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Accessing HealthcareResponding to diversity$
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Judith Healy and Martin McKee

Print publication date: 2004

Print ISBN-13: 9780198516187

Published to Oxford Scholarship Online: September 2009

DOI: 10.1093/acprof:oso/9780198516187.001.0001

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Delivering Health Services in Diverse Societies

Delivering Health Services in Diverse Societies

(p.351) Chapter 18 Delivering Health Services in Diverse Societies
Accessing Healthcare

Judith Healy

Martin McKee

Oxford University Press

Which service delivery model is the most appropriate in terms of access, use, and health outcomes for particular population groups? These chapters demonstrate that the answer depends upon the context. Separate services may be participatory, alternative, or parallel (usually providing primary not secondary or tertiary care), while universal services may be viewed as mainstream, collective, or integrationist. The advantages versus the disadvantages of separate services potentially are as follows: self-determination vs less national social solidarity; more control vs less state responsibility; consumer choice vs reduced scope and scale; better access for some vs less population access; more responsive services vs lower clinical quality; better targeting vs higher cost; and higher profile vs greater stigma. Ultimately many of these arguments are decided in relation to views of citizenship and nationhood.

Keywords:   delivery models, separate services, mainstream services, universal services, citizenship, nationhood

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