National Health Systems (2017 Summer Term Abroad)

We began the National Health Systems Term Abroad Journey at Union College in Schenectady, NY. The course of this program will run from June 12th through July 21st, and will span across four countries: the US, Canada, England, and the Netherlands to explore and compare the health care policies and systems across the named countries. The entire journey will last 6 weeks with one week in Schenectady, one in Canada, three in the UK, and one in the Netherlands. During our observation, some objectives we will examine includes the procedures to how the country delivers health care services, its national health and drug policies, palliative care, medical ethics, cost of provisions, social policies that contribute to the determinants of health and to understand the micro and macro aspects of each health care system in its ability to provide comprehensive care for its citizens. We will further understand how health care is provided under circumstances of culture, funding, medical structure, facilities and conditions, and the structure and functions in the medical hierarchy to understand the integration of care, with developments in new technology/research, implementation of alternative medicine, changes in the process of treatment, and the supportive roles health care providers other than physicians provide to maintain the wellbeing of the patient. We will be examining the three A’s and E’s which will guide the focus of our comparative study. We must examine:

  1. Accessibility
    • What population is served by the facility (i.e. illnesses, social class, age, numbers, average length of stay, etc.)?
    • How does the facility or services relate or interact with other providers of care?
    • How do patients gain access to the facility and care (who are the ‘gatekeepers’)?
    • Is the care equitable (are there differences in care on the basis of how a patient is funded or referred)?
    • Do patients have to pay?
    • Is it affordable?
  2. Availability
    • What are the kinds of treatment provided?
    • Who provides the treatment (aides, nurses, specialists etc.)?
    • What are the number of beds available and resources available for diagnostic/treatment purposes?
    • What is the composition of the staff in terms of numbers and kinds of physicians, nurses, physician assistants, etc.?
    • What reliance is there on family, volunteers, community for labor, resources and support?
    • Are there waiting lists for services, if so how long?
  3. Accountability
    • How is the quality of care monitored?
    • What groups check that appropriate care is provided?
    • Who runs the show (to whom do physicians/staff report)?
  4. Effectiveness
    • Is the health care facility meeting its goals?
    • How do they know if they are?
  5. Efficiency
    • Are day to day operations carried out in an organized and smooth fashion?
    • Does there appear to be a balance among workload, pay, and financial status of the facility?
    • Are there too many hospital beds or lengthy waiting periods for care?
    • How do the financial incentives in the system work?
    • How are the physicians compensated?
  6. Equity
    • Are health care services equally available to all?
    • Are certain members of society overlooked, omitted or denied care?
    • Are their differences in access by gender, social class or is the system set up in such a manner that access might be easier for some?
Continued factors to evaluate may include physician training and medical education costs, access for the poor, innovations in technology, and its influence on health care, primary care, elderly care, palliative care, evidence based medicine, access to psychiatric treatments, reproductive rights, caring for pregnancies/birth, managing medical errors/malpractice, policies/funding for the disables, addiction management, drug policies, specialty care, and healthcare utilization.