Delivery of services

The delivery of health care services¡ªfrom primary care to secondary and tertiary levels of care¡ªis the most visible part of any health care system, both to users and the general public.^[14] There are many ways of providing health care in the modern world. The place of delivery may be in the home, the community, the workplace, or in health facilities. The most common way is face-to-face delivery, where care provider and patient see each other 'in the flesh'. This is what occurs in general medicine in most countries. However, with modern telecommunications technology, in absentia health care is becoming more common. This could be when practitioner and patient communicate over the phone, video conferencing, the internet, email, text messages, or any other form of non-face-to-face communication.

Improving access, coverage and quality of health services depends on the ways services are organized and managed, and on the incentives influencing providers and users. In market-based health care systems, for example such as that in the United States, such services are usually paid for by the patient or through the patient's health insurance company. Other mechanisms include government-financed systems (such as the National Health Service in the United Kingdom). In many poorer countries, development aid, as well as funding through charities or volunteers, help support the delivery and financing of health care services among large segments of the population.^[15]

The structure of health care charges can also vary dramatically among countries. For instance, Chinese hospital charges tend toward 50% for drugs, another major percentage for equipment, and a small percentage for health care professional fees.^[16] China has implemented a long-term transformation of its health care industry, beginning in the 1980s. Over the first twenty-five years of this transformation, government contributions to health care expenditures have dropped from 36% to 15%, with the burden of managing this decrease falling largely on patients. Also over this period, a small proportion of state-owned hospitals have been privatized. As an incentive to privatization, foreign investment in hospitals¡ªup to 70% ownership¡ªhas been encouraged.^[16]