Health system models

Wieselgren et al (1999) Health-care model based on Tran et al (1997) (applied to Swedish systems) Olanzapine and risperidone... 

The primary objective of establishing SEALs is to protect crew members from adverse health effects—particularly to the respiratory and central nervous systems— from exposures to the combustion gases and chlorine. The Navy will use SEALs as one of many parameters in its Submarine Escape and Rescue Expert System model. That model takes into account several additional parameters, such as geographical position and depth of the submarine, number and medical condition of the crew members, ability to communicate with search and rescue forces, and compartment temperature, and is used by the senior officer to assist in making a decision on whether to escape from the disabled submarine. 

We look at six countries very briefly in this article to highlight the incredibly diverse approaches to health service organization and financing. In essence, most health systems fit into one of the following models ... 

Unfortunately, a pool of gasoline lies on the water table beneath the site of an abandoned gas station 150 m south of the well. Although the health department has pronounced the well safe, it may not remain so. When will dissolved gasoline reach the municipal water system (Model the gasoline, a complex mix of hydrocarbons, as though it were benzene.)... 

Mental illness is frequently viewed as an embarrassment or stigma by Asian patients and their families. Asians tend to delay psychiatric care until they are seriously disturbed (Lin et al. 1982). When Asians do enter the mental health system, their psychiatric conditions often have become severe and chronic and likely require psychopharmacotherapy (Lin et al. 1982). Because Asians tend to underuse or avoid seeking psychiatric care, the general public and some health care professionals may believe that Asians are a well-adjusted "model minority" and have little or no need... 

National Committee for Clinical Laboratory Standards A Quality System Model for Health Care Approved Guideline. HSOl-A, Vol 22, Number 13. Wayne, PA National Committee for Clinical Laboratory Standards, 2002. 

This definition is the same for all models of health systems but the application and focus of care differ. However, in most systems home care implies the application of high technology in the patient s home for a limited period, rather than care for chronic patients. For this reason, in most systems, the referral centers are the hospitals. 

The federal government has experimented with various models of pharmacist prescribing.The VA and the IHS appear to have the most liberal policies toward pharmacist prescribing.In the VA, clinical pharmacy specialists are required to have an advanced degree or have completed an accredited residency (e.g., an American Society of Health Systems Pharmacy, ASHP, accredited residency) or specialty board certification (e.g., a Board of Pharmaceutical Specialties, BPS, certification) before they may prescribe medications within their scope of practice. The scope of practice is established within the local VA facility. Once this criterion is satisfied, the clinical pharmacy specialist may function as an independent health care provider. In the IHS, pharmacists can be credentialed to provide primary care and use their prescriptive authority to evaluate and manage the care of certain patients. 

Lindenberg, M., Kopp, S. and Dressman, J.B. (2004) Classification of orally administered drugs on the World Health Organization Model list of Essential Medicines according to the biopharmaceutics classification system. European Journal of Pharmaceutical Sciences, 58 (2), 265. 

The selection of pharmaceutical products based on a national formulary or on the essential medicines list is recommended. WHO s Model Formulary (15 and Model Essential Medicines List 4) identify the most cost-effective and affordable pharmaceutical products to treat prevailing health problems. They are updated regularly and are made freely available for adaptation by countries. The health systems of many industrialized and developing countries have used the essential medicines concept for decades to use existing resources effectively. Because the use of a national formulary reduces the number of products used, supply management activities and inventorycarrying costs are minimized. 

Gallego, B., Westbrook, M.T., Dunn, A.G. and Braithwaite, J. 2012. Investigating patient safety culture across a health system Multilevel modelling of differences associated with service types and staff demographics. International Journal of Quality in Health Care, 24(4), 311-20. 

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