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The Andersen healthcare utilization model is a conceptual model aimed at demonstrating the factors that lead to the use of health services. According to the model, the usage of health services (including inpatient care, physician visits, dental care etc.) is determined by three dynamics: predisposing factors, enabling factors, and need.
In other words, PHC is an approach to health beyond the traditional health care system that focuses on health equity-producing social policy. [ 4 ] [ 5 ] PHC includes all areas that play a role in health, such as access to health services, environment and lifestyle. [ 6 ]
It was created by the Patient Protection and Affordable Care Act, the 2010 U.S. health care reform legislation. CMS provides healthcare coverage to more than 100 million Americans through Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the Health Insurance Marketplace. [2]
The most common managed care financial arrangement, capitation, places healthcare providers in the role of micro-health insurers, assuming the responsibility for managing the unknown future health care costs of their patients. Small insurers, like individual consumers, tend to have annual costs that fluctuate far more than larger insurers.
Higher unemployment due to the 2008–2010 recession, which limited the ability of consumers to purchase healthcare; Out-of-pocket costs rose, reducing demand for healthcare services. [35] The proportion of workers with employer-sponsored health insurance requiring a deductible climbed to about three-quarters in 2012 from about half in 2006. [36]
Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society". [1] According to the World Health Organization, an explicit health policy can achieve several things: it defines a vision for the future; it outlines priorities and the expected roles of different groups; and it builds consensus and informs people.
A 2007 article from The BMJ by Steffie Woolhandler and David Himmelstein strongly argued that the United States' healthcare model delivered inferior care at inflated prices, and further stated: "The poor performance of US health care is directly attributable to reliance on market mechanisms and for-profit firms and should warn other nations ...
This has led to many instances of misuse of MCDA models in health care and in shared decision-making in particular. A prime example is the case of decision aids for life-critical SDM. The use of additive MCDA models for life-critical shared decision-making is misleading because additive models are compensatory in nature.