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  • 5 - Health Service Delivery

  • from Section II
  • Edited by Jo. M. Martins, Indra Pathmanathan, David T. Tan, Shiang Cheng Lim, Pascale Allotey
  • Book:
    Systems Thinking Analyses for Health Policy and Systems Development
    Published online:
    04 September 2021
    Print publication:
    26 August 2021, pp 116-171
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  • Summary

    Secondary and tertiary care (STC) evolved to progressively improve access and quality of care. For various phases of development, the chapter analyses the dynamic interactions of various components of the health system such as human resources, financing, information, medical products and technology and their influence on STC, and the influence of wider factors such as political, socio-economic, demographic and population behaviour. Challenges include the provision of affordable, integrated, seamless care from primary to tertiary levels. Outcomes are discussed in terms of access, utilisation, client satisfaction and quality of care. The analysis includes the dynamics inherent in the dichotomy between the public and private sectors in financing and provision of STC services. Systems thinking illustrates the challenges in the dichotomous public-private system that is subject on the one hand to increasing specialisation and compartmentalisation in medical care and on the other hand to the need for integrated care for the individual patient.