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Healthcare delivery model evolution

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Health care delivery models have evolved overtime.
What events, social, demographics, economic, political, environmental, governmental triggered the various models of healthcare to come and go?

Answers (still formulating but wanted to get started sending something).

Events - 3 Main (Preindustrial; Postindustrial and Managed Health Care- Globalization)
Pre-industrial - no standards or education (Barbers also were medical doctors/surgeons and during this time a doctor was a trade and not a profession; no prestige and was considered a 2nd job. Medical procedures were primitive; education was substandard and doctors had to travel long distances and received pay for their travel.

Post-industrial - cities were born; science and technology advances were made. AMA enacted in 1847; American Medical Association); set minimum standards of education and again in 1870 reforms were passed such as (?)? Doctors were at the lower end of the middle class and served the upper classes. Almshouses and Managed Health Care / MHC -

Globalization - E-Health and Pesthouses were the precursor to hospitals (called pesthouses because they took care of the poor and people without families and the disabled). Pesthouses contained people during epidemics (cholera, smallpox, tuberculosis etc.). Dependent on charity.

Social - Medicaid and Medicare (talk about); Value and Beliefs (Canada believes in taxation for better medical care which has equated to less day missed from work; overall quality of life improved and better for the social justice. Whereas, Americans feel that moral justice; what a man earns is what he can buy; to be self-reliant and not reliant on the government. With this said, there are many factors that play a role in the overall development and quality of life for an individual (location, parents education, access to healthcare. Etc.).

Shi, L. & Singh, D. (2012). Delivering health care in America: A system approach. (5th. ed.). Boston, MA: Jones & Bartlett.

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This solution discusses the evolution of healthcare deliver models.

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http://www.africanursingsciencesjournal.com/article/S2214-1391(14)00004-3/fulltext

What Events, social, demographics, economic, political, environmental, governmental triggered the various models of healthcare to come and go.

It's important to recognize that global healthcare improvements in delivery of care are predicated upon a fragmented collection of unrelated events rather than a streamlined organized effort prior to 1960. Therefore, for much of history, fragmented, social, economic, political, environmental, and governmental events triggered the various models of healthcare that have evolved over hundreds of years. Prior to the industrial revolution, healthcare was not a scientific medium, and despite the fact that the first medical school in the United States was established in 1765 at the College of Philadelphia, which was adjacent to the Pennsylvania Hospital, and had faculty that was trained in Scotland and England, the doctors in the 18th and early-to-mid 19th century were trained in medical schools that lacked quality programs and produced inconsistent models for delivery of care. Medical schools sprung up across the following the War of 1812, but these weren't able to greatly advance the quality of care provided by doctors who graduated from these schools as they lacked regulations and unification. Quintessentially, healthcare prior to the 1850s was rife with unscientific practices and patient suffering as a result of a lack of quality care.

Quality improvement documentation Nightingale England

One of the most influential individuals in shaping current healthcare delivery and quality was Florence Nightingale. This nurse was a pioneer in quality improvement of patient care and delivery through documentation, and the meticulous records she kept and documented during Great Britain's Crimea War campaign ...

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