The article by Pina et al. (2015) forms a framework that is used to describe health care delivery firms and set-ups. This framework describes, evaluates, and conducts research on questions that are raised by comparing the research's effectiveness. The framework entailed domains and several components that are effective for characterization of the distinct types and sizes of health care delivery organization and how they impact the outcomes. Recently, there have been ongoing innovations in networks responsible for deliverying and remunerating health care in the U.S. which has contributed to the desire of various stakeholders wanting to diversify their systems. As a result, the objective of the article is to present a framework for providing descriptions of essential distinctions in health care conveyance firms in the U.S.
The researchers' proposal for the framework was built on a precursory taxonomic description of health care systems in the U.S. In this case, the Agency for Healthcare Research and Quality (AHRQ) financed the structuring and developing of taxonomic units. The essence of the formation of this taxonomy organizations was to check on their progress concerning the delivery of health care services. This implied that the more complex a taxonomy is, the more the services delivered by healthcare. As a result, if an organization missed a particular element in its services, then, it should consider integrating with other firms to bring the missing elements (Pina et al., 2015) . However, this integrations brought about fragmentations. In this case, the rocketing complexities and heterogeneities of health care delivery networks are what has contributed to the rising rates of fragmentations. According to Pina et al. (2015), fragmentation can result in poor health care services. As a result, due to the poor quality in services caused by fragmentation, the researchers decided to come up with the framework methodology of describing health care delivery networks to improve healthcare services.
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Moreover, in the research approach, the Delivery Systems Committee (DSC), which was part of the AHRQ community, used the literature review and the Delphi method in developing the framework. DSC's framework majorly focused on the outcomes defined by quality, cost, patient care centralization, and also equality. Besides, the approach identified health conditions such as diabetes which could be used to determine the outcomes of interest. This framework resulted in a sample of 30 elements being classified into four domains, for instance, structure, culture, resources and also a function of the process (Pina et al., 2015) . From the results, six domains were used. This was inclusive of patients and capacity. Thus, the findings indicated that the majority of value-based measures are directional. This implies that improvement in one desirable attribute may come to another desirable attribute's expense—for instance, financial solvency against comprehension of services and societal benefits. Therefore, the framework was supposed to be used in balancing such competing values. Also, from the results, DSC indicated that the elements of health care do not always determine the quality of services. Hence, not all elements are required to describe an organization.
Conclusively, the research results imply that this framework can be used in the characterization of potentially essential distinctions in terms of network and functions of healthcare conveyance firms and set-ups. Therefore, the framework can be used to describe a study's delivery setting, thus enhancing the understanding of whether the findings can be applied in certain contexts and circumstances. However, the framework brings into light the reason as to why health care systems should consider other forms of enhancing quality instead of looking for firms that already provide better services and joining hands with them. This is because the high-rank firm too might be having a certain missing element which with time may lead to the fall of both. Therefore, this framework is vital as it takes into account the continuous evolutions of health care systems more so for institutions that want to undertake a Comparative Effective Research (CER).
Reference
Pina, I. L., Cohen, P. D., Larson, D. B., Marion, L. N., Sills, M. R., Solberg, L. I., & Zerzan, J. (2015, April). A Framework for Describing Health Care Delivery Organizations and Systems. American Journal of Public Health, 105 (4), 670–679.
