Sociology

The rapid development of world population as well as advances in technology pose great challenge to the health care delivery in the modern times. The growing and aging population has highly increased the demand for health services. In the US, for instance, the non-institutional population of civilians is expected to increase by about 21 million over the period of 2006-2016 (Department of Labor, 2009).

Information technology on the other hand is vital in the designation of health care infrastructure. However, constraints can not be ruled out. The aforementioned issues together with changes in epidemiology, cost, effectiveness and efficiency of the health care delivery have led to changes in the system of health care delivery (Jonas, Knickman  Kovner, 2008).

Health care delivery is mainly dependent on the cost, quality of care and access of the health services. The cost of construction and operation of health facilities is on the rise. It is therefore wise to build sustainable facilities to meet the relevant needs. The increase in expenditure on health care has surpassed the expenditures of the economy in other sectors for the last thirty years (Jonas, Knickman  Kovner, 2008). The trio articulates the increase in technological expenses, aging population as well as prevalence in chronic diseases to the increased cost of health care over time. The expenditure on health care in the US, for instance, increased from 717 billion in 1990 to 1.9 trillion in 2004 (Kaiser Family Foundation, 2004).

There has been a recognizable change in the determination of the cost of health care services. According to Montague Brown (1996), physicians were the sole determinants of cost of the health service they offered in the past and their practices were unquestionable by the lay community. He further attributes the variation in the pricing by different hospitals in the same city in the past to the pattern of physician practice. However, the cost of the service in the modern world involves cost sharing among all the stakeholders in the health sector. Delivery of health care has therefore transformed from dependency on professionals to era of modern managed care   HYPERLINK httpbooks.google.co.kebooksqinauthor22OlePeterGrell22clientfirefox-asourcegbs_metadata_rcad9 (Grell,  HYPERLINK httpbooks.google.co.kebooksqinauthor22Dr.AndrewCunningham22clientfirefox-asourcegbs_metadata_rcad9 Cunningham   HYPERLINK httpbooks.google.co.kebooksqinauthor22BerndRoeck22clientfirefox-asourcegbs_metadata_rcad9 Roeck, 2005).

Quality of health care is another important aspect of health whose transition has been steady over time. Studies have shown that in the recent past, between 44000-98000 U.S citizens used to die each year of complications resulting from medical errors. The system of payment in place dictates the quality of health care service rendered to a patient. The current system of payment is based on the quantity and not the quality of service offered. This favors the health providers and not the patients or physicians hence lowering the quality of health care (Jonas, Knickman  Kovner, 2008). Finally the limiting cost as well as incompetence of the health care providers is a factor that adversely affects the access as well as quality of the service rendered (Wolper, 2004).

Equitability and cost effectiveness of health care access is a predominant issue that has remained a challenge to the health care system for a long time (Wolper, 2004). Health care services in the traditional setting depended upon basic care and public health which operated mainly off the hospital setting. These medical services were fairly accessible since the costs of the services were affordable either. This was made possible by the fact that cost of treatment of the sick was met mainly by the community. Additionally, the church leaders were responsible for the well being of their followers and therefore would ensure that the sick accessed medication  HYPERLINK httpbooks.google.co.kebooksqinauthor22OlePeterGrell22clientfirefox-asourcegbs_metadata_rcad9 (Grell,  HYPERLINK httpbooks.google.co.kebooksqinauthor22Dr.AndrewCunningham22clientfirefox-asourcegbs_metadata_rcad9 Cunningham   HYPERLINK httpbooks.google.co.kebooksqinauthor22BerndRoeck22clientfirefox-asourcegbs_metadata_rcad9 Roeck, 2005).  The modern generation, on the other hand explores the hospital care option which provides medical services to the patients in a hospital setting. This medical service has however proved to be more costly and therefore reduced accessibility of the treatment by the patients.

The health care insurance in the traditional system was disintegrated whereby the four aspects, including the financiers, providers, payers and insurers of the health care service were different persons. The U.S however, embarked on tighter health care changes where the four basic functions stipulated above were integrated in the health care system through a managed care ( HYPERLINK httpbooks.google.co.kebooksqinauthor22LeiyuShi22clientfirefox-asourcegbs_metadata_rcad11 Shi   HYPERLINK httpbooks.google.co.kebooksqinauthor22DouglasA.Singh22clientfirefox-asourcegbs_metadata_rcad11 Singh, 2008). Health financing has changed in the recent past and an issue such as health insurance is a phenomenon of the current generation. An increase in expenditure in the developed states as a result of increase in the ageing populations and therefore increase in demand, as well as increase in cost and labor has prompted governments of such countries to embark on a system of meeting the cost of health care to its citizens. In France, for instance, the government meets universal cost of treatment of patients in hospital as an aspect of social protection (Jonas, Knickman  Kovner, 2008).

The current health care system has incorporated a variety of aspects that were not practiced in the traditional system of health care. Vertical integration for instance was not practiced in the traditional system. Horizontal integration that was in place involved collaboration and coordination of different stages of production. This practice had brought quite a number of positive changes in the health sector. To start with, it reduced the administrative costs as well as enhancing coordination of medical services. Furthermore, it improved the quality of care provided by enhancing efficiency and therefore enabling the sector to increase market influence. The vertical integration on the other hand has been employed by the current generation in the delivery of health care to increase the benefits. This method ensures that a broad range of services are offered in unison by integrating the channels of distribution or stages of production. It displays the sole principle advantage of unity of control and direction (Brown, 1996).
The last era of the 20th century has seen a remarkable change in the health care delivery. This is due to advances in technology that have led to introduction of sophisticated machines and equipments used in the examination and treatment of various diseases. Diseases such as heart attack provided certainty of death cases to patients since the relevant equipments were not available. This has become a thing of the past (Weinberg, 2000).

Information technology has mainly contributed to transition that is currently witnessed in various sectors and health sector is not an exception. Use of information technology has created opportunities for organizations through introduction of capabilities that could not be achieved before. It has also enhanced production through direct substitution whereby a non-functioning or slow and inefficient equipment or process is replaced by a new automatic process. Finally, Information technology aids in regulation of production process unlike the traditional system where everything was done manually (Wolper, 2004).

The delivery of health care is controlled by a variety of stakeholders. First, the government is sovereign in regard to adoption of system of the health care delivery in a country. The government lays down health care infrastructure where all other stakeholders operate. It further stipulates the rules, regulation and policies guiding both public and private sectors in the delivery of health care services.  In the US however, the health care facilities are largely owned and controlled to a greater extent by the private sector. Health insurance is also mainly provided by the private sector. About 16 of the American population is completely uninsured, and many more are underinsured according to the U.S Department of Labor report. The report further indicates that America spends more money per person on health care than any other industrialized country in the world (Department of Labor, 2009).

 Other stakeholders are also important as far as ownership of health care is concerned. The physician for example, plays a pivotal role in the delivery of health care service through direct administration of medication to a patient. The physician is capable of offering quality service to a customer provided the condition under which the service is rendered is suitable. Another equally important stakeholder is the health care provider. Care providers ensure that the facilities are of required standards and that the staff is well trained so as to provide high quality services. The organization is entitled to providing modern equipments that are necessary in handling cases of emerging and re-emerging infections as well as chronic complications. Pharmaceutical companies that manufacture the drugs are meant to produce drugs that meet the laid down standards and that are of high quality. Finally, patients have a very significant role as far as delivery of health care is concerned. They need to be involved in the early stages of policy making since this will directly affect their lives. The patients need to take full responsibility of their own health by learning from the health provider and deciding what to do with the information. Generally, the patient-doctor relationship determines the quality of health care the former would receive (Jonas, Knickman  Kovner, 2008).

Conclusion
Health care delivery has undergone through series of transitions from the traditional system of health care to the modern system. These changes have been articulated to population increase, advances in technology as well as emergence and re-emergence of diseases. The transition of health care is revolving around the aspects of minimization of cost, enhancing accessibility of health care and provision of high quality service to the customer. Health financing has also undergone through a system of transformation from the traditional insurance system where financiers, health providers, insurers and patients were different entities to a modern managed care integrating the four basic health care insurance aspects. Furthermore, the modern health care has incorporated management strategy of vertical integration enhancing efficiency and effectiveness through provision of broad range services in unity compared to the horizontal integration. Finally, various stakeholders involved in the delivery of services have made progress as far as information on the health care is concerned, therefore enhancing the quality of the services rendered. Health care delivery has changed from dominance by professionals to managed care.