a reasonable chance of being implemented: (1) the Professional Model, the name I have applied to the existing American health system, (2) the Central Planning Model, which is sometimes called the “political economy model,” and (3) the Competitive Health Maintenance Organization (HMO) Model, which could also be called the “market economy model.” Conceivably, any of these organizational arrangements (or even a combination of them) could form the basis of health care delivery in the future, since each has a cadre of active supporters, and since economic and social forces are at work portending change in the system as it now exists.

The structure and performance of the Professional Model are well known. The performance of the Central Planning Model is probably less familiar, however, even though it is the most prevalent pattern of organizing health care delivery among Western European nations and, until recently at least, has been preferred by most health planners. The HMO model is found exclusively in the United States, and has become much better known in recent months. Yet no one can say for certain what a truly competitive health market would be like, because in no instance do HMOs command a large enough segment of the health market to make their competitive influence felt.

In a general way, the effectiveness of these models can be compared simply by examining their working examples in this country and abroad. However, it is more difficult, if not impossible, to quantitatively assess and compare their effectiveness in optimizing the cost, quality and distribution of health care, because of the differing conditions in which they function and the varying populations they serve, and because models do not exist in pure form.

Example of Transitional Care: a broad range of time-limited services designed to ensure health care continuity, avoid preventable poor outcomes among at-risk populations, and promote the safe and timely transfer of patients from one level of care to another or from one type of setting to another.

Home care

Wound care for pressure sores or a surgical wound. Patient and caregiver education. Intravenous or nutrition therapy. Injections.