� Type: Essay
Length: 2,500 words (10% margin)
The Task
In this written assignment you are required to write an essay of 2500 words in which
you analyse and discuss the following statement.
The Australian Health care system is founded on the concept of equity of access. Discuss
this statement with relation to the concept of effectiveness and efficiency and any
interrelationships that may exist
In putting together your essay, you might like to consider the following:
� provide all the necessary definitions of terms and concepts
� how does equity of access relate to effectiveness and efficiency of health care delivery
� read extensively on the relevant literature before writing your essay
- This assignment is demanding and will require you to read a lot of journals books.
This is deliberate so that you read widely. Therefore, you will need to plan this
assignment and work on it progressively over the next few weeks. - APA is the preferred referencing method,
- The assignment is 2,500 words; it is expected that there will be approximately 20 to
25 references. - References MUST be academic standard i.e. no Wikipedia or media references.
- Assignment is to be written from Australia healthcare system perspective. However,
it will need to also be founded on the concept of equity otherwise the assignment does
not make sense. - The assignment will require you to define the three concepts. They are subjective and
different writers will have different opinions. You will need to discuss this. - A suggested layout was discussed as follows. However, YOU ARE FREE TO
DEVELOP WHATEVER LAYOUT YOU LIKE.
The Australian Healthcare System
Introduction 200
2
THE AUSTRALIAN HEALTHCARE SYSTEM
The health care system of Australia is founded on the concept of equity of access. In
this paper, the purpose is to provide a discussion of this statement with relation to the concept
of effectiveness and efficiency, as well as any interrelationships that may exist. The definition
of all terms and concepts are provided. How equity of access relates to effectiveness and
efficiency of healthcare delivery is discussed comprehensively in this paper. The Australian
Council of Social Service (COSS) is committed to ensuring equity in outcomes and equity in
health care access effectively and efficiently. It calls for a health delivery system which
promotes positive health outcomes for every Australian not considering their socioeconomic
situation (Russell & Dawda, 2014). Inequity is understood as the disparities that are
preventable and needless but, additionally, are also deemed as both unjust and unfair. In the
health context, the word just implies equal opportunities for social groups and people, in
terms of providing access to and utilizing health services according to the requirements of
diverse groups of a given population, despite of their capacity to pay. In Australia today,
people in remote and rural regions have poorer health compared to people who live in
regional and metropolitan areas. The reason for this is that there is less access to primary
healthcare services, and the financial support for primary healthcare services in
native/aboriginal communities has not, in essence, been commensurate with need (Riggs,
Coleman & Due, 2014).
Equity of access
Equity of access to high quality health services basically means to ensure that
everyone can get access to high-quality health services. It is of note that equity/fairness is at
the core of the Australian health system and is a potent component of the Australian social
psyche. The health system in Australia is not fair for all Australians. This implies that some
groups are missing out on health services, or they access these services when it is very late
for effective treatment or intervention. In turn, this results in high usage and healthcare costs
3
THE AUSTRALIAN HEALTHCARE SYSTEM
at the acute end of the healthcare continuum (Leveratt, 2009). Australians who live in far-
flung regions have inimitable health concerns relating directly to their conditions of living,
socioeconomic disadvantage, distance from health services, and social isolation. Their death
rates are twice the rate in urban areas because of injury, twice because of falls in the elderly,
and thrice because of road accidents. The rates of hospital admission because of diabetes are
4 times the rate in urban admission. Yet Australians in rural and far-flung places have lower
access to healthcare in relation to the general Australian population due to time factors,
distance, transport availability and cost (Leveratt, 2009). One impact of this disparate access
to healthcare could be seen when preventable hospital admission rates for ambulatory care-
sensitive conditions are linked to geographic remoteness.
Improving equity as well as access in the healthcare system of Australia encompasses
the following: ensuring that children and people who are most marginalized have access to
quality healthcare. Advocating equity of access in regards to the Australian health care
system requires all the Australian governments to endeavor to remove inequalities in health
status of those groups that are presently experiencing poor heath outcomes in relation to the
broader community. To properly ensure equity of access, it is important to examine particular
areas in which the healthcare system is failing certain communities or groups currently, and
then taking the appropriate measures to attain better outcomes for these groups (Leveratt,
2009). It is noteworthy that more equitable and accessible healthcare will benefit
communities, people, as well as the entire society in general. This essentially includes
improved well-being, thriving children, less disability, better mental health, and more
cohesive, sustainable communities. Although a lot of these aforesaid factors are amenable to
intervention, disparities in health are primarily preventable. Equitable access to quality
healthcare is purely a subject of social justice (Deek et al., 2013).
Concept of effectiveness of healthcare delivery
4
THE AUSTRALIAN HEALTHCARE SYSTEM
The concept of effectiveness is essentially understood as the relationship between the
level of resources invested, and the improvements in health, or the level of outcomes.
Evaluating effectiveness comprises measuring the effects of medical techniques and practices
on the health and well-being of an individual. This has to consider both the observed health
improvements and the negative impacts, for instance side effects (Betancourt, 2014). The
economic aspect of effectiveness brings in the concept of cost, and hence refers to cost-
reduction and cost-effectiveness.
When applied generally, the concept of effectives mixes both the economic and
clinical elements of healthcare. As such, evaluating effectiveness makes it possible to
determine the medical techniques and practices which both help in improving health, and
makes proper use of resources. According to Campbell et al., (2013), effective care is
understood as services which are of proven value and are without major tradeoffs; meaning
that the benefits of the services outweigh the risks that every patient with particular medical
requirements has to receive them. In Australia, most effective care is underused particularly
by indigenous groups. This is because the country’s healthcare delivery system does not have
the means to support systematic compliance with treatment guidelines (Boudville, Anjou &
Taylor, 2013). The rate of preventable hospital admissions for the Torres Strait islander and
Aboriginal people is substantially higher – 4.9 times higher – in relation to the general
Australian population. This basically implies that the primary healthcare system is not
operating in an effective manner. There are several geographic, economic and cultural
barriers for access to healthcare for Torres Strait islander and Aboriginal people in both
remote/rural and urban settings (Riggs, Coleman & Due, 2014).
In Australia, effectiveness of healthcare system is conceptualized as
intervention/care/action achieving the desired outcome within a suitable timeframe. As a
performance dimension, the Australian effective dimension comprises the time constituent in
5
THE AUSTRALIAN HEALTHCARE SYSTEM
order to assess whether or not health interventions, care or action are attaining the desired or
anticipated results in the proper time context. In addition, effective care must be delivered to
the individuals or groups who are most at need (Madore, 2011). The indicators for the
effectiveness dimension are basically drawn primarily from early detection and prevention
areas of population health, and hence comprise breast screening and the detection of small
size breast cancers, as well as education about HIV and the practice of safe sex. It is notable
that these measures are inclined to be outcome and/or output, or in the short term, process
indicators. In essence, the effective dimension can include the domains of timeliness, access,
appropriateness as well as quality (Madore, 2011).
A healthcare system would only perform properly if it is providing high-quality
interventions in a manner which is cost-effective. The economic and clinical appraisal of
healthcare is helpful in determining the services that are inappropriate or ineffective. A
healthcare service will be deemed as ineffective if it does not have the effect that is desired
for instance improving health. Conversely, a health care service will be deemed as ineffective
if it produces negligible improvement in health for its cost (Cama, 2009).
Concept of efficiency of healthcare delivery
The concept of efficiency is much wider; it is essentially the correlation between the
amount of resources that has been invested within the healthcare system, and volume of
services, or improvements in health attained. It is of note efficiency aims at maximizing
results in an effective manner, or services which are provided, given a certain budget (Durey
et al., 2012). As per the concept of efficiency, every service has to be provided at the lowest
possible cost. In addition, the services delivered must have benefits of value greater than, or
equivalent to its costs, and must make best possible utilization of resources invested. Distinct
from effectiveness, the concept of efficiency considers costs in relation to benefits.
6
THE AUSTRALIAN HEALTHCARE SYSTEM
Appraising the efficiency of medical techniques and treatments helps in setting
priorities when allocating resources. For instance, one can assume that the Australian
commonwealth/national government has a budget of $2.5 million to buy drugs that have been
proved to be effective in treating fatal diseases. In addition, one can as well suppose that, in
the opinion of professionals, 123 lives can be saved if the whole of these funds were spent on
drug X, although 201 deaths could be avoided if the entire budget were spent on drug Z. The
commonwealth government should buy which drugs? In accordance with the efficiency
criteria, the commonwealth government has to spend the budget in purchasing drug Z since
its benefits are higher – the total number of people’s lives saved.
Efficiency is a key attribute for a high-performing health care system. Nonetheless,
there is strong evidence suggesting that the healthcare system in Australia is inefficient. For
instance, there is a high variation in healthcare spending in Australia with small impact on
beneficiary outcome. Some regions of the country are more efficient than others given that
some areas have clearly higher costs without health improvement or patient satisfaction
(Russell & Dawda, 2014). It is of note that there is no correlation between quality of health
care and cost; some lower cost hospitals offer high-quality care, whereas some high-cost
hospitals offer low quality care. As such, measuring, rewarding, as well as making
transparent the quality of health care and costs might result in improved efficiency without
negatively affecting quality (Cama, 2009). Evaluating efficiency is vital especially when
choices have to be made from several medical treatments and practices. It is imperative to
consider marginal benefits. Evaluating efficiency is basically an effort aimed at comparing
the benefits and costs for society in general, and to emphasize the monetary effects of public
expenditure options so that governments are able to determine which extra investments will
maximize the net benefits (Riggs, Coleman & Due, 2014).
Interrelationships
7
THE AUSTRALIAN HEALTHCARE SYSTEM
Health care organizations which are equitable, effective and efficient typically focus
on delivering care that is of highest possible quality at low cost, value-based, patient-centered
to ensure improved patient-outcomes. In Australia, cost-effective, efficient and equitable
health care delivery is a critical objective for all Australian governments. Health outcomes
are very much different for various groups living in Australia and such inequities could be
decreased without sacrificing effectiveness and efficiency (Leveratt, 2009). Health care
spending has to be more effective, or else healthcare demands would undermine public
finances. By improving the efficiency of the health care delivery system, public spending
savings will be immense.
Underutilization of effective health care signifies a wasted opportunity for preventing
serious diseases. Equitable, efficient and effective health care that demonstrably lowers
mortality and morbidity, and which improves the quality of life has to be delivered all the
time whenever warranted (Deek et al., 2013). An efficient, equitable and effective health care
delivery system will not only improve access to care, but will also improve healthcare
outcomes and decrease spending. The concepts of effectiveness and efficiency essentially add
an economic dimension to healthcare in Australia.
Applying economic theory to healthcare is a vital effort to addressing the critical
issues of allocating financial, human as well as physical resources and laying down priorities
in the budget decision-making process. Determining the optimal amount to be allocated to
health care is the first issue, and this is dependent on the extent of resources to be apportioned
in order to satisfy other needs of the society. To address this particular issue, it is vital to
make a choice: what share of the budget should go to healthcare and what share is to go to
other, also significant, public investments including job creation, education, and research and
development (R&D). The 2 nd issue is how to apportion resources amongst the several
healthcare components, for instance medical research, curative care and preventive care. It
8
THE AUSTRALIAN HEALTHCARE SYSTEM
also encompasses how to allocate resources to various groups including the marginalized,
indigenous communities who live in the remote and rural regions of Australia; children;
women; the disabled people; the elderly; and other susceptible persons and groups. This
would ensure that there is equity of care due to equitable allocation of resources (Betancourt,
2014).
The healthcare quality chasm in Australia is properly expressed as a gulf for some
segments of the Australian population particularly the ethnic/racial and indigenous minority
communities, given the gap between best/ideal health care quality, and the actual care
received. All healthcare organizations in Australia are challenged to 3 aims of healthcare
improvement: equity, efficiency and effectiveness. Through pursuing effectiveness, health
care organizations have to deliver services basing on scientific knowledge to everyone who
can benefit and they should desist from offering health care services to those individuals not
likely to benefit; they should avoid underuse, as well as overuse respectively. As the health
care organizations provide care services, they should be efficient by totally avoiding waste,
and this includes waste of energy, ideas, financial resources, supplies and equipment. At the
same time, the health care organizations should deliver health care which does not differ in
quality due to personal characteristics like socioeconomic status, geographic location,
ethnicity/race, and gender or other personal characteristics that do not relate to a patient’s
reason for seeking health care; hence, ensuring that it is equitable (Campbell et al., 2013).
The objective of achieving equitable best care in the Australian health care delivery
system is essential. Inequalities in health care access, utilization and outcomes have to be
examined; the economic, ethical and moral issues they bring about along with the serious
injustice they cause have to be corrected if this objective is to be met. Eradicating any
observed health care inequities has to be synergistically incorporated with improvement of
quality, efficiency and effectiveness of health care delivery (Betancourt, 2014). By ensuring
9
THE AUSTRALIAN HEALTHCARE SYSTEM
that health care delivery is effective, efficient and equitable, health care organization – both
public and private – have to ensure that care is delivered to all populations throughout
Australia, including the rural and remote areas. In particular, they need to ensure that the
Torres Strait islanders and Aboriginal communities receive health care. This care has to be
effective in the sense that there should be improved condition of every patient after treatment.
In addition, the health care delivery should be cost-effective; be of low-cost and highest
possible quality at the same time. An effective health care delivery system helps in improving
access to care, improving healthcare outcomes and decreasing spending. Effective health care
delivery also reduces emergency admissions and will improve the efficiency of healthcare
(Durey et al., 2012).
Conclusion
In conclusion, equity of access to high quality health services means ensuring that
everyone can get access to high-quality health services. It is noteworthy that equity/fairness is
at the core of the Australian health system and is a potent component of the Australian social
psyche. The health system in Australia is not fair for all Australians; some groups are missing
out on health services, or they access these services when it is very late for effective
treatment or intervention. Australians who live in far-flung regions have inimitable health
concerns relating directly to their conditions of living, socioeconomic disadvantage, distance
from health services, and social isolation. Yet Australians in rural and far-flung places have
lower access to healthcare in relation to the general Australian population due to time factors,
distance, transport availability and cost. Improving equity as well as access in the healthcare
system of Australia entails ensuring that children and people who are most marginalized have
access to quality healthcare. The concept of effectiveness is the relationship between the level
of resources invested, and the improvements in health, or the level of outcomes. Evaluating
effectiveness entails measuring the effects of medical techniques and practices on the health
10
THE AUSTRALIAN HEALTHCARE SYSTEM
and well-being of an individual. The concept of efficiency is fundamentally the correlation
between the amount of resources that has been invested within the healthcare system, and
volume of services, or improvements in health attained.
Reference
Betancourt, J. R. (2014). In Pursuit of High-Value Healthcare: The Case for Improving
Quality and Achieving Equity in a Time of Healthcare Transformation. Frontiers Of
Health Services Management, 30(3), 16-31.
11
THE AUSTRALIAN HEALTHCARE SYSTEM
Boudville, A., Anjou, M., & Taylor, H. (2013). Indigenous access to cataract surgery: an
assessment of the barriers and solutions within the Australian health system. Clinical
& Experimental Ophthalmology, 41(2), 148-154. doi:10.1111/j.1442-
9071.2012.02840.x
Cama, R. (2009). Designing a more efficient care model. Healthcare Design, 9(11), 12.
Campbell, J., Buchan, J., Cometto, G., David, B., Dussault, G., Fogstad, H., & … Viroj, T.
(2013). Human resources for health and universal health coverage: fostering equity
and effective coverage. Bulletin Of The World Health Organization, 91(11), 853-
- doi:10.2471/BLT.13.118729
Deek, H., Abbott, P., Moore, L., Davison, J., Cameron, S., DiGiacomo, M., & … Davidson,
P. (2013). Pneumococcus in Aboriginal and Torres Strait Islander peoples: The role
of Aboriginal health workers and implications for nursing practice. Contemporary
Nurse: A Journal For The Australian Nursing Profession, 46(1), 54-58.
doi:10.5172/conu.2013.46.1.54
Durey, A., Wynaden, D., Thompson, S., Davidson, P., Bessarab, D., & Katzenellenbogen, J.
(2012). Owning solutions: a collaborative model to improve quality in hospital care
for Aboriginal Australians. Nursing Inquiry, 19(2), 144-152. doi:10.1111/j.1440-
1800.2011.00546.x
Leveratt, M. (2009). Rural and Remote Australia – Equity of Access to Health Care Services.
The Australian Health Consumer, 2(6).
Madore, O. (2011). Effectiveness and Efficiency in Healthcare. London, England: CRC Press.
12
THE AUSTRALIAN HEALTHCARE SYSTEM
Riggs, D., Coleman, K., & Due, C. (2014). Healthcare experiences of gender diverse
Australians: a mixed-methods, self-report survey. BMC Public Health, 14(1), 1-10.
Russell, L., & Dawda, P. (2014). Lessons for the Australian healthcare system from the
Berwick report. Australian Health Review, 38(1), 106-108.