Equity of Access in the Australian Healthcare System

Equity of Access in the Australian Healthcare System The Concept of Equity of Access in the Australian Healthcare System The Australian health care system is founded on the concept of equity of Access. Discuss this Statement with relation to the concepts of Effectiveness and efficiency and any interrelation that may exist. Introduction: As Stated in National Health Reform Agreement-Equity of Access is the fundamental base of the Australian Health Care System (DHA. 2013a). Effectiveness, which focuses on ratio of outputs to outcomes and efficiency, which defines as achieving maximum outputs with available inputs or resources, these are other elementary component of the Australian Health Care System. Equity, effectiveness and efficiency these represents ideal health care system, which tends be effective and efficient and able to achieve the efficacy (specified outcomes) in a way that maximize access (distribution); Productivity (output) and outcomes within the resource provided (NHHRC. 2009. P.4). Responsibilities like funding, delivery regulation is shared by the national state government of Australia makes the Australian Health Care system universally accessible within the people (AIHW, 2000). Public hospitals community care funding is joined effort of common wealth (i.e. federal government), states territories where common wealth use its revenue and tax to fund most of hospital medical service health research (Common wealth Department of Health age care, 2000). Since 1990’s National State health Minister worked alongside of many health care professional to develop a certain Universal framework to assessing the Australian health system (NHPC, 2000). A new framework for measurement of Australian health performance was inspired from Canadian Health information Roadmap Initiative Indicator framework, which was commenced by NHPC (NHPC, 2001). Equity: Equity in health and health care with context of social objective can be defined in many different ways. As Amarty sen argued, when we talk equity we forget to ask on fundamental question ‘equity of what?’ (Sen, A.,1992). But for the context of our knowledge and study we base our understanding on the definition of culyer wagstaff, ‘the appropriate positive criteria for mormative judgement regarding equity in distribution of health and health care is equality of health status and health care access (Culyer, A.J., Wagstaff, A., 1993). By adding the equality in the process of equity gives the sense of clear fairness to the consumer. But equality is not equity; equality is just simply described as similarity of status, capacity and opportunity. Equity is an ethical value. A unequal opportunity of being healthy associated by people in socially less privileged groups such as poor people, different racial people to others native land, religious ethnic group, women and rural resident is reduced by equity in health ( Braverman, P. Gruskin, S., 2003). Further Braverman et.al stated that the equity in health pursued by eliminating disparities of health that are connected with certain social disadvantage or marginalized or disfranchised community and group within, but may not be limited to the poor. This definition argues for need for the health care services by individuals which is completely result of both of their medical condition and their social condition. As we know the problem of health care system is not only related to the inequity in health. According to Mathews, social, cultural and educational and more or less classical medical causes are related to the poor health of the indigenous Australian (Mathews, C., 2003). Equity of Access: Equity in health has been spoken and written frequently by many economist but they never tends to do or continue to do more consistently, clearly passionately. As Gavin Mooney stated, ‘equity means equal access to equal care for equal needs,’ (Gavin, M., 2003). Since 1960’s quest for equity in health has been major issue and concern to Australian health care system. The introduction of Medibank in 1975 and reinstatement as Medicare in 1984 was the most significant development in term of equity of access after the access of financial barrier (Scotton, R. B., Macdonald, C. R., 1993). The equity of health service and the consultation time frame for consumer of lower socio-economic status and consumer of high socio-economic status doesn’t shorten by breaking and disappearance of financial barrier (Furler, J.S., et.al 2002). The result in context of other dimension of equity is not good. Access of health care (both primary and hospital care) in term of geograp hical equity is significantly different between urban and rural area. Fewer doctors per 1000 population in rural Australia relative to urban area is the best example to describe the complex nature of geographic equity in simple. Rural communities considered access of specialist service, access to hospital service to be a problem due to traveling of significant distance to gain and access those service. Equity of Outcome: Environmental factor and the quality of health care provided equally affects the result of equity of outcomes. Major Policy attention is needed by the appalling health status of our Aboriginal Torres strait Islander population is one of the best example is equity of outcomes. By action in health sector will not remedied the factor Affecting health status, issue of dignity, identity and justice should be the strategy for the improvement of the health status of Aboriginal Torres Strait Islander. Reconciliation is one of the key elements required for progress further (Jackson, L.R., Ward, J.E., 1999). Efficiency: What is efficiency? According to Farrell efficiency is production of maximum amount of outputs from given amount of input or alternatively minimum input quantities producing a given amount of output (Farrell, M.J. 1957). It is referred as to a concrete goal oriented index indicating how well socially desirable health system is achieved desirable. Health Service efficiency is also considered to be great important dimension of quality health because service affordability is affected by it with the context of limited available resources in health care. Efficient service means providing optimal service and care to patient and community rather than maximum care to patient and community; it is about providing greatest benefit with available resource (Brown, L.D., et.al 1992). One of the key criteria for evaluating the health care system is efficiency. According to the economic point of view, efficiency divided into two key elements; allocative efficiency and technical efficiency. Allocative efficiency: To provide best outcomes health care system dependent on distribution and allocation of resources; technical efficiency, effectiveness and priority are involved in the process of best outcomes. The optimized ratio of outputs to outcomes, which is also known as effectiveness is the second key element of allocative efficiency. The priority setting in term of overall ratio of inputs to outcomes is the third and last element of allocative efficiency. Technical efficiency: Flexibility and adaptability to change and innovation of health care system as a whole and as its constituent elements, is known as technical efficiency. Development of casemix measure for hospital services by palmer was a unique contribution both nationally and internationally (Palmer, G.R., et al, 1986; Palmer, G.R., 1991). Over last decades significant improvement in allocative efficiency was achieved after introduction of casemix funding in Victoria in 1993 (Duckett, S.J., 1995). There have been constantly adaptations of new technologies (like drugs, surgical instrument, surgical technique and diagnostic instrument technique) since the development of Australian Health Care system. Over the decades of increase in publication and citation, Australia has been able to build up strong and dynamic medical research system (Butler, L., 2001). Comprise of allocative efficiency technical efficiency gives ‘overall efficiency’, firm can operate on cost or revenue frontier if i t’s able to achieve overall efficiency. Effectiveness: It acts as a key dimension for achieving desirable outcomes with correct provision of evidence based health care service to all who couldn’t benefit, but not to those who would not benefit (Aran, O.A., et.al 2003; WHO, 2000). Donabedian argued then effectiveness is the extent to which attainable improvements in health are in fact attained (Donabedian, A., 2002; Donabedian, A., 1982). In same way Juran Godfrey argued effectiveness to be the degree to the process which result in desired outcomes without any error (Juran, J. Godfrey, A.B., 1999). The ratio of output to outcome is optimized by effectiveness. Out of number of elements, ‘efficacy’ act as one of key component to the certain extent of which health care sector output leads to the ideal outcomes under best ideal condition (Cochrane, A.L., 1972). The major objective is to ensure the actual effectiveness (in term of ratio of outputs to actual outcomes) which helps to move closer to objective. Effectiveness is the dimension of Australian Health Care which explicitly includes time element, so we can evaluate whether the health intervention are primarily achieve the desired and appropriate outcome within the time frame. The interventions are the care must be provided to people most needed is advocated and supported by effectiveness framework. Early detection and prevention performance within a population area is the indicators for the effectiveness. Effectiveness conceptualize framework of health care system as dimension of performance where â€Å"care/intervention/action† achieves the desired result in an appropriate time frame (NHPC, 2001). Norms and specification at central level defines effectiveness to be an important dimension of quality. Effectiveness issue should be handle in local level too, where manager implement norms and work on how to adapt them to local condition. Actual outcomes (effectiveness) for an intervention or system is affected by numerous factor like the care system design, surrounding environment of discharge patient, safety of device manufactured pharmaceuticals used and care quality. Proof of evidence of significant level of preventable adverse events occurring in hospital leading to drastic outcomes can be provided by the quality in Australian health care study (Wilson, R.M.et al., 1995). As stated by McDermott, it is suggested that large number of death related to trauma can be preventable or potentially are preventable, which is has be documented after analysis of care following trauma (McDermott, F.T.et al., 1996). These study shows that there are important effectiveness issues in Australian healthcare system with respect to quality of care and it can be described as inability to provide high-quality care. Interaction between equity, efficiency and effectiveness: The concept of equity, effectiveness and efficiency in term of health input and its outcomes are internationally tackle by WHO and OECD (Organization for Economic Co-operation and Development) to reflect an economic way of thinking. Due to growing concern about safety, service delivery and quality of patient care there have been interesting trends of implicit and explicit link between the concept of equity, efficiency and effectiveness, which is understandable (Berwick, D.M., 1998). As we know second element of allocative efficiency is optimized ration of outputs to outcomes which is also known as effectiveness. Which shows that efficiency and effectiveness are linked and interacted? After the implementation of equity, sick individuals who seek help have their need meet. The value of treatment provided by health service organization is equally distributed to the people in need. With the equity you are not judge or treated and cared on the basis of your fame, fortune, you ability to p ay. When the resource is equally distributes between the need of people then equity taken an affect and when there is the equity then we can evaluate the efficiency and effectiveness of the health care service of that organization or of any country. Conclusion: Health policy where attributes and value plays prominent role, ideological driven problem related to it are inevitable as part of the policy. Perception of problem is affected by attributes and value which plays significant role in policy academics so as to attempt to shape public debate for making rational and reality based perception. There are many problem identified in the context of equity of access in the Australian healthcare system based on efficiency and effectiveness by many writers like Palmer, Wilson, McDermott, Jackson wards, Farrell and many more; even the solution to that problem have been presented by them but we haven’t yet identify the problem and adopted the solution presented by them. But important aspect is that progress are being made and hopefully health care system will experience continuous improvement in near future. References : Australian Institute of Health and Welfare (2000). Australia’s Health 2000. Canberra Australian Institute of Health and Welfare (2008). Australia’s Health 2008, Canberra Arah, O. A., Klazinga, N. S., Delnoij, D. M. J., Ten Asbroek, A. H. A., Custers, T. (2003). Conceptual frameworks for health systems performance: a quest for effectiveness, quality, and improvement.International Journal for Quality in Health Care,15(5), 377-398. Berwick, D. M. (1998). Developing and testing changes in delivery of care.Annals of Internal Medicine,128(8), 651-656. Braveman, P., Gruskin, S. (2003). Poverty, equity, human rights and health. Bulletin of the World Health organization,81(7), 539-545 Brown, L. D., Franco, L. M., Rafeh, N., Hatzell, T. (1992).Quality assurance of health care in developing countries. Quality assurance project. Butler, L. (2001).Monitoring Australias Scientific Research: Partial indicators of Australias research performance. Australian Academy of Science. Canberra Cochrane, A. L. (1972). Effectiveness and Efficiency (Rock Carling Fellowship, 1971).Nuffield Provincial Hospitals Trust. Commonwealth Department of Health and Aged Care, (2000). Australian Health Care Agreements Annual Performance Reports 1998–1999. Canberra: Common Wealth of Australia. Culyer, A. J., Wagstaff, A. (1993). Equity and equality in health and health care.Journal of health economics,12(4), 431-457. Department of Health (DHA) (2013). National Health Reform Agreement. Donabedian, A. (1982). Explorations in quality assessment and monitoring. Vol. 2. The criteria and standards of quality.Ann Arbor, MI: Health Administration Press. Donabedian, A. (2002).An introduction to quality assurance in health care. Oxford University Press. Duckett, S. J. (1995). Hospital payment arrangements to encourage efficiency: the case of Victoria, Australia.Health Policy,34(2), 113-134. Farrell, M. J. (1957). The measurement of productive efficiency.Journal of the Royal Statistical Society. Series A (General), 253-290. Furler, J. S., Harris, E., Chondros, P., Davies, P. P., Harris, M. F., Young, D. Y. (2002). The inverse care law revisited: impact of disadvantaged location on accessing longer GP consultation times.Medical Journal of Australia,177(2), 80-83. Jackson, L. R., Ward, J. E. (1999). Aboriginal health: why is reconciliation necessary?.The Medical Journal of Australia,170(9), 437-440. Juran, J., Godfrey, A. B. (1999). Quality Handbook.Republished McGraw-Hill. Matthews, C. (2003). Caught in a vicious cycle.Australian Medicine,15(12),16. McDermott, F. T., Cordner, S. M., Tremayne, A. B. (1996). Evaluation of the medical management and preventability of death in 137 road traffic fatalities in Victoria, Australia: an overview.Journal of Trauma-Injury, Infection, and Critical Care,40(4), 520-535. Mooney, G. H. (2003).Economics, medicine and health care. 3rd ed. London: Pearson Education. National Health and Hospitals Reform Commission. (2009). A healthier future for all Australians: Final report of the national health and hospitals reform commission. National Health Performance Committee (NHPC) (2000). Fourth National Report on Health Sector Performance Indicators – A Report to the Australian Health Ministers’ Conference. Sydney: New South Wales Health Department National Health Performance Committee (NHPC) (2001). National Health Performance FrameWork Report. Brisbane: Queensland Health. Palmer, G. R., Aisbett, C., Reid, B., Jayawardena, Y. (1986). The validity of Diagnosis Related Groups for use in Victorian public hospitals: report to the Department of Health, and of Management and the Budget.Victoria, Kensington, University of New South Wales. Palmer, G. R. (1991). The use of DRGs in the management and planning of hospital services.Australian Economic Review,24(1), 62-70. Scotton, R. B., Macdonald, C. R. (1993).The making of Medibank(No. 76). School of Health Services Management, University of New South Wales. Sen, A. (1992).Inequality reexamined. Oxford University Press. Wilson, R. M., Runciman, W. B., Gibberd, R. W., Harrison, B. T., Newby, L., Hamilton, J. D. (1995). The quality in Australian health care study.Medical Journal of Australia,163(9), 458-471. World Health Organization. (2000).The world health report 2000: health systems: improving performance. World Health Organization.

My first day in an English speaking school Essay

I thought back, to everything, everything that had happened and where it all had started. Here, it had started here. Memories flooded back, memories of people, memories of places, memories of†¦ of everything. With one last look around I took a deep breath and boarded the aeroplane, I was ready. I arrived the day before the start of the second semester. Though my things had arrived almost a week before, but I had been content living out of a suitcase if it meant I could spend more time at home. I sighed and looked around; they had tried to make the room nice, though from what I was feeling, all I wanted was my bed, in my flat, in my country. Looking around once more, I saw framed pictures of words- English, of course- I could not really read them. I felt betrayed, like someone had mocking me by putting them there. I was crying, I couldn’t stop; everything felt like it was cracking, falling apart at the seams. I had never felt so alone; I wasn’t close to anyone, not to my dad, step mom, brother, I didn’t feel I would ever be close to anyone. I fell to sleep feeling hopeless, alone, and desperate. Almost an hour later, someone was knocking on my door, calling my name. The voice was soft and American, blending the syllables of my name; I was being called to dinner. When I arrived downstairs, I found the food prepared was not too different from that of my home, I was at least a bit comforted because of that. While having dinner, my step mother and brother tried to converse with me, because I had prided myself in knowing a bit of English. I soon found out this was not the case, when they would speak, it was slurred and natural; when I spoke, it was halted and awkward. My accent impeded some of pronunciation, I sounded like an infant. While the conversation was stilted, I felt at least a bit more at home. Before sleeping, my father informed me that I would be attending American school; I would have a translator until I could speak with more fluency. When I arrived at the school, my father couldn’t accompany me into it, so I had to try to find my way to the office, explain myself, and make homeroom before the bell; needless to say, I was a bit worried. I found the office after using a translating app on my phone. In order to make the women in the office understand me, I had to once again use my translating app, after understanding my situation; they called my translator, who I learned was  called Mary. When Mary and I had finally met, I felt a great relief at having someone to talk to, while Mary was still very American, it was nice to have a person who spoke French around. My first class was ironically English; I went in late because they had wanted to check that I could understand a bit of English, seeing as my first period was English. When I arrived in the class, the teacher asked me to introduce myself, before I had even reached my seat; not realising she was talking to me, I ignored her until Mary told me what she saying. I turned around and quietly tried to stammer out my name. The teacher didn’t understand why I wouldn’t speak up. When Mary explained my situation, the teacher understood and tried to apologise. I was so embarrassed and tired at that point, I didn’t even care, I just took my seat and tried to understand what was going on. Second period was at least a little bit better; I had maths, so I could actually understand what the teacher was saying (for the most part). Third period was different, because I had never had American history. Because I had come into the class in the middle of the year, I had to try to catch up to the rest of the class. In her between discussions of the twenties, the teacher would have to pause because Mary would have to translate for me. This whole process made the class seem very long, and tedious, and the teacher was annoyed by the end. At the very end of the class, the teacher came over to talk to me. I was very surprised when she started speaking French, even more so when she explained to me that she had grown up in France and was therefore fluent. She proceeded to tell me that in order to accommodate for my English as a second language, she would print out her lectures in both French and English. I was delighted, seeing as none of the other teachers had offered to accommodate for my situation. I went to my next class feeling much happier. Entering my next class, I found that it was actually a French class I had been signed up for. French was the highlight of my day, I could understand what the teacher was saying (even if she butchered the pronunciation), the people tried to talk to me, and I didn’t feel completely isolated. After French was lunch, in France we had assigned lunch tables, and when I turned to ask Mary where to sit, I found she had already taken her lunch break. When I entered the cafà ©, I found that people had already saved seats for me; I had the pick of the cafà ©. I finally sat with some people I recognised from French class; almost immediately they started  asking me where I was from, and why I not speak English. When I had settled in and tried to comprehend what they were saying, I tried to answer in English. When I finally figured out what I would say, I stammered out something like this, â€Å"France, en Paris, where I live.† Everyone thought it was just brilliant that I had an accent, and proceeded to try to imitate it. I was a bit overwhelmed, as it was a lot to take in; people were just talking away in English, while I was just there, smiling and nodding. When you don’t understand the language, everything gets very confusing, very fast. By the end of lunch, I had started to come to terms with using English instead of French, though I was still not completely comfortable. When lunch was over, I had to head to another building where my orchestra class was to be held. When I got there, I found that I was in a senior orchestra class, which I thought meant it would be simple and easy for me. I was surprised to learn that, there was no one my age, and that I was the youngest in the class. Ironically enough, the first song we would be playing was Offenbach’s Chanson de Fortunio, a very French piece to play. I learned later, the teacher had apparently picked it for me, because both it and I were French. After hearing me play just the Offenbach, the teacher had me moved to first chair, the best place to play cello. Orchestra was by far the best class for me, that day. After my double period of orchestra, I had natural science; science was a fine class to end the day with, because for me the Latin terminology and â€Å"learning† the metre system was a breeze. Science moved into an x period, for studying, or in my case, ESL help. All ESL help was, was help with English fluency. After the x period, it was time to go home. All in all, my first day at an English speaking school was not as bad as I expected.

Facebook A Non Replicable Competitive Advantage

According to Marketline.com, Facebook Incorporated is one of the social networking which enables users to share their pictures, videos, activities and opinions. The company’s reach is a non-replicable competitive advantage that can be explored to the advertisers’ curiousness. However, significant competition may impact its user base and level of user engagement, making it less attractive to developers and marketers, so the bad thing will affect its revenue and results of operations. From there we can tell the strengths, weaknesses, opportunities and threats of Facebook’s company. From Facebook page information, in 2004 they found that Facebook’s mission is to give their users a power that they can share their things, connected to the world, and explored their world in their mind. With me, yes, their mission is correct because some of my friends in middle school did not contact each other for a long time we found our friends again by â€Å"Suggested Friends† option on Facebook. Facebook helps people know more of what the world is doing by other users sharing things they are interested in. Starting with their Strengths, growing user base contributing to increasing ARPU-average revenue per unit. According to the Marketline.com â€Å"The company provides unprecedented reach with 1.2 billion monthly active users (MAUs) as of December 2014, a significant increase from 901 million MAUs in 2012. In December 2014, the company had 208 million MAUs in the US and Canada; 301 million in Europe;Show MoreRelatedA Study On Equal Exchange1658 Words   |  7 Pagesbusiness to support farmers and trade their goods to not harm the environment. They opened the company as a worker-owned cooperative; it is seen as the one worker- one vote model. EE is a mission-driven business model that shows to be sustainable and replicable. Their idea was to connect trade products such as organic food, coffee, tea, and chocolate. 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Legalization Of Euthanasia Dying With Dignity - 1883 Words

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