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HEALTH SYSTEMS IN AUSTRALIA AND UNITED KINGDOM

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HEALTH SYSTEMS IN AUSTRALIA AND UNITED KINGDOM

 

HEALTH SYSTEMS IN AUSTRALIA AND UNITED KINGDOM

Introduction

The impact of a health care system in a country always differs in its strategic approach when compared to the other country (1). As health system in a country, matters the methods that are further applied by hospitals and other healthcare providers for their payment service are also important. However, the aim of this report is to highlight the related knowledge to health service payment and its strategies structured in the two different countries. These countries are marked as Australia and United Kingdom. Moreover, the each of the country has been critically summarised and integrated for their appropriate health service information. There are application of conceptual frameworks made in respect to both Australia and United Kingdom. There are discussions made related to the suitable and applied health care policies within Australia and UK. The concluding part of the report shed lights upon a brief structured for the overall report that has been linked to the further made recommendations. The recommendations are made in order to mitigate the faced complexities within health systems prevailing in both UK and Australia. Therefore, all the above information has been collected from relevant sources being available from journals, articles, websites and authentic news articles.

Knowledge related to health service payment strategies in two countries

Summarising and integrating appropriate health service information

Payment systems in Australia

The Australian health care measures a favourable performance in comparison to the other countries. In addition to it, there is information further collected for the fact of fourth rank sustained by Australia from the Commonwealth Fund among the eleven nations (2). However, in a country the role of their respective Government also plays an important part. Therefore, in case of payment systems for the healthcare in Australia, the Australian Government has embarked upon the overarching health systems to create a situation of complexity within the sector. One of the policy interventions held to manage the current fiscal issues in Australia was possible by reforming the health payment. Moreover, the major health programs funded by the Australian Government are marked for the Medicare Benefits Schedule (MBS) along with the Pharmaceutical Benefits Schedule (PBS) (3). The MBS includes majority of the general practise of funding. MBS has been initially introduced as a scheme that would provide the most efficient and equitable mean for providing health insurance coverage for all Australians. Growth in future spending for health related issues has been attributed as per the demographic and non-demographic factors. Therefore, in Australia, the service system of provider payment fee accounts to increase as a barrier for the effective, efficient and coordinated care of the service users (4). In addition to the held discussion, there are different schemes marked for the provider payment along with their impacts. Theses schemes further comprised of Salary, Fee-for-service (FFS), Diagnosis Related Groups (DRG), Capitation, Budget and Per Diem. [Refer to Appendix]  

However, by utilising the payment schemes on a simultaneous manner, the impact led by salary, capitation and budget are expected to stay more effective on the cost containment. This may further result for a low productivity and quality of health care services that are delivered to the service users. On the contrary, FFS, DRG along with Per Diem encourages the service providers to deliver better and more services without expecting any incentives for the restraining costs. Moreover, it has also been marked that different types of service providers in the same country have been paid in different procedures.    

Conceptual Framework for health care payment strategies

As discussed in the above section, the payment strategies applied for health care provider services are subjected to contain costs for health care. There are reports being collected in order to analyse the payment strategies to stay relevant for sustaining the cost for health care. The framework marked by Quinn known as ‘Quinn’s Framework’ has been analysed for its eight methods of funding in health (5). Moreover, the Miller’s Framework on the other hand, relates to the key methods that are considered for addressing problems of health care payment strategies at an international level. The following is the framework marked for both Quinn and Miller contributing for the cost of healthcare within the payment strategy in Australia.

 

 

 

 

References

1.Johnson JA, Stoskopf C, Shi L. Comparative Health Systems. Jones & Bartlett Learning; 2017 Mar 2.

2.Stark Z, Schofield D, Alam K, Wilson W, Mupfeki N, Macciocca I, Shrestha R, White SM, Gaff C. Prospective comparison of the cost-effectiveness of clinical whole-exome sequencing with that of usual care overwhelmingly supports early use and reimbursement. Genetics in Medicine. 2017 Aug;19(8):867.

3.Macinko J, Harris MJ, Rocha MG. Brazil's National Program for Improving Primary Care Access and Quality (PMAQ): Fulfilling the Potential of the World's Largest Payment for Performance System in Primary Care. The Journal of ambulatory care management. 2017 Apr;40(2 Suppl):S4.



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