Health Policy Implementation and Its Barriers: The Case Study of US Health System

Health Policy Implementation and Its Barriers: The Case Study of US Health System

Augustine Nduka Eneanya (University of Lagos, Nigeria)
DOI: 10.4018/978-1-4666-9944-1.ch003
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Abstract

The chapter describes policy implementation components of a health system in United States of America and explains how they affect health outcomes (service delivery). It argues that implemented policies affect various components of a health system in terms of service delivery, workforce, information, financing, medical products, technologies, leadership and governance. Using health system as framework of analysis, the paper explains that the outcome of health policy implementation determines the availability, quality and equitability of program service delivery. The chapter goes on to argue that policy implementation barriers, such as demand-and supply-side barriers, market, insufficient resources, cultural barriers, imperfect communication, information, education, coordination, leadership and governance affect the poor and vulnerable groups in developed and developing countries from benefitting from public spending on public health policies and programs.
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Conceptual Clarifications

Health System

Health system comprises all organizations, institutions and resources that are devoted to producing health actions. Health actions in this context refers to any efforts, whether in personal healthcare, public health services or through inter-sectional initiatives whose primary purpose is to improve health. It is an open system with three components of input, processes and outputs. Inputs required in a healthcare system include: finance, physical structure, equipment personnel and clients. The process refers to a series of activities that transform inputs (resources) into a desired product, service or output. The term output is used to describe the direct result of the interaction of inputs and processes in the system, the types of and quantities of goods and services produced by any activity, program or project. On the other hand, the term outcome refers to the result of the outputs, the effects or impacts. All these depend on how efficiently the system within the operating environment is administered and how the resources are managed.

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