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Health care delivery systems.

Stevens, F., Zee, J. van der. Health care delivery systems. In: G.R. Ritzer (Ed.). The Blackwell encyclopedia of sociology. Londen: Blackwell, 2007. p. 2052-2058.
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A health care delivery system is the organized response of a society to the health problems of its inhabitants. Societies choose from alternative health care delivery models and, in doing so, they organize and set goals and priorities in such a way that the actions of different actors are effective, meaningful, and socially accepted. From a sociological point of view, the analysis of health care delivery systems implies recognition of their distinct history over time, their specific values and value patterns that go beyond technological requirements, and their commitment to a set of normative standards (Parsons 1951; Selznick 1957). The term ‘‘system’’ is used here in a sociological sense (Parsons 1951; Philipsen 1980). Typical system features are functional specificity (operational goals), structural differentiation (the division of labor), goal-setting (including effectiveness, efficiency), coordination (of activities, occupations, and facilities by mutual agreement, standards, or hierarchy), and boundary maintaining autonomy (in relation to political, economic, or normative structures). Some health care delivery systems comply more with these system characteristics than others. Where health care delivery systems vary, it is mainly due to longterm cultural and structural developments. The authors describe four different models which reflect the major types of healthcare delivery systems. (aut. ref.)