health and care essay

📕 Studying HQ

120+ healthcare argumentative essay topics [+outline], dr. wilson mn.

• August 3, 2022
• Essay Topics and Ideas , Samples

If you’re a nursing student, then you know how important it is to choose Great Healthcare argumentative essay topics.

After all, your essay will be graded on both the content of your argument and how well you defend it. That’s why it’s so important to choose topics that you’re passionate about and that you can research thoroughly.

What You'll Learn

Strong Healthcare argumentative essay topics

To help you get started, here are some strong Healthcare argumentative essay topics to consider:

• Is there a nurse shortage in the United States? If so, what are the causes, and what can be done to mitigate it?
• What are the benefits and drawbacks of various types of Nurse staffing models?
• What are the implications of the current opioid epidemic on nurses and patients?
• Are there any ethical considerations that should be taken into account when providing care to terminally ill patients?
• What are the most effective ways to prevent or treat healthcare-acquired infections?
• Should nurses be allowed to prescribe medication? If so, under what circumstances?
• How can nurses best advocate for their patients’ rights?
• What is the role of nurses in disaster relief efforts?
• The high cost of healthcare in the United States.
• The debate over whether or not healthcare is a human right.
• The role of the government in providing healthcare.
• The pros and cons of the Affordable Care Act.
• The impact of healthcare on the economy.
• The problem of access to healthcare in rural areas.
• The debate over single-payer healthcare in the United States.
• The pros and cons of private health insurance.
• The rising cost of prescription drugs in the United States.
• The use of medical marijuana in the United States.
• The debates over end-of-life care and assisted suicide in the United States.

As you continue,  thestudycorp.com  has the top and most qualified writers to help with any of your assignments. All you need to do is  place an order  with us.

Controversial Healthcare topics

There is no shortage of controversial healthcare topics to write about. From the high cost of insurance to the debate over medical marijuana, there are plenty of issues to spark an interesting and thought-provoking argumentative essay.

Here are some Controversial healthcare argumentative essay topics to get you started:

1. Is healthcare a right or a privilege?

2. Should the government do more to regulate the healthcare industry?

3. What is the best way to provide quality healthcare for all?

4. Should medical marijuana be legalized?

5. How can we control the rising cost of healthcare?

6. Should cloning be used for medical research?

7. Is it ethical to use stem cells from embryos?

8. How can we improve access to quality healthcare?

9. What are the implications of the Affordable Care Act?

10. What role should pharmaceutical companies play in healthcare?

11. The problems with the current healthcare system in the United States.

12. The need for reform of the healthcare system in the United States.

Great healthcare argumentative essay topics

Healthcare is a controversial and complex issue, and there are many different angles that you can take when writing an argumentative essay on the topic. Here are some great healthcare argumentative essay topics to get you started:

1. Should the government provide free or low-cost healthcare to all citizens?

2. Is private healthcare better than public healthcare?

3. Should there be more regulation of the healthcare industry?

4. Are medical costs too high in the United States?

5. Should all Americans be required to have health insurance?

6. How can the rising cost of healthcare be controlled?

7. What is the best way to provide healthcare to aging Americans?

8. What role should the government play in controlling the cost of prescription drugs?

9. What impact will the Affordable Care Act have on the healthcare system in the United States?

Hot healthcare argumentative essay topics

Healthcare is always a hot-button issue. Whether it’s the Affordable Care Act, single-payer healthcare, or something else entirely, there’s always plenty to debate when it comes to healthcare. Here are some great healthcare argumentative essay topics to help get you started.

1. Is the Affordable Care Act working?

2. Should the government do more to provide healthcare for its citizens?

3. Should there be a single-payer healthcare system in the United States?

4. What are the pros and cons of the Affordable Care Act?

5. What impact has the Affordable Care Act had on healthcare costs in the United States?

6. Is the Affordable Care Act sustainable in the long run?

7. What challenges does the Affordable Care Act face?

8. What are the potential solutions to the problems with the Affordable Care Act?

9. Is single-payer healthcare a good idea?

10. What are the pros and cons of single-payer healthcare?

Argumentative topics related to healthcare

Healthcare is always an ever-evolving issue. It’s one of those topics that everyone has an opinion on and is always eager to discuss . That’s why it makes for such a great topic for an argumentative essay . If you’re looking for some fresh ideas, here are some great healthcare argumentative essay topics to get you started.

1. Is our healthcare system in need of a complete overhaul?

3. Are rising healthcare costs making it difficult for people to access care?

4. Is our current healthcare system sustainable in the long term?

5. Should we be doing more to prevent disease and promote wellness?

6. What role should the private sector play in providing healthcare?

7. What can be done to reduce the number of errors in our healthcare system?

8. How can we make sure that everyone has access to quality healthcare?

9. What can be done to improve communication and collaboration between different parts of the healthcare system?

10. How can we make sure that everyone has access to the care they need when they need it?

Argumentative essay topics about health

There are many different stakeholders in the healthcare debate, and each one has their own interests and perspectives. Here are some great healthcare argumentative essay topics to get you started:

1. Who should pay for healthcare?

2. Is healthcare a right or a privilege?

3. What is the role of the government in healthcare?

4. Should there be limits on what treatments insurance companies must cover?

5. How can we improve access to healthcare?

6. What are the most effective methods of preventing disease?

7. How can we improve the quality of care in our hospitals?

8. What are the best ways to control costs in the healthcare system?

9. How can we ensure that everyone has access to basic care?

10. What are the ethical implications of rationing healthcare?

Medical argumentative essay topics

• Is healthcare a fundamental human right?

2. Should there be limits on medical research using human subjects?

3. Should marijuana be legalized for medicinal purposes?

4. Should the government do more to regulate the use of prescription drugs?

5. Is alternative medicine effective?

6. Are there benefits to using placebos in medical treatment?

7. Should cosmetic surgery be covered by health insurance?

8. Is it ethical to buy organs on the black market?

9. Are there risks associated with taking herbal supplements?

10. Is it morally wrong to end a pregnancy?

11. Should physician-assisted suicide be legal?

12. Is it ethical to test new medical treatments on animals?

13. Should people with terminal illnesses have the right to end their lives?

14. Is it morally wrong to sell organs for transplantation?

15. Are there benefits to using stem cells from embryos in medical research?

16. Is it ethical to use human beings in medical experiments?

17. Should the government do more to fund medical research into cancer treatments?

18. Are there risks associated with genetic engineering of humans?

19. Is it ethical to clones humans for the purpose

Argumentative essays on mental illness

• Should there be more focus on mental health in schools?
• Are our current treatments for mental illness effective?
• Are mental health disorders more common now than they were in the past?
• How does social media impact mental health?
• How does trauma impact mental health?
• What are the most effective treatments for PTSD?
• Is therapy an effective treatment for mental illness?
• What causes mental illness?
• How can we destigmatize mental illness?
• How can we better support those with mental illness?
• Should insurance companies cover mental health treatments?
• What are the most effective treatments for depression?
• Should medication be used to treat mental illness?
• What are the most effective treatments for anxiety disorders?
• What are the most effective treatments for OCD?
• What are the most effective treatments for eating disorders?
• What are the most effective treatments for bipolar disorder?
• How can we better support caregivers of those with mental illness?
• What role does stigma play in mental illness?

Start by filling this short order form order.studyinghq.com

And then follow the progressive flow. 

Having an issue, chat with us here

Cathy, CS. 

New Concept ? Let a subject expert write your paper for You​

Have a subject expert write for you now, have a subject expert finish your paper for you, edit my paper for me, have an expert write your dissertation's chapter, popular topics.

Business StudyingHq Essay Topics and Ideas How to Guides Samples

• Nursing Solutions
• Study Guides
• Free Study Database for Essays
• Privacy Policy
• Writing Service 
• Discounts / Offers 

Study Hub: 

• Studying Blog
• Topic Ideas 
• How to Guides
• Business Studying 
• Nursing Studying 
• Literature and English Studying

Writing Tools  

• Citation Generator
• Topic Generator
• Paraphrasing Tool
• Conclusion Maker
• Research Title Generator
• Thesis Statement Generator
• Summarizing Tool
• Terms and Conditions
• Confidentiality Policy
• Cookies Policy
• Refund and Revision Policy

Our samples and other types of content are meant for research and reference purposes only. We are strongly against plagiarism and academic dishonesty. 

Contact Us:

📧 [email protected]

📞 +15512677917

2012-2024 © studyinghq.com. All rights reserved

How to build a better health system: 8 expert essays

We need to focus on keeping people healthy, not just treating them when they're sick Image:  REUTERS/Rupak De Chowdhuri

.chakra .wef-1c7l3mo{-webkit-transition:all 0.15s ease-out;transition:all 0.15s ease-out;cursor:pointer;-webkit-text-decoration:none;text-decoration:none;outline:none;color:inherit;}.chakra .wef-1c7l3mo:hover,.chakra .wef-1c7l3mo[data-hover]{-webkit-text-decoration:underline;text-decoration:underline;}.chakra .wef-1c7l3mo:focus,.chakra .wef-1c7l3mo[data-focus]{box-shadow:0 0 0 3px rgba(168,203,251,0.5);} Global Future Council on Health and Healthcare

Introduction

By Francesca Colombo , Head, Health Division, Organisation for Economic Co-operation and Development (OECD) and Helen E. Clark , Prime Minister of New Zealand (1999-2008), The Helen Clark Foundation

Our healthy future cannot be achieved without putting the health and wellbeing of populations at the centre of public policy.

Ill health worsens an individual’s economic prospects throughout the lifecycle. For young infants and children, ill health affects their capacity to acumulate human capital; for adults, ill health lowers quality of life and labour market outcomes, and disadvantage compounds over the course of a lifetime.

And, yet, with all the robust evidence available that good health is beneficial to economies and societies, it is striking to see how health systems across the globe struggled to maximise the health of populations even before the COVID-19 pandemic – a crisis that has further exposed the stresses and weaknesses of our health systems. These must be addressed to make populations healthier and more resilient to future shocks.

Each one of us, at least once in our lives, is likely to have been frustrated with care that was inflexible, impersonal and bureaucratic. At the system level, these individual experiences add up to poor safety, poor care coordination and inefficiencies – costing millions of lives and enormous expense to societies.

This state of affairs contributes to slowing down the progress towards achieving the sustainable development goals to which all societies, regardless of their level of economic development, have committed.

Many of the conditions that can make change possible are in place. For example, ample evidence exists that investing in public health and primary prevention delivers significant health and economic dividends. Likewise, digital technology has made many services and products across different sectors safe, fast and seamless. There is no reason why, with the right policies, this should not happen in health systems as well. Think, for example, of the opportunities to bring high quality and specialised care to previously underserved populations. COVID-19 has accelerated the development and use of digital health technologies. There are opportunities to further nurture their use to improve public health and disease surveillance, clinical care, research and innovation.

To encourage reform towards health systems that are more resilient, better centred around what people need and sustainable over time, the Global Future Council on Health and Health Care has developed a series of stories illustrating why change must happen, and why this is eminently possible today. While the COVID-19 crisis is severally challenging health systems today, our healthy future is – with the right investments – within reach.

1. Five changes for sustainable health systems that put people first

The COVID-19 crisis has affected more than 188 countries and regions worldwide, causing large-scale loss of life and severe human suffering. The crisis poses a major threat to the global economy, with drops in activity, employment, and consumption worse than those seen during the 2008 financial crisis . COVID-19 has also exposed weaknesses in our health systems that must be addressed. How?

For a start, greater investment in population health would make people, particularly vulnerable population groups, more resilient to health risks. The health and socio-economic consequences of the virus are felt more acutely among disadvantaged populations, stretching a social fabric already challenged by high levels of inequalities. The crisis demonstrates the consequences of poor investment in addressing wider social determinants of health, including poverty, low education and unhealthy lifestyles. Despite much talk of the importance of health promotion, even across the richer OECD countries barely 3% of total health spending is devoted to prevention . Building resilience for populations also requires a greater focus on solidarity and redistribution in social protection systems to address underlying structural inequalities and poverty.

Beyond creating greater resilience in populations, health systems must be strengthened.

High-quality universal health coverage (UHC) is paramount. High levels of household out-of-pocket payments for health goods and services deter people from seeking early diagnosis and treatment at the very moment they need it most. Facing the COVID-19 crisis, many countries have strengthened access to health care, including coverage for diagnostic testing. Yet others do not have strong UHC arrangements. The pandemic reinforced the importance of commitments made in international fora, such as the 2019 High-Level Meeting on Universal Health Coverage , that well-functioning health systems require a deliberate focus on high-quality UHC. Such systems protect people from health threats, impoverishing health spending, and unexpected surges in demand for care.

Second, primary and elder care must be reinforced. COVID-19 presents a double threat for people with chronic conditions. Not only are they at greater risk of severe complications and death due to COVID-19; but also the crisis creates unintended health harm if they forgo usual care, whether because of disruption in services, fear of infections, or worries about burdening the health system. Strong primary health care maintains care continuity for these groups. With some 94% of deaths caused by COVID-19 among people aged over 60 in high-income countries, the elder care sector is also particularly vulnerable, calling for efforts to enhance control of infections, support and protect care workers and better coordinate medical and social care for frail elderly.

Third, the crisis demonstrates the importance of equipping health systems with both reserve capacity and agility. There is an historic underinvestment in the health workforce, with estimated global shortages of 18 million health professionals worldwide , mostly in low- and middle-income countries. Beyond sheer numbers, rigid health labour markets make it difficult to respond rapidly to demand and supply shocks. One way to address this is by creating a “reserve army” of health professionals that can be quickly mobilised. Some countries have allowed medical students in their last year of training to start working immediately, fast-tracked licenses and provided exceptional training. Others have mobilised pharmacists and care assistants. Storing a reserve capacity of supplies such as personal protection equipment, and maintaining care beds that can be quickly transformed into critical care beds, is similarly important.

Fourth, stronger health data systems are needed. The crisis has accelerated innovative digital solutions and uses of digital data, smartphone applications to monitor quarantine, robotic devices, and artificial intelligence to track the virus and predict where it may appear next. Access to telemedicine has been made easier. Yet more can be done to leverage standardised national electronic health records to extract routine data for real-time disease surveillance, clinical trials, and health system management. Barriers to full deployment of telemedicine, the lack of real-time data, of interoperable clinical record data, of data linkage capability and sharing within health and with other sectors remain to be addressed.

Fifth, an effective vaccine and successful vaccination of populations around the globe will provide the only real exit strategy. Success is not guaranteed and there are many policy issues yet to be resolved. International cooperation is vital. Multilateral commitments to pay for successful candidates would give manufacturers certainty so that they can scale production and have vaccine doses ready as quickly as possible following marketing authorisation, but could also help ensure that vaccines go first to where they are most effective in ending the pandemic. Whilst leaders face political pressure to put the health of their citizens first, it is more effective to allocate vaccines based on need. More support is needed for multilateral access mechanisms that contain licensing commitments and ensure that intellectual property is no barrier to access, commitments to technology transfer for local production, and allocation of scarce doses based on need.

The pandemic offers huge opportunities to learn lessons for health system preparedness and resilience. Greater focus on anticipating responses, solidarity within and across countries, agility in managing responses, and renewed efforts for collaborative actions will be a better normal for the future.

OECD Economic Outlook 2020 , Volume 2020 Issue 1, No. 107, OECD Publishing, Paris

OECD Employment Outlook 2020 : Worker Security and the COVID-19 Crisis, OECD Publishing, Paris

OECD Health at a Glance 2019, OECD Publishing, Paris

https://www.un.org/pga/73/wp-content/uploads/sites/53/2019/07/FINAL-draft-UHC-Political-Declaration.pdf

OECD (2020), Who Cares? Attracting and Retaining Care Workers for the Elderly, OECD Health Policy Studies, OECD Publishing, Paris

Working for Health and Growth: investing in the health workforce . Report of the High-Level Commission on Health Employment and Economic Growth, Geneva.

Colombo F., Oderkirk J., Slawomirski L. (2020) Health Information Systems, Electronic Medical Records, and Big Data in Global Healthcare: Progress and Challenges in OECD Countries . In: Haring R., Kickbusch I., Ganten D., Moeti M. (eds) Handbook of Global Health. Springer, Cham.

2. Improving population health and building healthy societies in times of COVID-19

By Helena Legido-Quigley , Associate Professor, London School of Hygiene and Tropical Medicine

The COVID-19 pandemic has been a stark reminder of the fragility of population health worldwide; at time of writing, more than 1 million people have died from the disease. The pandemic has already made evident that those suffering most from COVID-19 belong to disadvantaged populations and marginalised communities. Deep-rooted inequalities have contributed adversely to the health status of different populations within and between countries. Besides the direct and indirect health impacts of COVID-19 and the decimation of health systems, restrictions on population movement and lockdowns introduced to combat the pandemic are expected to have economic and social consequences on an unprecedented scale .

Population health – and addressing the consequences of COVID-19 – is about improving the physical and mental health outcomes and wellbeing of populations locally, regionally and nationally, while reducing health inequalities.¹ Moreover, there is an increasing recognition that societal and environmental factors, such as climate change and food insecurity, can also influence population health outcomes.

The experiences of Maria, David, and Ruben – as told by Spanish public broadcaster RTVE – exemplify the real challenges that people living in densely populated urban areas have faced when being exposed to COVID-19.¹

Maria is a Mexican migrant who has just returned from Connecticut to the Bronx. Her partner Jorge died in Connecticut from COVID-19. She now has no income and is looking for an apartment for herself and her three children. When Jorge became ill, she took him to the hospital, but they would not admit him and he was sent away to be cared for by Maria at home with their children. When an ambulance eventually took him to hospital, it was too late. He died that same night, alone in hospital. She thinks he had diabetes, but he was never diagnosed. They only had enough income to pay the basic bills. Maria is depressed, she is alone, but she knows she must carry on for her children. Her 10-year old child says that if he could help her, he would work. After three months, she finds an apartment.

David works as a hairdresser and takes an overcrowded train every day from Leganés to Chamberi in the centre of Madrid. He lives in a small flat in San Nicasio, one of the poorest working-class areas of Madrid with one of the largest ageing populations in Spain. The apartments are very small, making it difficult to be in confinement, and all of David’s neighbours know somebody who has been a victim of COVID-19. His father was also a hairdresser. David's father was not feeling well; he was taken to hospital by ambulance, and he died three days later. David was not able to say goodbye to his father. Unemployment has increased in that area; small local shops are losing their customers, and many more people are expecting to lose their jobs.

Ruben lives in Iztapalapa in Mexico City with three children, a daughter-in-law and five grandchildren. Their small apartment has few amenities, and no running water during the evening. At three o’clock every morning, he walks 45 minutes with his mobile stall to sell fruit juices near the hospital. His daily earnings keep the family. He goes to the central market to buy fruit, taking a packed dirty bus. He thinks the city's central market was contaminated at the beginning of the pandemic, but it could not be closed as it is the main source of food in the country. He has no health insurance, and he knows that as a diabetic he is at risk, but medication for his condition is too expensive. He has no alternative but to go to work every day: "We die of hunger or we die of COVID."

These real stories highlight the issues that must be addressed to reduce persistent health inequalities and achieve health outcomes focusing on population health. The examples of Maria, David and Ruben show the terrible outcomes COVID-19 has had for people living in poverty and social deprivation, older people, and those with co-morbidities and/or pre-existing health conditions. All three live in densely populated urban areas with poor housing, and have to travel long distances in overcrowded transport. Maria’s loss of income has had consequences for her housing security and access to healthcare and health insurance, which will most likely lead to worse health conditions for her and her children. Furthermore, all three experienced high levels of stress, which is magnified in the cases of Maria and David who were unable to be present when their loved ones died.

The COVID-19 pandemic has made it evident that to improve the health of the population and build healthy societies, there is a need to shift the focus from illness to health and wellness in order to address the social, political and commercial determinants of health; to promote healthy behaviours and lifestyles; and to foster universal health coverage.² Citizens all over the world are demanding that health systems be strengthened and for governments to protect the most vulnerable. A better future could be possible with leadership that is able to carefully consider the long-term health, economic and social policies that are needed.

In order to design and implement population health-friendly policies, there are three prerequisites. First, there is a need to improve understanding of the factors that influence health inequalities and the interconnections between the economic, social and health impacts. Second, broader policies should be considered not only within the health sector, but also in other sectors such as education, employment, transport and infrastructure, agriculture, water and sanitation. Third, the proposed policies need to be designed through involving the community, addressing the health of vulnerable groups, and fostering inter-sectoral action and partnerships.

Finally, within the UN's Agenda 2030 , Sustainable Development Goal (SDG) 3 sets out a forward-looking strategy for health whose main goal is to attain healthier lives and wellbeing. The 17 interdependent SDGs offer an opportunity to contribute to healthier, fairer and more equitable societies from which both communities and the environment can benefit.

The stories of Maria, David and Ruben are real stories featured in the Documentary: The impact of COVID19 in urban outskirts, Directed by Jose A Guardiola. Available here. Permission has been granted to narrate these stories.

Buck, D., Baylis, A., Dougall, D. and Robertson, R. (2018). A vision for population health: Towards a healthier future . [online] London: The King's Fund. [Accessed 20 Sept. 2020]

Wilton Park. (2020). Healthy societies, healthy populations (WP1734). Wiston House, Steyning. Retrieved from https://www.wiltonpark.org.uk/event/wp1734/ Cohen B. E. (2006). Population health as a framework for public health practice: a Canadian perspective. American journal of public health , 96 (9), 1574–1576.

3. Imagine a 'well-care' system that invests in keeping people healthy

By Maliha Hashmi , Executive Director, Health and Well-Being and Biotech, NEOM, and Jan Kimpen , Global Chief Medical Officer, Philips

Imagine a patient named Emily. Emily is aged 32 and I’m her doctor.

Emily was 65lb (29kg) above her ideal body weight, pre-diabetic and had high cholesterol. My initial visit with Emily was taken up with counselling on lifestyle changes, mainly diet and exercise; typical advice from one’s doctor in a time-pressured 15-minute visit. I had no other additional resources, incentives or systems to support me or Emily to help her turn her lifestyle around.

I saw Emily eight months later, not in my office, but in the hospital emergency room. Her husband accompanied her – she was vomiting, very weak and confused. She was admitted to the intensive care unit, connected to an insulin drip to lower her blood sugar, and diagnosed with type 2 diabetes. I talked to Emily then, emphasizing that the new medications for diabetes would only control the sugars, but she still had time to reverse things if she changed her lifestyle. She received further counselling from a nutritionist.

Over the years, Emily continued to gain weight, necessitating higher doses of her diabetes medication. More emergency room visits for high blood sugars ensued, she developed infections of her skin and feet, and ultimately, she developed kidney disease because of the uncontrolled diabetes. Ten years after I met Emily, she is 78lb (35kg) above her ideal body weight; she is blind and cannot feel her feet due to nerve damage from the high blood sugars; and she will soon need dialysis for her failing kidneys. Emily’s deteriorating health has carried a high financial cost both for herself and the healthcare system. We have prevented her from dying and extended her life with our interventions, but each interaction with the medical system has come at significant cost – and those costs will only rise. But we have also failed Emily by allowing her diabetes to progress. We know how to prevent this, but neither the right investments nor incentives are in place.

Emily could have been a real patient of mine. Her sad story will be familiar to all doctors caring for chronically ill patients. Unfortunately, patients like Emily are neglected by health systems across the world today. The burden of chronic disease is increasing at alarming rates. Across the OECD nearly 33% of those over 15 years live with one or more chronic condition, rising to 60% for over-65s. Approximately 50% of chronic disease deaths are attributed to cardiovascular disease (CVD). In the coming decades, obesity, will claim 92 million lives in the OECD while obesity-related diseases will cut life expectancy by three years by 2050.

These diseases can be largely prevented by primary prevention, an approach that emphasizes vaccinations, lifestyle behaviour modification and the regulation of unhealthy substances. Preventative interventions have been efficacious. For obesity, countries have effectively employed public awareness campaigns, health professionals training, and encouragement of dietary change (for example, limits on unhealthy foods, taxes and nutrition labelling).⁴,⁵ Other interventions, such as workplace health-promotion programmes, while showing some promise, still need to demonstrate their efficacy.

The COVID-19 crisis provides the ultimate incentive to double down on the prevention of chronic disease. Most people dying from COVID-19 have one or more chronic disease, including obesity, CVD, diabetes or respiratory problems – diseases that are preventable with a healthy lifestyle. COVID-19 has highlighted structural weaknesses in our health systems such as the neglect of prevention and primary care.

While the utility of primary prevention is understood and supported by a growing evidence base, its implementation has been thwarted by chronic underinvestment, indicating a lack of societal and governmental prioritization. On average, OECD countries only invest 2.8% of health spending on public health and prevention. The underlying drivers include decreased allocation to prevention research, lack of awareness in populations, the belief that long-run prevention may be more costly than treatment, and a lack of commitment by and incentives for healthcare professionals. Furthermore, public health is often viewed in a silo separate from the overall health system rather than a foundational component.

Health benefits aside, increasing investment in primary prevention presents a strong economic imperative. For example, obesity contributes to the treatment costs of many other diseases: 70% of diabetes costs, 23% for CVD and 9% for cancers. Economic losses further extend to absenteeism and decreased productivity.

Fee-for-service models that remunerate physicians based on the number of sick patients they see, regardless the quality and outcome, dominate healthcare systems worldwide. Primary prevention mandates a payment system that reimburses healthcare professionals and patients for preventive actions. Ministries of health and governmental leaders need to challenge skepticism around preventive interventions, realign incentives towards preventive actions and those that promote healthy choices by people. Primary prevention will eventually reduce the burden of chronic diseases on the healthcare system.

As I reflect back on Emily and her life, I wonder what our healthcare system could have done differently. What if our healthcare system was a well-care system instead of a sick-care system? Imagine a different scenario: Emily, a 32 year old pre-diabetic, had access to a nutritionist, an exercise coach or health coach and nurse who followed her closely at the time of her first visit with me. Imagine if Emily joined group exercise classes, learned where to find healthy foods and how to cook them, and had access to spaces in which to exercise and be active. Imagine Emily being better educated about her diabetes and empowered in her healthcare and staying healthy. In reality, it is much more complicated than this, but if our healthcare systems began to incentivize and invest in prevention and even rewarded Emily for weight loss and healthy behavioural changes, the outcome might have been different. Imagine Emily losing weight and continuing to be an active and contributing member of society. Imagine if we invested in keeping people healthy rather than waiting for people to get sick, and then treating them. Imagine a well-care system.

Anderson, G. (2011). Responding to the growing cost and prevalence of people with multiple chronic conditions . Retrieved from OECD.

Institute for Health Metrics and Evaluation. GBD Data Visualizations. Retrieved here.

OECD (2019), The Heavy Burden of Obesity: The Economics of Prevention, OECD Health Policy Studies, OECD Publishing, Paris.

OECD. (2017). Obesity Update . Retrieved here.

Malik, V. S., Willett, W. C., & Hu, F. B. (2013). Global obesity: trends, risk factors and policy implications. Nature Reviews Endocrinology , 9 (1), 13-27.

Lang, J., Cluff, L., Payne, J., Matson-Koffman, D., & Hampton, J. (2017). The centers for disease control and prevention: findings from the national healthy worksite program. Journal of occupational and environmental medicine , 59 (7), 631.

Gmeinder, M., Morgan, D., & Mueller, M. (2017). How much do OECD countries spend on prevention? Retrieved from OECD.

Jordan RE, Adab P, Cheng KK. Covid-19: risk factors for severe disease and death. BMJ. 2020;368:m1198.

Richardson, A. K. (2012). Investing in public health: barriers and possible solutions. Journal of Public Health , 34 (3), 322-327.

Yong, P. L., Saunders, R. S., & Olsen, L. (2010). Missed Prevention Opportunities The healthcare imperative: lowering costs and improving outcomes: workshop series summary (Vol. 852): National Academies Press Washington, DC.

OECD. (2019). The Heavy Burden of Obesity: The Economics of Prevention. Retrieved here .

McDaid, D., F. Sassi and S. Merkur (Eds.) (2015a), “Promoting Health, Preventing Disease: The Economic Case ”, Open University Press, New York.

OECD. (2019). The Heavy Burden of Obesity: The Economics of Prevention. Retrieved from OECD.

4. Why e arly detection and diagnosis is critical

By Paul Murray , Head of Life and Health Products, Swiss Re, and André Goy , Chairman and Executive Director & Chief of Lymphoma, John Theurer Cancer Center, Hackensack University Medical Center

Although healthcare systems around the world follow a common and simple principle and goal – that is, access to affordable high-quality healthcare – they vary significantly, and it is becoming increasingly costly to provide this access, due to ageing populations, the increasing burden of chronic diseases and the price of new innovations.

Governments are challenged by how best to provide care to their populations and make their systems sustainable. Neither universal health, single payer systems, hybrid systems, nor the variety of systems used throughout the US have yet provided a solution. However, systems that are ranked higher in numerous studies, such as a 2017 report by the Commonwealth Fund , typically include strong prevention care and early-detection programmes. This alone does not guarantee a good outcome as measured by either high or healthy life expectancy. But there should be no doubt that prevention and early detection can contribute to a more sustainable system by reducing the risk of serious diseases or disorders, and that investing in and operationalizing earlier detection and diagnosis of key conditions can lead to better patient outcomes and lower long-term costs.

To discuss early detection in a constructive manner it makes sense to describe its activities and scope. Early detection includes pre-symptomatic screening and treatment immediately or shortly after first symptoms are diagnosed. Programmes may include searching for a specific disease (for example, HIV/AIDS or breast cancer), or be more ubiquitous. Prevention, which is not the focus of this blog, can be interpreted as any activities undertaken to avoid diseases, such as information programmes, education, immunization or health monitoring.

Expenditures for prevention and early detection vary by country and typically range between 1-5% of total health expenditures.¹ During the 2008 global financial crisis, many countries reduced preventive spending. In the past few years, however, a number of countries have introduced reforms to strengthen and promote prevention and early detection. Possibly the most prominent example in recent years was the introduction of the Affordable Care Act in the US, which placed a special focus on providing a wide range of preventive and screening services. It lists 63 distinct services that must be covered without any copayment, co-insurance or having to pay a deductible.

Whilst logic dictates that investment in early detection should be encouraged, there are a few hurdles and challenges that need to be overcome and considered. We set out a few key criteria and requirements for an efficient early detection program:

1. Accessibility The healthcare system needs to provide access to a balanced distribution of physicians, both geographically (such as accessibility in rural areas), and by specialty. Patients should be able to access the system promptly without excessive waiting times for diagnoses or elective treatments. This helps mitigate conditions or diseases that are already quite advanced or have been incubating for months or even years before a clinical diagnosis. Access to physicians varies significantly across the globe from below one to more than 60 physicians per 10,000 people.² One important innovation for mitigating access deficiencies is telehealth. This should give individuals easier access to health-related services, not only in cases of sickness but also to supplement primary care.

2. Early symptoms and initial diagnosis Inaccurate or delayed initial diagnoses present a risk to the health of patients, can lead to inappropriate or unnecessary testing and treatment, and represents a significant share of total health expenditures. A medical second opinion service, especially for serious medical diagnoses, which can occur remotely, can help improve healthcare outcomes. Moreover, studies show that early and correct diagnosis opens up a greater range of curative treatment options and can reduce costs (e.g. for colon cancer, stage-four treatment costs are a multiple of stage-one treatment costs).³

3. New technology New early detection technologies can improve the ability to identify symptoms and diseases early: i. Advances in medical monitoring devices and wearable health technology, such as ECG and blood pressure monitors and biosensors, enable patients to take control of their own health and physical condition. This is an important trend that is expected to positively contribute to early detection, for example in atrial fibrillation and Alzheimers’ disease. ii. Diagnostic tools, using new biomarkers such as liquid biopsies or volatile organic compounds, together with the implementation of machine learning, can play an increasing role in areas such as oncology or infectious diseases.⁴

4. Regulation and Intervention Government regulation and intervention will be necessary to set ranges of normality, to prohibit or discourage overdiagnosis and to reduce incentives for providers to overtreat patients or to follow patients' inappropriate requests. In some countries, such as the US, there has been some success through capitation models and value-based care. Governments might also need to intervene to de-risk the innovation paradigm, such that private providers of capital feel able to invest more in the development of new detection technologies, in addition to proven business models in novel therapeutics.

OECD Health Working Papers No. 101 "How much do OECD countries spend on prevention" , 2017

World Health Organization; Global Health Observatory (GHO) data; https://www.who.int/gho/health_workforce/physicians_density/en/

Saving lives, averting costs; A report for Cancer Research UK, by Incisive Health, September 2014

Liquid Biopsy: Market Drivers And Obstacles; by Divyaa Ravishankar, Frost & Sullivan, January 21, 2019

Liquid Biopsies Become Cheap and Easy with New Microfluidic Device; February 26, 2019

How America’s 5 Top Hospitals are Using Machine Learning Today; by Kumba Sennaar, February 19, 2019

5. The business case for private investment in healthcare for all

Pascal Fröhlicher, Primary Care Innovation Scholar, Harvard Medical School, and Ian Wijaya, Managing Director in Lazard’s Global Healthcare Group

Faith, a mother of two, has just lost another customer. Some households where she is employed to clean, in a small town in South Africa, have little understanding of her medical needs. As a type 2 diabetes patient, this Zimbabwean woman visits the public clinic regularly, sometimes on short notice. At her last visit, after spending hours in a queue, she was finally told that the doctor could not see her. To avoid losing another day of work, she went to the local general practitioner to get her script, paying more than three daily wages for consultation and medication. Sadly, this fictional person reflects a reality for many people in middle-income countries.

Achieving universal health coverage by 2030, a key UN Sustainable Development Goal (SDG), is at risk. The World Bank has identified a $176 billion funding gap , increasing every year due to the growing needs of an ageing population, with the health burden shifting towards non-communicable diseases (NCDs), now the major cause of death in emerging markets . Traditional sources of healthcare funding struggle to increase budgets sufficiently to cover this gap and only about 4% of private health care investments focus on diseases that primarily affect low- and middle-income countries.

In middle-income countries, private investors often focus on extending established businesses, including developing private hospital capacity, targeting consumers already benefiting from quality healthcare. As a result, an insufficient amount of private capital is invested in strengthening healthcare systems for everyone.

Why is this the case? We discussed with senior health executives investing in Lower and Middle Income Countries (LMIC) and the following reasons emerged:

• Small market size . Scaling innovations in healthcare requires dealing with country-specific regulatory frameworks and competing interest groups, resulting in high market entry cost.
• Talent . Several LMICs are losing nurses and doctors but also business and finance professionals to European and North American markets due to the lack of local opportunities and a significant difference in salaries.
• Untested business models with relatively low gross margins. Providing healthcare requires innovative business models where consumers’ willingness to pay often needs to be demonstrated over a significant period of time. Additionally, relatively low gross margins drive the need for scale to leverage administrative costs, which increases risk.
• Government Relations. The main buyer of health-related products and services is government; yet the relationship between public and private sectors often lacks trust, creating barriers to successful collaboration. Add to that significant political risk, as contracts can be cancelled by incoming administrations after elections. Many countries also lack comprehensive technology strategies to successfully manage technological innovation.
• Complexity of donor funding. A significant portion of healthcare is funded by private donors, whose priorities might not always be congruent with the health priorities of the government.

Notwithstanding these barriers, healthcare, specifically in middle-income settings, could present an attractive value proposition for private investors:

• Economic growth rates . A growing middle class is expanding the potential market for healthcare products and services.
• Alignment of incentives . A high ratio of out-of-pocket payments for healthcare services is often associated with low quality. However, innovative business models can turn out of pocket payments into the basis for a customer-centric value proposition, as the provider is required to compete for a share of disposable income.
• Emergence of National Health Insurance Schemes . South Africa, Ghana, Nigeria and others are building national health insurance schemes, increasing a population’s ability to fund healthcare services and products .
• Increased prevalence of NCDs. Given the increasing incidence of chronic diseases and the potential of using technology to address these diseases, new business opportunities for private investment exist.

Based on the context above, several areas in healthcare delivery can present compelling opportunities for private companies.

• Aggregation of existing players.
• Leveraging primary care infrastructure. Retail companies can leverage their real estate, infrastructure and supply chains to deploy primary care services at greater scale than is currently the case.
• Telemedicine . Telecommunications providers can leverage their existing infrastructure and customer base to provide payment mechanisms and telehealth services at scale. As seen during the COVID-19 pandemic, investment in telemedicine can ensure that patients receive timely and continuous care in spite of restrictions and lockdowns.
• Cost effective diagnostics . Diagnostic tools operated by frontline workers and combined with the expertise of specialists can provide timely and efficient care.

To fully realize these opportunities, government must incentivise innovation, provide clear regulatory frameworks and, most importantly, ensure that health priorities are adequately addressed.

Venture capital and private equity firms as well as large international corporations can identify the most commercially viable solutions and scale them into new markets. The ubiquity of NCDs and the requirement to reduce costs globally provides innovators with the opportunity to scale their tested solutions from LMICs to higher income environments.

Successful investment exits in LMICs and other private sector success stories will attract more private capital. Governments that enable and support private investment in their healthcare systems would, with appropriate governance and guidance, generate benefits to their populations and economies. The economic value of healthy populations has been proven repeatedly , and in the face of COVID-19, private sector investment can promote innovation and the development of responsible, sustainable solutions.

Faith – the diabetic mother we introduced at the beginning of this article - could keep her client. As a stable patient, she could measure her glucose level at home and enter the results in an app on her phone, part of her monthly diabetes programme with the company that runs the health centre. She visits the nurse-led facility at the local taxi stand on her way to work when her app suggests it. The nurse in charge of the centre treats Faith efficiently, and, if necessary, communicates with a primary care physician or even a specialist through the telemedicine functionality of her electronic health system.

Improving LMIC health systems is not only a business opportunity, but a moral imperative for public and private leaders. With the appropriate technology and political will, this can become a reality.

6. How could COVID-19 change the way we pay for health services?

John E. Ataguba, Associate Professor and Director, University of Cape Town and Matthew Guilford, Co-Founder and Chief Executive Officer, Common Health

The emergence of the new severe acute respiratory syndrome coronavirus (SARS-Cov-2), causing the coronavirus disease 2019 (COVID-19), has challenged both developing and developed countries.

Countries have approached the management of infections differently. Many people are curious to understand their health system’s performance on COVID-19, both at the national level and compared to international peers. Alongside limited resources for health, many developing countries may have weak health systems that can make it challenging to respond adequately to the pandemic.

Even before COVID-19, high rates of out-of-pocket spending on health meant that every year, 800 million people faced catastrophic healthcare costs ,100 million families were pushed into poverty, and millions more simply avoided care for critical conditions because they could not afford to pay for it.

The pandemic and its economic fallout have caused household incomes to decline at the same time as healthcare risks are rising. In some countries with insurance schemes, and especially for private health insurance, the following questions have arisen: How large is the co-payment for a COVID-19 test? If my doctor’s office is closed, will the telemedicine consultation be covered by my insurance? Will my coronavirus care be paid for regardless of how I contracted the virus? These and other doubts can prevent people from seeking medical care in some countries.

In Nigeria, like many other countries in Africa, the government bears the costs associated with testing and treating COVID-19 irrespective of the individual’s insurance status. In the public health sector, where COVID-19 cases are treated, health workers are paid monthly salaries while budgets are allocated to health facilities for other services. Hospitals continue to receive budget allocations to finance all health services including the management and treatment of COVID-19. That implies that funds allocated to address other health needs are reduced and that in turn could affect the availability and quality of health services.

Although health workers providing care for COVID-19 patients in isolation and treatment centres in Nigeria are paid salaries that are augmented with a special incentive package, the degree of impact on the quality improvement of services remains unclear. The traditional and historical allocation of budgets does not always address the needs of the whole population and could result in poor health services and under-provision of health services for COVID-19 patients.

In some countries, the reliance on out-of-pocket funding is hardly better for private providers, who encounter brand risks, operational difficulties, and – in extreme cases – the risk of creating “debtor prisons” as they seek to collect payment from patients. Ironically, despite the huge demand for medical services to diagnose and treat COVID-19, large healthcare institutions and individual healthcare practitioners alike are facing financial distress.

Dependence on a steady stream of fee-for-service payments for outpatient consultations and elective procedures is leading to pay cuts for doctors in India , forfeited Eid bonuses for nurses in Indonesia , and hospital bankruptcies in the United States . In a recent McKinsey & Company survey, 77% of physicians reported that their business would suffer in 2020 , and 46% were concerned about their practice surviving the coronavirus pandemic.

COVID-19 is exposing how fee-for-service, historical budget allocation and out-of-pocket financing methods can hinder the performance of the health system. Some providers and health systems that deployed “value-based” models prior to the pandemic have reported that these approaches have improved financial resilience during COVID-19 and may support better results for patients. Nevertheless, these types of innovations do not represent the dominant payment model in any country.

How health service providers are paid has implications for whether service users can get needed health services in a timely fashion, and at an appropriate quality and an affordable cost. By shifting from fee-for-service reimbursements to fixed "capitation" and performance-based payments, these models incentivize providers to improve quality and coordination while also guaranteeing a baseline income level, even during times of disruption.

Health service providers could be paid either in the form of salaries, a fee for services they provide, by capitation (whether adjusted or straightforward), through global budgets, or by using a case-based payment system (for example, the diagnostics-related groups), among others. Because there are different incentives to consider when adopting any of the methods, they could be combined to achieve a specific goal. For example, in some countries, health workers are paid salaries , and some specific services are paid on a fee-for-service basis.

Ideally, health services could be purchased strategically , incorporating aspects of provider performance in transferring funds to providers and accounting for the health needs of the population they serve.

In this regard, strategic purchasing for health has been advocated and should be highlighted as crucial with the emergence of the COVID-19 pandemic. There is a need to ensure value in the way health providers are paid, inter alia to increase efficiency, ensure equity, and improve access to needed health services. Value-based payment methods, although not new in many countries, provide an avenue to encourage long-term value for money, better quality, and strategic purchasing for health, helping to build a healthier, more resilient world.

7. L essons in integrated care from the COVID-19 pandemic

Sarah Ziegler, Postdoctoral Researcher, Department of Epidemiology and Biostatistics, University of Zurich, and Ninie Wang, Founder & CEO, Pinetree Care Group.

Since the start of the COVID-19 pandemic, people suffering non-communicable diseases (NCDs) have been at higher risk of becoming severely ill or dying. In Italy, 96.2% of people who died of COVID-19 lived with two or more chronic conditions.

Beyond the pandemic, cardiovascular disease, cancer, respiratory disease and diabetes are the leading burden of disease, with 41 million annual deaths. People with multimorbidity - a number of different conditions - often experience difficulties in accessing timely and coordinated healthcare, made worse when health systems are busy fighting against the pandemic.

Here is what happened in China with Lee, aged 62, who has been living with Chronic Obstructive Pulmonary Disease (COPD) for the past five years.

Before the pandemic, Lee’s care manager coordinated a multi-disciplinary team of physicians, nurses, pulmonary rehabilitation therapists, psychologists and social workers to put together a personalized care plan for her. Following the care plan, Lee stopped smoking and paid special attention to her diet, sleep and physical exercises, as well as sticking to her medication and follow-up visits. She participated in a weekly community-based physical activity program to meet other COPD patients, including short walks and exchange experiences. A mobile care team supported her with weekly cleaning and grocery shopping.

Together with her family, Lee had follow-up visits to ensure her care plan reflected her recovery and to modify the plan if needed. These integrated care services brought pieces of care together, centered around Lee’s needs, and provided a continuum of care that helped keep Lee in the community with a good quality of life for as long as possible.

Since the COVID-19 outbreak, such NCD services have been disrupted by lockdowns, the cancellation of elective care and the fear of visiting care service . These factors particularly affected people living with NCDs like Lee. As such, Lee was not able to follow her care plan anymore. The mobile care team was unable to visit her weekly as they were deployed to provide COVID-19 relief. Lee couldn’t participate in her community-based program, follow up on her daily activities, or see her family or psychologists. This negatively affected Lee’s COPD management and led to poor management of her physical activity and healthy diet.

The pandemic highlights the need for a flexible and reliable integrated care system to enable healthcare delivery to all people no matter where they live, uzilizing approaches such as telemedicine and effective triaging to overcome care disruptions.

Lee’s care manager created short videos to assist her family through each step of her care and called daily to check in on the implementation of the plan and answer questions. Lee received tele-consultations, and was invited to the weekly webcast series that supported COPD patient communities. When her uncle passed away because of pneumonia complications from COVID-19 in early April, Lee’s care manager arranged a palliative care provider to support the family through the difficult time of bereavement and provided food and supplies during quarantine. Lee could even continue with her physical activity program with an online training coach. There were a total of 38 exercise videos for strengthening and stretching arms, legs and trunk, which she could complete at different levels of difficulty and with different numbers of repetitions.

Lee’s case demonstrates that early detection, prevention, and management of NCDs play a crucial role in a global pandemic response. It shows how we need to shift away from health systems designed around single diseases towards health systems designed for the multidimensional needs of individuals. As part of the pandemic responses, addressing and managing risks related to NCDs and prevention of their complications are critical to improve outcomes for vulnerable people like Lee.

How to design and deliver successful integrated care

The challenge for the successful transformation of healthcare is to tailor care system-wide to population needs. A 2016 WHO Framework on integrated people-centered health services developed a set of five general strategies for countries to progress towards people-centered and sustainable health systems, calling for a fundamental transformation not only in the way health services are delivered, but also in the way they are financed and managed . These strategies call for countries to:

• Engage and empower people / communities: an integrated care system must mobilize everyone to work together using all available resources, especially when continuity of essential health and community services for NCDs are at risk of being undermined.
• Strengthen governance and accountability, so that integration emphasizes rather than weakens leadership in every part of the system, and ensure that NCDs are included in national COVID-19 plans and future essential health services.
• Reorient the model of care to put the needs and perspectives of each person / family at the center of care planning and outcome measurement, rather than institutions.
• Coordinate services within and across sectors, for example, integrate inter-disciplinary medical care with social care, addressing wider socio-economic, environmental and behavioral determinants of health.
• Create an enabling environment, with clear objectives, supportive financing, regulations and insurance coverage for integrated care, including the development and use of systemic digital health care solutions.

Whether due to an unexpected pandemic or a gradual increase in the burden of NCDs, each person could face many health threats across the life-course.

Only systems that dynamically assess each person’s complex health needs and address them through a timely, well-coordinated and tailored mix of health and social care services will be able to deliver desired health outcomes over the longer term, ensuring an uninterrupted good quality of life for Lee and many others like her.

• Wang B, Li R, Lu Z, Huang Y. Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis. Aging (Albany NY) 2020;12: 6049–57.
• WHO. Noncommunicable diseases in emergencies. Geneva: World Health Organization, 2016.
• WHO. COVID-19 significantly impacts health services for noncommunicable diseases. June 2020.
• Kluge HHP, Wickramasinghe K, Rippin HL, et al. Prevention and control of non-communicalbe diseases in the COVID-19 response. The Lancet. 2020. 395:1678-1680
• WHO. Framework on integrated people-centred health services. Geneva: World Health Organization, 2016.

8 . Why access to healthcare alone will not save lives

Donald Berwick, President Emeritus and Senior Fellow, Institute for Healthcare Improvement; Nicola Bedlington, Special Adviser, European Patient Forum; and David Duong, Director, Program in Global Primary Care and Social Change, Harvard Medical School.

Joyce lies next to 10 other women in bare single beds in the post-partum recovery room at a rural hospital in Uganda. Just an hour ago, Joyce gave birth to a healthy baby boy. She is now struggling with abdominal pain. A nurse walks by, and Joyce tries to call out, but the nurse was too busy to attend to her; she was the only nurse looking after 20 patients.

Another hour passes, and Joyce is shaking and sweating profusely. Joyce’s husband runs into the corridor to find a nurse to come and evaluate her. The nurse notices Joyce’s critical condition - a high fever and a low blood pressure - and she quickly calls the doctor. The medical team rushes Joyce to the intensive care unit. Joyce has a very severe blood stream infection. It takes another hour before antibiotics are started - too late. Joyce dies, leaving behind a newborn son and a husband. Joyce, like many before her, falls victim to a pervasive global threat: poor quality of care.

Adopted by United Nations (UN) in 2015, the Sustainable Development Goals (SDG) are a universal call to action to end poverty, protect the planet and ensure that all enjoy peace and prosperity by 2030. SDG 3 aims to ensure healthy lives and promote wellbeing for all. The 2019 UN General Assembly High Level Meeting on Universal Health Coverage (UHC) reaffirmed the need for the highest level of political commitment to health care for all.

However, progress towards UHC, often measured in terms of access, not outcomes, does not guarantee better health, as we can see from Joyce’s tragedy. This is also evident with the COVID-19 response. The rapidly evolving nature of the COVID-19 pandemic has highlighted long-term structural inefficiencies and inequities in health systems and societies trying to mitigate the contagion and loss of life.

Systems are straining under significant pressure to ensure standards of care for both COVID-19 patients and other patients that run the risk of not receiving timely and appropriate care. Although poor quality of care has been a long-standing issue, it is imperative now more than ever that systems implement high-quality services as part of their efforts toward UHC.

Poor quality healthcare remains a challenge for countries at all levels of economic development: 10% of hospitalized patients acquire an infection during their hospitalization in low-and-middle income countries (LMIC), whereas 7% do in high-income countries. Poor quality healthcare disproportionally affects the poor and those in LMICs. Of the approximately 8.6 million deaths per year in 137 LMICs, 3.6 million are people who did not access the health system, whereas 5 million are people who sought and had access to services but received poor-quality care.

Joyce’s story is all too familiar; poor quality of care results in deaths from treatable diseases and conditions. Although the causes of death are often multifactorial, deaths and increased morbidity from treatable conditions are often a reflection of defects in the quality of care.

The large number of deaths and avoidable complications are also accompanied by substantial economic costs. In 2015 alone, 130 LMICs faced US $6 trillion in economic losses. Although there is concern that implementing quality measures may be a costly endeavor, it is clear that the economic toll associated with a lack of quality of care is far more troublesome and further stunts the socio-economic development of LMICs, made apparent with the COVID-19 pandemic.

Poor-quality care not only leads to adverse outcomes in terms of high morbidity and mortality, but it also impacts patient experience and patient confidence in health systems. Less than one-quarter of people in LMICs and approximately half of people in high-income countries believe that their health systems work well.

A lack of application and availability of evidenced-based guidelines is one key driver of poor-quality care. The rapidly changing landscape of medical knowledge and guidelines requires healthcare workers to have immediate access to current clinical resources. Despite our "information age", health providers are not accessing clinical guidelines or do not have access to the latest practical, lifesaving information.

Getting information to health workers in the places where it is most needed is a delivery challenge. Indeed, adherence to clinical practice guidelines in eight LMICs was below 50%, and in OECD countries, despite being a part of national guidelines, 19-53% of women aged 50-69 years did not receive mammography screening.4 The evidence in LMICs and HICs suggest that application of evidence-based guidelines lead to reduction in mortality and improved health outcomes.

Equally, the failure to change and continually improve the processes in health systems that support the workforce takes a high toll on quality of care. During the initial wave of the COVID-19 pandemic, countries such as Taiwan, Hong Kong, Singapore and Vietnam, which adapted and improved their health systems after the SARS and H1N1 outbreaks, were able to rapidly mobilize a large-scale quarantine and contact tracing strategy, supported with effective and coordinated mass communication.

These countries not only mitigated the economic and mortality damage, but also prevented their health systems and workforce from enduring extreme burden and inability to maintain critical medical supplies. In all nations, investing in healthcare organizations to enable them to become true “learning health care systems,” aiming at continual quality improvement, would yield major population health and health system gains.

The COVID-19 pandemic underscores the importance for health systems to be learning systems. Once the dust settles, we need to focus, collectively, on learning from this experience and adapting our health systems to be more resilient for the next one. This implies a need for commitment to and investment in global health cooperation, improvement in health care leadership, and change management.

With strong political and financial commitment to UHC, and its demonstrable effect in addressing crises such as COVID-19, for the first time, the world has a viable chance of UHC becoming a reality. However, without an equally strong political, managerial, and financial commitment to continually improving, high-quality health services, UHC will remain an empty promise.

1. United Nations General Assembly. Political declaration of the high-level meeting on universal health coverage. New York, NY2019.

2. Marmot M, Allen J, Boyce T, Goldblatt P, Morrison J. Health equity in England: the Marmot review 10 years on. Institute of Health Equity;2020.

3. National Academies of Sciences, Engineering, and Medicine: Committee on Improving the Quality of Health Care Globally. Crossing the global quality chasm: Improving health care worldwide. Washington, DC: National Academies Press;2018.

4. World Health Organization, Organization for Economic Co-operation and Development, World Bank Group. Delivering quality health services: a global imperative for universal health coverage. World Health Organization; 2018.

5. Kruk ME, Gage AD, Arsenault C, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution. The Lancet Global Health. 2018;6(11):e1196-e1252.

6. Ricci-Cabello I, Violán C, Foguet-Boreu Q, Mounce LT, Valderas JM. Impact of multi-morbidity on quality of healthcare and its implications for health policy, research and clinical practice. A scoping review. European Journal of General Practice. 2015;21(3):192-202.

7. Valtis YK, Rosenberg J, Bhandari S, et al. Evidence-based medicine for all: what we can learn from a programme providing free access to an online clinical resource to health workers in resource-limited settings. BMJ global health. 2016;1(1).

8. Institute of Medicine. Best Care at Lower Cost: The Path to Continuously Learning Health Care in America . Washington, DC: National Academies Press 2012.

Related topics:

Home — Essay Samples — Nursing & Health — Health Care

Essays on Health Care

Five nursing pillars, optometrist: advantages and disadvantages, made-to-order essay as fast as you need it.

Each essay is customized to cater to your unique preferences

+ experts online

Occupational Therapy Application

Aspects of nursing shortage, the importance of nursing philosophy, examples of icare values in healthcare, let us write you an essay from scratch.

• 450+ experts on 30 subjects ready to help
• Custom essay delivered in as few as 3 hours

Fresh Fruit, Broken Bodies: a Summary and Analysis

Analysis of "a walk to beautiful", universal health care: persuasive speech outline, the importance of hand washing in nursing, get a personalized essay in under 3 hours.

Expert-written essays crafted with your exact needs in mind

Sick Around America Documentary Analysis

Middle range theory of acute pain, patch adams reflection paper, nursing personal statement, self-assessment in nursing, vimax extender analysis, delegation in nursing case study, cleveland clinic mission statement, challenges of istj in nursing, topics in this category.

• Affordable Care Act
• Universal Health Care
• Nursing Care Plan
• Health Care Policy
• Healthcare Crisis
• Opioid Epidemic
• Nursing Theory

Popular Categories

• Neurology & Nervous System Diseases
• Infectious Diseases
• Other Diseases & Conditions
• Public Health Issues
• Maintaining Health

Get Your Personalized Essay in 3 Hours or Less!

We use cookies to personalyze your web-site experience. By continuing we’ll assume you board with our cookie policy .

• Instructions Followed To The Letter
• Deadlines Met At Every Stage
• Unique And Plagiarism Free

ORDER YOUR PAPER

15% off today

from a verified trusted writer

Mastering the Art of Writing a Health Care Essay on a Good Topic

'A healthy nation is a wealthy nation' - this famous proverb inspires many young people to pursue a career in healthcare, becoming nurses, physicians, therapists, etc. However, some of them fail to realize the responsibility that comes with such occupations. This may bring about a situation whereby colleges and universities turn out unqualified healthcare and nursing experts. To prevent it from happening, professors who teach respective disciplines assign their students the task of writing a health care essay. Being either an essay or research paper, it presents the students with a choice: to examine the problem on their own using various tools and equipment or analyze all available sources on the given research question, offering some personal findings.

14 Amazing Health Care Essay Topics with Introduction Examples

In your essay about health care, you may either talk about various diseases, symptoms, diagnosis, treatment, or methods used by doctors to help their patients, as well as their roles in general. In most cases, students should criticize the modern healthcare system as it really is in need of improvement. It is necessary that they provide some vivid real-life examples if they wish to convince their audience of their point of view.

Approaches to healthcare in the US, UK, and Australia differ, so you may focus on discussing their pros and cons in the essays about health care.

To help you understand which issues to discuss, we have listed the best health care essay topics below. You can also find short answers to each question.

Why is Healthcare Important to Society?

"Healthcare and medicine is a broad term that refers to a system involving maintenance and enhancement of medical services to cater to the health demands of human beings and other living creatures. The quality of healthcare services is one of the most critical factors that predetermines a country's well-being. The system usually varies depending on the healthcare policies of the region. In highly industrialized countries (i.e.countries of the First World), the system is advanced, with almost every citizen having unrestricted access to healthcare services. The low economic level in underdeveloped countries exerts an adverse impact on the healthcare system of these nations."

Is Healthcare a Right or a Privilege

"In the countries of the Third World, healthcare and medicine are not developed enough to save the lives of all of their citizens. Most of them cannot afford quality services, and that is the main difference between developed and underdeveloped countries as far as healthcare is concerned. Unlike poor people, the rich should make health their priority. However, they often neglect to do so, wasting almost all their money on things that harm their body, such as tobacco, alcoholic beverages, drugs, etc. In other words, they tend to have more bad habits, and they value their health less."

Overweight is Putting Strain on the Health Care in the United States

"Childhood obesity in the United States has reached epidemic proportions. This type of disorder has adverse effects on both physical and mental health, as obese kids tend to fall victim to school bullies. The worst consequence of being overweight is Diabetes Type II, and, unfortunately, more and more US children are facing this problem. The pivotal role in the increase in fat intake is played by environmental factors, tastes and preferences, and culture. Highly stressful activities like homework assignments may cause the child to eat more sweets, while their parents do nothing to restrict their consumption of sugar-rich foods. And finally, the lack of physical exercises also takes its toll."

Is Healthcare a Human Right?

"According to NCBI, healthcare is not a human right. To understand why it is important to define both terms. 'Human right' refers to a moral right of great significance that each human being should be entitled to. Dictionaries define healthcare as 'the act of taking prevention or important procedures to make a person's well-being better.' Healthcare is even more complex and confusing to define. Its meaning is too broad to be considered a human right. So, is there a person ultimately responsible for providing healthcare to the entire world? Insisting that healthcare is a human right is, therefore, wrong and pointless."

Should the Government Provide Health Care Insurance?

"The US government is not the only one responsible for providing healthcare insurance to all its citizens. It is only typical of the representatives of the political left to believe that the government should do that. All parties agree that health care is a valuable service, but the government has other important things to take care of. Rather than take care of medicine and nursing, the government's main goal should be to monitor and control the political and economic situation in the country. In fact, each organization has its goals, and so does the government. The government may protect the customer's freedom to buy goods and services by putting in place the corresponding laws and regulations. That is the best thing the US government can do as far as healthcare is concerned."

Causes and Effects of Health Care Crisis in America

"While urban population is more or less OK with its healthcare system, the rural areas of the US keep on suffering from what they call an American healthcare crisis. Hospitals in these regions continue to close down, while those that remain operational provide services of increasingly poor quality. More than 80 rural hospitals have shuttered during the last eight years because their personnel lacked the qualifications to cure patients properly. More than 700 hospitals are at high risk of being closed down, as they lack qualified healthcare professionals. Therefore, emergency medical services are becoming very important, because this is the only way of providing help to patients suffering from strokes, heart attacks, and other heart-related conditions."

Professionalism in Healthcare

"Being a doctor is the most responsible job in the world. It is also the most in-demand one, even though not always properly remunerated. In the underdeveloped countries, the doctor's salaries are among the lowest. In the US, the situation is much better, but still needs improvement in many respects. Medical personnel in this country are granted a license to invest long hours in research and diligent evaluation. Licensure is the way to guarantee the doctor's excellent skills and rich experience in a specific field. It is their willingness to place personal needs after the needs of the patient."

What Has Been the Impact of Medicare on the Healthcare System?

"Quality medicare and teamwork are the essential prerequisites of professional attitude and behavior. The most essential qualities of any medical expert are integrity, accountability, motivation, altruism, and empathy. This way the crucial trust between the patient and professionals is developed. Advanced interpersonal and communication skills impact the quality of medicare as well. Over the past 20 years, we have been witnessing the resurgence of interest in professional training and fair evaluation in the US. It is, therefore, experienced doctors' job to support and guide young professionals on their way to success."

Why Do You Want to Pursue a Career in Healthcare?

"Several factors, the salary being probably the most important one, motivate a lot of young people to choose a career in healthcare. Everyone knows that good medical experts are valued extremely high in the United States. Jobs in healthcare guarantee great opportunities and full security. Quite a few students consider helping other people their priority because they lost their loved ones to fatal diseases. They want to contribute to the medical field by finding a cure to the most complicated disorders some day. And finally, a career in healthcare provides an excellent opportunity to live and work in different parts of the world."

Cultural Diversity in Healthcare

"The purpose of this research paper is to identify basic nuances and issues of cultural diversity in the context of medical treatment, as well as offer solutions aimed at preventing said issues. The main focus is on communication as a culture-based phenomenon, correlation between the patient's progress and expert's treatment, and possible communication characteristics that act as obstacles between healthcare staff and patients. Of the two theoretical approaches used in the study, the first one relates to the information processing, while the second one concerns changing behaviors and interpretation."

Healthcare in America

"Though considered one of the best in the world, the American health care system still has some catching up to do with other countries, including the US's closest neighbor Canada. The US lacks a uniform health system that could offer universal healthcare coverage. Its healthcare system can be referred to as hybrid as it is funded from different sources, such as private funds (48%), households funds (28%), and private businesses funds(20%). The majority of medical and nursing services in this country are privately-owned, even if they are financed by the government. What makes this system stand out from the rest of the world is its great professional staff."

Healthcare in Canada

"Canada has implemented one of the best healthcare reforms in the world. Over the past 4 decades, the country has introduced a number of improvements, making medical treatment affordable for almost every citizen. Urgent and essential health care services are provided based on the needs rather than financial opportunities. This fact alone shows how generous the Canadian government and its healthcare professionals are. When it comes to healthcare, they value fairness and equality more than other nations do. The local healthcare system keeps getting improved as the nation's population increases. It is also important to acknowledge that the very essence of healthcare is also undergoing change."

Public vs. Private Healthcare Sectors

"When comparing the public and private healthcare sectors, it is impossible to ignore the NHS or the National Health Service. The organization, whose staff is made up mostly of primary care nurses or emergency care nurses, provides free health care services to the UK population. That is the reason why the job of Registered Nurse is so prevalent in local healthcare institutions. Specialized caregivers account for another sizeable portion of the healthcare sector. Each young professional is provided with a lot of opportunities for professional development and further career growth.

Communication in Healthcare

"Communication is one of the most important factors in healthcare. Without knowing the details of the patient's conditions and their medical history, the doctor will not be able to make a proper diagnosis. The evidence obtained in the course of this study indicates that there's a direct correlation between the medical representative's communication skills and the patient's willingness to follow the doctor's advice. The doctor's duty is to help the patient control their chronic condition all by themselves, if needed, as well as acquire preventive behaviors. The doctor should not simply cure the patient, but rather teach them some significant lessons to help them remain healthy."

Hopefully, these samples of papers on medicine and nursing will help you choose the hottest topics and best introductions to your essays and research papers. Still having problems? We can offer affordably-priced assistance with any sort of academic writing, including an essay on health care! Try our services at any time, and you won't be disappointed!

• Stats & Feedback

Have your tasks done by our professionals to get the best possible results.

NO Billing information is kept with us. You pay through secure and verified payment systems.

All papers we provide are of the highest quality with a well-researched material, proper format and citation style.

Our 24/7 Support team is available to assist you at any time. You also can communicate with your writer during the whole process.

You are the single owner of the completed order. We DO NOT resell any papers written by our expert

All orders are done from scratch following your instructions. Also, papers are reviewed for plagiarism and grammar mistakes.

You can check the quality of our work by looking at various paper examples in the Samples section on our website.

Not my first time and not the last, for sure) Good quality even for my urgent papers. I love my writer and will always ask for his help only. Add more services, I am sure you can do anything)

Hi! This was the first time when I decided to use such kind of company. Actually, I was not sure if you are able to complete this task. I used to perform all my reports by myself. However this time I had no time due to some urgent issues. Well..what can I say. You have exceeded my expectations. Well done! Will definetely continue my cooperation with you and will reccomend you to my friends!

• High School $11.23 page 14 days
• College $12.64 page 14 days
• Undergraduate $13.2 page 14 days
• Graduate $14.08 page 14 days
• PhD $14.59 page 14 days

Our service has received a swarm of positive reviews, around 596 testimonials proving our success rate to be 9.7 / 10 .

"To be honest, I'm pretty tired of writing about all those symbols, characters, and images in the novels. So, glad to have found your service! Your writers know how to prepare a perfect essay in two shakes ;) Thanks for fast delivery!"

"Hate all these essays and research papers, but you made it very exciting to read! I hadn't actually read it well enough and got a B, but no complaints :)"

"What a fool I was before trying your proofreading services. Just one day and what a result! You definitely made my essay shine bright like a diamond :D Not my last order, for sure!"

"I've completely fallen out of reality! I got so caught up in the charity projects I've been doing that I forgot about my term paper. I'm forever grateful to your writers for saving my neck last-minute!"

"I like how the writer communicated with me, clarified all the details and provided the paper I wanted. He was very loyal with me and my numerous requests for revision) You do what you advertise, high quality paper followed all my requirements!"

"Very happy with the lab report your writer provided. I am always so stressed when I get such tasks. I will definitely ask you to help me again. "

• Essay Writing
• Term Paper Writing
• Research Paper Writing
• Coursework Writing
• Case Study Writing
• Article Writing
• Article Critique
• Annotated Bibliography Writing
• Research Proposal
• Thesis Proposal
• Dissertation Writing
• Admission / Application Essay
• Editing and Proofreading
• Multiple Choice Questions
• Group Project
• Lab Report Help
• Statistics Project Help
• Math Problems Help
• Buy Term Paper
• Term Paper Help
• Case Study Help
• Complete Coursework for Me
• Dissertation Editing Services
• Marketing Paper
• Bestcustomwriting.com Coupons
• Edit My Paper
• Hire Essay Writers
• Buy College Essay
• Custom Essay Writing
• Culture Essay
• Argumentative Essay
• Citation Styles
• Cause and Effect Essay
• 5 Paragraph Essay
• Paper Writing Service
• Help Me Write An Essay
• Write My Paper
• Research Paper Help
• Term Papers for Sale
• Write My Research Paper
• Homework Help
• College Papers For Sale
• Write My Thesis
• Coursework Assistance
• Custom Term Paper Writing
• Buy An Article Critique
• College Essay Help
• Paper Writers Online
• Write My Lab Report
• Mathematics Paper
• Write My Essay
• Do My Homework
• Buy a PowerPoint Presentation
• Buy a Thesis Paper
• Buy an Essay
• Comparison Essay
• Buy Discussion Post
• Buy Assignment
• Deductive Essay
• Exploratory Essay
• Literature Essay
• Narrative Essay
• Opinion Essay
• Take My Online Class
• Reflective Essay
• Response Essay
• Custom Papers
• Dissertation Help
• Buy Research Paper
• Criminal Law And Justice Essay
• Political Science Essay
• Pay for Papers
• College Paper Help
• How to Write a College Essay
• High School Writing
• Personal Statement Help
• Book Report
• Report Writing
• Cheap Coursework Help
• Literary Research Paper
• Essay Assistance
• Academic Writing Services
• Coursework Help
• Thesis Papers for Sale
• Coursework Writing Service UK

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• v.367; 2019

Quality Improvement

How to improve healthcare improvement—an essay by mary dixon-woods.

As improvement practice and research begin to come of age, Mary Dixon-Woods considers the key areas that need attention if we are to reap their benefits

In the NHS, as in health systems worldwide, patients are exposed to risks of avoidable harm 1 and unwarranted variations in quality. 2 3 4 But too often, problems in the quality and safety of healthcare are merely described, even “admired,” 5 rather than fixed; the effort invested in collecting information (which is essential) is not matched by effort in making improvement. The National Confidential Enquiry into Patient Outcome and Death, for example, has raised many of the same concerns in report after report. 6 Catastrophic degradations of organisations and units have recurred throughout the history of the NHS, with depressingly similar features each time. 7 8 9

More resources are clearly necessary to tackle many of these problems. There is no dispute about the preconditions for high quality, safe care: funding, staff, training, buildings, equipment, and other infrastructure. But quality health services depend not just on structures but on processes. 10 Optimising the use of available resources requires continuous improvement of healthcare processes and systems. 5

The NHS has seen many attempts to stimulate organisations to improve using incentive schemes, ranging from pay for performance (the Quality and Outcomes Framework in primary care, for example) to public reporting (such as annual quality accounts). They have had mixed results, and many have had unintended consequences. 11 12 Wanting to improve is not the same as knowing how to do it.

In response, attention has increasingly turned to a set of approaches known as quality improvement (QI). Though a definition of exactly what counts as a QI approach has escaped consensus, QI is often identified with a set of techniques adapted from industrial settings. They include the US Institute for Healthcare Improvement’s Model for Improvement, which, among other things, combines measurement with tests of small change (plan-do-study-act cycles). 8 Other popular approaches include Lean and Six Sigma. QI can also involve specific interventions intended to improve processes and systems, ranging from checklists and “care bundles” of interventions (a set of evidence based practices intended to be done consistently) through to medicines reconciliation and clinical pathways.

QI has been advocated in healthcare for over 30 years 13 ; policies emphasise the need for QI and QI practice is mandated for many healthcare professionals (including junior doctors). Yet the question, “Does quality improvement actually improve quality?” remains surprisingly difficult to answer. 14 The evidence for the benefits of QI is mixed 14 and generally of poor quality. It is important to resolve this unsatisfactory situation. That will require doing more to bring together the practice and the study of improvement, using research to improve improvement, and thinking beyond effectiveness when considering the study and practice of improvement.

Uniting practice and study

The practice and study of improvement need closer integration. Though QI programmes and interventions may be just as consequential for patient wellbeing as drugs, devices, and other biomedical interventions, research about improvement has often been seen as unnecessary or discretionary, 15 16 particularly by some of its more ardent advocates. This is partly because the challenges faced are urgent, and the solutions seem obvious, so just getting on with it seems the right thing to do.

But, as in many other areas of human activity, QI is pervaded by optimism bias. It is particularly affected by the “lovely baby” syndrome, which happens when formal evaluation is eschewed because something looks so good that it is assumed it must work. Five systematic reviews (published 2010-16) reporting on evaluations of Lean and Six Sigma did not identify a single randomised controlled trial. 17 18 19 20 21 A systematic review of redesigning care processes identified no randomised trials. 22 A systematic review of the application of plan-do-study-act in healthcare identified no randomised trials. 23 A systematic review of several QI methods in surgery identified just one randomised trial. 56

The sobering reality is that some well intentioned, initially plausible improvement efforts fail when subjected to more rigorous evaluation. 24 For instance, a controlled study of a large, well resourced programme that supported a group of NHS hospitals to implement the IHI’s Model for Improvement found no differences in the rate of improvement between participating and control organisations. 25 26 Specific interventions may, similarly, not survive the rigours of systematic testing. An example is a programme to reduce hospital admissions from nursing homes that showed promise in a small study in the US, 27 but a later randomised implementation trial found no effect on admissions or emergency department attendances. 28

Some interventions are probably just not worth the effort and opportunity cost: having nurses wear “do not disturb” tabards during drug rounds, is one example. 29 And some QI efforts, perversely, may cause harm—as happened when a multicomponent intervention was found to be associated with an increase rather than a decrease in surgical site infections. 30

Producing sound evidence for the effectiveness of improvement interventions and programmes is likely to require a multipronged approach. More large scale trials and other rigorous studies, with embedded qualitative inquiry, should be a priority for research funders.

Not every study of improvement needs to be a randomised trial. One valuable but underused strategy involves wrapping evaluation around initiatives that are happening anyway, especially when it is possible to take advantage of natural experiments or design roll-outs. 31 Evaluation of the reorganisation of stroke care in London and Manchester 32 and the study of the Matching Michigan programme to reduce central line infections are good examples. 33 34

It would be impossible to externally evaluate every QI project. Critically important therefore will be increasing the rigour with which QI efforts evaluate themselves, as shown by a recent study of an attempt to improve care of frail older people using a “hospital at home” approach in southwest England. 35 This ingeniously designed study found no effect on outcomes and also showed that context matters.

Despite the potential value of high quality evaluation, QI reports are often weak, 18 with, for example, interventions so poorly reported that reproducibility is frustrated. 36 Recent reporting guidelines may help, 37 but some problems are not straightforward to resolve. In particular, current structures for governance and publishing research are not always well suited to QI, including situations where researchers study programmes they have not themselves initiated. Systematic learning from QI needs to improve, which may require fresh thinking about how best to align the goals of practice and study, and to reconcile the needs of different stakeholders. 38

Using research to improve improvement

Research can help to support the practice of improvement in many ways other than evaluation of its effectiveness. One important role lies in creating assets that can be used to improve practice, such as ways to visualise data, analytical methods, and validated measures that assess the aspects of care that most matter to patients and staff. This kind of work could, for example, help to reduce the current vast number of quality measures—there are more than 1200 indicators of structure and process in perioperative care alone. 39

The study of improvement can also identify how improvement practice can get better. For instance, it has become clear that fidelity to the basic principles of improvement methods is a major problem: plan-do-study-act cycles are crucial to many improvement approaches, yet only 20% of the projects that report using the technique have done so properly. 23 Research has also identified problems in measurement—teams trying to do improvement may struggle with definitions, data collection, and interpretation 40 —indicating that this too requires more investment.

Improvement research is particularly important to help cumulate, synthesise, and scale learning so that practice can move forward without reinventing solutions that already exist or reintroducing things that do not work. Such theorising can be highly practical, 41 helping to clarify the mechanisms through which interventions are likely to work, supporting the optimisation of those interventions, and identifying their most appropriate targets. 42

Research can systematise learning from “positive deviance,” approaches that examine individuals, teams, or organisations that show exceptionally good performance. 43 Positive deviance can be used to identify successful designs for clinical processes that other organisations can apply. 44

Crucially, positive deviance can also help to characterise the features of high performing contexts and ensure that the right lessons are learnt. For example, a distinguishing feature of many high performing organisations, including many currently rated as outstanding by the Care Quality Commission, is that they use structured methods of continuous quality improvement. But studies of high performing settings, such as the Southmead maternity unit in Bristol, indicate that although continuous improvement is key to their success, a specific branded improvement method is not necessary. 45 This and other work shows that not all improvement needs to involve a well defined QI intervention, and not everything requires a discrete project with formal plan-do-study-act cycles.

More broadly, research has shown that QI is just one contributor to improving quality and safety. Organisations in many industries display similar variations to healthcare organisations, including large and persistent differences in performance and productivity between seemingly similar enterprises. 46 Important work, some of it experimental, is beginning to show that it is the quality of their management practices that distinguishes them. 47 These practices include continuous quality improvement as well as skills training, human resources, and operational management, for example. QI without the right contextual support is likely to have limited impact.

Beyond effectiveness

Important as they are, evaluations of the approaches and interventions in individual improvement programmes cannot answer every pertinent question about improvement. 48 Other key questions concern the values and assumptions intrinsic to QI.

Consider the “product dominant” logic in many healthcare improvement efforts, which assumes that one party makes a product and conveys it to a consumer. 49 Paul Batalden, one of the early pioneers of QI in healthcare, proposes that we need instead a “service dominant” logic, which assumes that health is co-produced with patients. 49

More broadly, we must interrogate how problems of quality and safety are identified, defined, and selected for attention by whom, through which power structures, and with what consequences. Why, for instance, is so much attention given to individual professional behaviour when systems are likely to be a more productive focus? 50 Why have quality and safety in mental illness and learning disability received less attention in practice, policy, and research 51 despite high morbidity and mortality and evidence of both serious harm and failures of organisational learning? The concern extends to why the topic of social inequities in healthcare improvement has remained so muted 52 and to the choice of subjects for study. Why is it, for example, that interventions like education and training, which have important roles in quality and safety and are undertaken at vast scale, are often treated as undeserving of evaluation or research?

How QI is organised institutionally also demands attention. It is often conducted as a highly local, almost artisan activity, with each organisation painstakingly working out its own solution for each problem. Much improvement work is conducted by professionals in training, often in the form of small, time limited projects conducted for accreditation. But working in this isolated way means a lack of critical mass to support the right kinds of expertise, such as the technical skill in human factors or ergonomics necessary to engineer a process or devise a safety solution. Having hundreds of organisations all trying to do their own thing also means much waste, and the absence of harmonisation across basic processes introduces inefficiencies and risks. 14

A better approach to the interorganisational nature of health service provision requires solving the “problem of many hands.” 53 We need ways to agree which kinds of sector-wide challenges need standardisation and interoperability; which solutions can be left to local customisation at implementation; and which should be developed entirely locally. 14 Better development of solutions and interventions is likely to require more use of prototyping, modelling and simulation, and testing in different scenarios and under different conditions, 14 ideally through coordinated, large scale efforts that incorporate high quality evaluation.

Finally, an approach that goes beyond effectiveness can also help in recognising the essential role of the professions in healthcare improvement. The past half century has seen a dramatic redefining of the role and status of the healthcare professions in health systems 54 : unprecedented external accountability, oversight, and surveillance are now the norm. But policy makers would do well to recognise how much more can be achieved through professional coalitions of the willing than through too many imposed, compliance focused diktats. Research is now showing how the professions can be hugely important institutional forces for good. 54 55 In particular, the professions have a unique and invaluable role in working as advocates for improvement, creating alliances with patients, providing training and education, contributing expertise and wisdom, coordinating improvement efforts, and giving political voice for problems that need to be solved at system level (such as, for example, equipment design).

Improvement efforts are critical to securing the future of the NHS. But they need an evidence base. Without sound evaluation, patients may be deprived of benefit, resources and energy may be wasted on ineffective QI interventions or on interventions that distribute risks unfairly, and organisations are left unable to make good decisions about trade-offs given their many competing priorities. The study of improvement has an important role in developing an evidence-base and in exploring questions beyond effectiveness alone, and in particular showing the need to establish improvement as a collective endeavour that can benefit from professional leadership.

Mary Dixon-Woods is the Health Foundation professor of healthcare improvement studies and director of The Healthcare Improvement Studies (THIS) Institute at the University of Cambridge, funded by the Health Foundation. Co-editor-in-chief of BMJ Quality and Safety , she is an honorary fellow of the Royal College of General Practitioners and the Royal College of Physicians. This article is based largely on the Harveian oration she gave at the RCP on 18 October 2018, in the year of the college’s 500th anniversary. The oration is available here: http://www.clinmed.rcpjournal.org/content/19/1/47 and the video version here: https://www.rcplondon.ac.uk/events/harveian-oration-and-dinner-2018

This article is one of a series commissioned by The BMJ based on ideas generated by a joint editorial group with members from the Health Foundation and The BMJ , including a patient/carer. The BMJ retained full editorial control over external peer review, editing, and publication. Open access fees and The BMJ ’s quality improvement editor post are funded by the Health Foundation.

Competing interests: I have read and understood BMJ policy on declaration of interests and a statement is available here: https://www.bmj.com/about-bmj/advisory-panels/editorial-advisory-board/mary-dixonwoods

Provenance and peer review: Commissioned; not externally peer reviewed.

Career mentorship, clinical and technology skills

• See us on facebook
• See us on youtube
• See us on instagram

APPLICATION GUIDE Clinical Science, Technology and Medicine Summer Internship

Applications Now Open

Applications open for the 2020 Clinical Science, Technology and Medicine Summer Internship program. Program application deadline is February 14, 2020.

How to write "the change you want to see in health care" essay

By SeventyFourImages via EnvatoElements

By Urvi Gupta

There are many ways of approaching an essay such as this one. Here are some methods that we find useful, and we hope they will be helpful to you as well.

The most powerful essays are those which could not be written by anyone other than yourself. Keep this in mind as you begin your brainstorm. Finding stories which are personal and teach the reader something about you is crucial.

Pull out some pen and paper. Set a 5-minute timer on your phone. Use this time to jot down every thought that comes into mind about the ways you wish our health care system was better. Try to keep your pen to the paper and keep writing throughout the 5 minutes. 

Look over your list. Which ones stick out to you as the most compelling? Through your interactions with healthcare, have any of the challenges you brainstormed impacted you personally? Have you had any experiences where you worked towards any of these goals? Use these questions to pick 1-3 topics from your list.

Begin outlining your essay. For each of your topics, try to include answers to the following questions:

Briefly describe the topic/issue.

Why is this topic important to you specifically? How has it affected you/the people around you/the world? Give concrete examples.

How do you propose you can make it better? Again, be specific and try to draw inspiration from your own life. 

Begin writing!

Read your draft out loud to yourself or a friend/family member to look for areas that are unclear or that could be improved.

Remember that it is less important as to what you pick for the change you want to see in health care and more important that you have something compelling and personal to say about it. We want to learn about you!

The views expressed here are the authors and they do not necessarily reflect the views and opinions of Stanford University School of Medicine. External websites are shared as a courtesy. They are not endorsed by the Stanford University School of Medicine.

The most powerful essays are those which could not be written by anyone other than yourself.

Urvi Gupta, BS SASI Teaching Assistant

Essay on Health for Students and Children

500+ words essay on health.

Essay on Health: Health was earlier said to be the ability of the body functioning well. However, as time evolved, the definition of health also evolved. It cannot be stressed enough that health is the primary thing after which everything else follows. When you maintain good health , everything else falls into place.

Similarly, maintaining good health is dependent on a lot of factors. It ranges from the air you breathe to the type of people you choose to spend your time with. Health has a lot of components that carry equal importance. If even one of them is missing, a person cannot be completely healthy.

Constituents of Good Health

First, we have our physical health. This means being fit physically and in the absence of any kind of disease or illness . When you have good physical health, you will have a longer life span. One may maintain their physical health by having a balanced diet . Do not miss out on the essential nutrients; take each of them in appropriate quantities.

Secondly, you must exercise daily. It may be for ten minutes only but never miss it. It will help your body maintain physical fitness. Moreover, do not consume junk food all the time. Do not smoke or drink as it has serious harmful consequences. Lastly, try to take adequate sleep regularly instead of using your phone.

Next, we talk about our mental health . Mental health refers to the psychological and emotional well-being of a person. The mental health of a person impacts their feelings and way of handling situations. We must maintain our mental health by being positive and meditating.

Subsequently, social health and cognitive health are equally important for the overall well-being of a person. A person can maintain their social health when they effectively communicate well with others. Moreover, when a person us friendly and attends social gatherings, he will definitely have good social health. Similarly, our cognitive health refers to performing mental processes effectively. To do that well, one must always eat healthily and play brain games like Chess, puzzles and more to sharpen the brain.

Get the huge list of more than 500 Essay Topics and Ideas

Physical Health Alone is Not Everything

There is this stigma that surrounds mental health. People do not take mental illnesses seriously. To be completely fit, one must also be mentally fit. When people completely discredit mental illnesses, it creates a negative impact.

For instance, you never tell a person with cancer to get over it and that it’s all in their head in comparison to someone dealing with depression . Similarly, we should treat mental health the same as physical health.

Parents always take care of their children’s physical needs. They feed them with nutritious foods and always dress up their wounds immediately. However, they fail to notice the deteriorating mental health of their child. Mostly so, because they do not give it that much importance. It is due to a lack of awareness amongst people. Even amongst adults, you never know what a person is going through mentally.

Thus, we need to be able to recognize the signs of mental illnesses . A laughing person does not equal a happy person. We must not consider mental illnesses as a taboo and give it the attention it deserves to save people’s lives.

Customize your course in 30 seconds

Which class are you in.

• Travelling Essay
• Picnic Essay
• Our Country Essay
• My Parents Essay
• Essay on Favourite Personality
• Essay on Memorable Day of My Life
• Essay on Knowledge is Power
• Essay on Gurpurab
• Essay on My Favourite Season
• Essay on Types of Sports

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Download the App

• ALL MOSCOW TOURS
• Getting Russian Visa
• Top 10 Reasons To Go
• Things To Do In Moscow
• Sheremetyevo Airport
• Domodedovo Airport
• Vnukovo Airport
• Airports Transfer
• Layover in Moscow
• Best Moscow Hotels
• Best Moscow Hostels
• Art in Moscow
• Moscow Theatres
• Moscow Parks
• Free Attractions
• Walking Routes
• Sports in Moscow
• Shopping in Moscow
• The Moscow Metro
• Moscow Public Transport
• Taxi in Moscow
• Driving in Moscow
• Moscow Maps & Traffic
• Facts about Moscow – City Factsheet
• Expat Communities
• Groceries in Moscow
• Healthcare in Moscow
• Blogs about Moscow
• Flat Rentals

Healthcare in Moscow – Personal and Family Medicine

Emergency : 112 or 103

Obstetric & gynecologic : +7 495 620-41-70

About medical services in Moscow

Moscow polyclinic

Emergency medical care is provided free to all foreign nationals in case of life-threatening conditions that require immediate medical treatment. You will be given first aid and emergency surgery when necessary in all public health care facilities. Any further treatment will be free only to people with a Compulsory Medical Insurance, or you will need to pay for medical services. Public health care is provided in federal and local care facilities. These include 1. Urban polyclinics with specialists in different areas that offer general medical care. 2. Ambulatory and hospitals that provide a full range of services, including emergency care. 3. Emergency stations opened 24 hours a day, can be visited in a case of a non-life-threatening injury. It is often hard to find English-speaking staff in state facilities, except the largest city hospitals, so you will need a Russian-speaking interpreter to accompany your visit to a free doctor or hospital. If medical assistance is required, the insurance company should be contacted before visiting a medical facility for treatment, except emergency cases. Make sure that you have enough money to pay any necessary fees that may be charged.

Insurance in Russia

Travelers need to arrange private travel insurance before the journey. You would need the insurance when applying for the Russian visa. If you arrange the insurance outside Russia, it is important to make sure the insurer is licensed in Russia. Only licensed companies may be accepted under Russian law. Holders of a temporary residence permit or permanent residence permit (valid for three and five years respectively) should apply for «Compulsory Medical Policy». It covers state healthcare only. An employer usually deals with this. The issued health card is shown whenever medical attention is required. Compulsory Medical Policyholders can get basic health care, such as emergencies, consultations with doctors, necessary scans and tests free. For more complex healthcare every person (both Russian and foreign nationals) must pay extra, or take out additional medical insurance. Clearly, you will have to be prepared to wait in a queue to see a specialist in a public health care facility (Compulsory Medical Policyholders can set an appointment using EMIAS site or ATM). In case you are a UK citizen, free, limited medical treatment in state hospitals will be provided as a part of a reciprocal agreement between Russia and UK.

Some of the major Russian insurance companies are:

Ingosstrakh , Allianz , Reso , Sogaz , AlfaStrakhovanie . We recommend to avoid  Rosgosstrakh company due to high volume of denials.

Moscow pharmacies

A.v.e pharmacy in Moscow

Pharmacies can be found in many places around the city, many of them work 24 hours a day. Pharmaceutical kiosks operate in almost every big supermarket. However, only few have English-speaking staff, so it is advised that you know the generic (chemical) name of the medicines you think you are going to need. Many medications can be purchased here over the counter that would only be available by prescription in your home country.

Dental care in Moscow

Dentamix clinic in Moscow

Dental care is usually paid separately by both Russian and expatriate patients, and fees are often quite high. Dentists are well trained and educated. In most places, dental care is available 24 hours a day.

Moscow clinics

«OAO Medicina» clinic

It is standard practice for expats to visit private clinics and hospitals for check-ups, routine health care, and dental care, and only use public services in case of an emergency. Insurance companies can usually provide details of clinics and hospitals in the area speak English (or the language required) and would be the best to use. Investigate whether there are any emergency services or numbers, or any requirements to register with them. Providing copies of medical records is also advised.

Moscow hosts some Western medical clinics that can look after all of your family’s health needs. While most Russian state hospitals are not up to Western standards, Russian doctors are very good.

Some of the main Moscow private medical clinics are:

American Medical Center, European Medical Center , Intermed Center American Clinic ,  Medsi , Atlas Medical Center , OAO Medicina .

Several Russian hospitals in Moscow have special arrangements with GlavUPDK (foreign diplomatic corps administration in Moscow) and accept foreigners for checkups and treatments at more moderate prices that the Western medical clinics.

Medical emergency in Moscow

Moscow ambulance vehicle

In a case of a medical emergency, dial 112 and ask for the ambulance service (skoraya pomoshch). Staff on these lines most certainly will speak English, still it is always better to ask a Russian speaker to explain the problem and the exact location.

Ambulances come with a doctor and, depending on the case, immediate first aid treatment may be provided. If necessary, the patient is taken to the nearest emergency room or hospital, or to a private hospital if the holder’s insurance policy requires it.

Our Private Tours in Moscow

Moscow metro & stalin skyscrapers private tour, moscow art & design private tour, soviet moscow historical & heritage private tour, gastronomic moscow private tour, «day two» moscow private tour, layover in moscow tailor-made private tour, whole day in moscow private tour, all-in-one moscow essential private tour, tour guide jobs →.

Every year we host more and more private tours in English, Russian and other languages for travelers from all over the world. They need best service, amazing stories and deep history knowledge. If you want to become our guide, please write us.

Contact Info

+7 495 166-72-69

[email protected]

119019 Moscow, Russia, Filippovskiy per. 7, 1

Mon - Sun 10.00 - 18.00

I Hope You All Feel Terrible Now

How the internet—and Stephen Colbert—hounded Kate Middleton into revealing her diagnosis

Updated at 4:04 p.m ET on March 22, 2024

For many years, the most-complained-about cover of the British satirical magazine Private Eye was the one it published in the week after the death of Diana, Princess of Wales, in 1997. At the time, many people in Britain were loudly revolted by the tabloid newspapers that had hounded Diana after her divorce from Charles, and by the paparazzi whose quest for profitable pictures of the princess ended in an underpass in Paris.

Under the headline “Media to Blame,” the Eye cover carried a photograph of a crowd outside Buckingham Palace, with three speech bubbles. The first was: “The papers are a disgrace.” The next two said: “Yeah, I couldn’t get one anywhere” and “Borrow mine, it’s got a picture of the car.” People were furious. Sacks of angry, defensive mail arrived for days afterward, and several outlets withdrew the magazine from sale. (I am an Eye contributor, and these events have passed into office legend.) But with the benefit of hindsight, the implication was accurate: Intruding on the private lives of the royals is close to a British tradition. We Britons might have the occasional fit of remorse, but that doesn’t stop us. And now, because of the internet, everyone else can join in too.

Read: Just asking questions about Kate Middleton

That cover instantly sprang to mind when, earlier today, the current Princess of Wales announced that she has cancer. In a video recorded on Wednesday in Windsor, the former Kate Middleton outlined her diagnosis in order to put an end to weeks of speculation, largely incubated online but amplified and echoed by mainstream media outlets, about the state of her health and marriage.

Kate has effectively been bullied into this statement, because the alternative—a wildfire of gossip and conspiracy theories—was worse. So please, let’s not immediately switch into maudlin recriminations about how this happened. It happened because people felt they had the right to know Kate’s private medical information. The culprits may include three staff members at the London hospital that treated her, who have been accused of accessing her medical records, perhaps driven by the same curiosity that has lit up my WhatsApp inbox for weeks. Everyone hates the tabloid papers, until they become them.

In her statement, Kate said that after her abdominal surgery earlier in the year, which the press was told at the time was “planned”—a word designed to minimize its seriousness—later tests revealed an unspecified cancer. She is now undergoing “preventative chemotherapy,” but has not revealed the progression of the disease, or her exact prognosis. “I am well,” she said, promising that she is getting stronger every day. “I hope you will understand that as a family, we now need some time, space and privacy while I complete my treatment.”

This news will surely make many people feel bad. The massive online guessing game about the reasons for Kate’s invisibility seems far less fun now. Stephen Colbert’s “spilling the tea” monologue , which declared open season on the princess’s marriage, should probably be quietly interred somewhere. The sad simplicity of today’s statement, filmed on a bench with Kate in casual jeans and a striped sweater, certainly gave me pause. She mentioned the difficulty of having to “process” the news, as well as explaining her condition to her three young children in terms they could understand. The reference to the importance of “having William by my side” was pointed, given how much of the speculation has gleefully dwelt on the possibility that she was leaving him or vice versa.

Read: The eternal scrutiny of Kate Middleton

However, the statement also reveals that the online commentators who suggested that the royal household was keeping something from the public weren’t entirely wrong. Kate’s condition was described as noncancerous when her break from public life was announced in late January . The updated diagnosis appears to have been delivered in February, around the time her husband, Prince William, abruptly pulled out of speaking at a memorial service for the former king of Greece. Today’s statement represents a failure of Kensington Palace to control the narrative: first, by publishing a photograph of Kate and her children that was so obviously edited that photo agencies retracted it, and second, by giving its implicit permission for the publication of a grainy video of the couple shopping in Windsor over the weekend. Neither of those decisions quenched the inferno raging online—in fact, they fed it.

Some will say that Kate has finally done what she should have done much earlier: directly address the rumors in an official video, rather than drip-feed images that raised more questions than they answered. King Charles III has taken a different approach to his own (also unspecified) cancer, allowing footage to be filmed of him working from home. But then again, Kate has cancer at 42, is having chemo, and has three young children. Do you really have it in you to grade her media strategy and find it wanting?

Ironically, Britain’s tabloid papers have shown remarkable restraint; as I wrote earlier this month , they declined to publish the first paparazzi pictures of Kate taken after her withdrawal from public life. They have weighted their decisions toward respect and dignity—more so than the Meghan stans, royal tea-spillers, and KateGate theorists, who have generated such an unstoppable wave of interest in this story that its final destination was a woman with cancer being forced to reveal her diagnosis. If you ever wanted proof that the “mainstream media” are less powerful than ever before, this video of Kate Middleton sitting on a bench is it.

United Helpers opens behavioral health clinic in former senior care facility

OGDENSBURG, New York (WWNY) - United Helpers has cut the ribbon, taking a building it’s known well for another use.

“The community, Ogdensburg, and beyond, has been so supportive of what we’re doing,” said Dave Nelson, United Helpers’ director of behavioral health services.

The building used to house the Rehabilitation and Senior Care facility. It closed its doors in September 2021.

That opened the door for a larger space to expand its behavioral health services.

“We need to adapt to the community’s needs,” Nelson said. “People deserve that.”

Wide hallways, views of the St. Lawrence River, and rooms for telehealth appointments.

“When clients come in to meet with their primary therapist, they can step into these private rooms,” Nelson said.

This new space puts all of the behavioral health services under one roof.

“We were really spread out, like two miles, three miles apart,” said assistant behavioral health services director Breanne Snyder. “It was pick up a phone, send an email. It wasn’t let me just walk down the hall and see you.”

Staff will use these rooms to meet before visiting clients at their homes. One of the services is the Assertive Community Treatment program.

“It saves people the burden of travel to come into the office,” Nelson said, “so it’s really efficient meeting with the seriously and persistently mentally ill.”

Another program, Health Home Coordination, serves a wide variety of clients.

“Recently released from incarceration, the hospital, people who are homeless,” Snyder said. “Ground zero homeless. That’s what they do, they help them figure out what they need to be successful and give them the tools to do it independently.”

Nelson says services have nearly doubled in the past few years. In 2023, United Helpers completed more than 16,000 visits.

“We’ve increased the number of services by about 100%,” Nelson said. “We’ve increased our staff by about 40%.”

It’s a building with a lot of room to expand into and United Helpers plans to do just that.

Copyright 2024 WWNY. All rights reserved.

What was that rattle last night? Earthquake? UFO? Or...?

Report: former treasurer took nearly $65,000

Watertown man charged in meth, fentanyl bust

19th annual SNIRT Run brings many to the Tug Hill earlier than usual

Correctional officers union ratifies contract, gets pay raises

Latest news.

Watertown man charged after shooting himself, another woman

Saturday Sports: Top 10 battle in Canton at Hall-Leet Stadium