The location of healthcare facilities is limited to the larger municipalities.
Accountability
The entity that is responsible for the healthcare system is the United States Government. In addition, Puerto Rico has a governor and a cabinet in place to ensure that the appropriate laws are carried out. The entity that makes laws concerning healthcare is outside of the country but the entity that enforces these laws is inside the country. Services are evaluated by state run entities and agencies of the United States government such as that CDC and Health and Human Services. These entities are effective at evaluating problems but not so effective at finding solutions. The people of the territory participate in the evaluations but have little to do with the actual decision making process.
Planning
Priorities for improving the condition of the healthcare system in Puerto Rico have not been set. Like the mainland-United States, it is obvious that problems exist within the healthcare system but the ability to fix these problems has not been realized. There is a centralized planning entity within the local government on the island. Consumer groups, especially patient advocacy groups are attempting to draft a solution to the problems that plague the healthcare system in Puerto Rico.
Patient Autonomy and Satisfaction
Many patients are displeased with the type of care that they receive because of the restraints placed on their doctors by insurance companies. Many insurance companies will not pay for procedures that are perceived to be experimental even it may be the only way to save the patients' life. Within the territory patients have the same rights as American patients because Puerto Ricans are American citizens.
Patients' rights are limited in that insurance companies also have rights and they have a certain amount of power over patients because they have deep pockets. Patient satisfaction is recognized but rarely responded to by the appropriate government entities. The inequities in the system have to do with the treatment of the poor, elderly and uninsured.
Effectiveness of Overall Healthcare System
Overall, the healthcare system is moderately effective. The population is healthier in some respects but less healthy in other respects. The health problems that plague Puerto Rico are similar to those of the United States. Diabetes and obesity are major concerns. These healthcare issues are being addressed through early screening and education. This issue of HIV / AIDS is a growing concern and the importance of testing must be addressed. However, the system is broken and must be repaired. Steps to ensure that it will be repaired must include comprehensive health coverage for all and discounts to those that are elderly, unemployed and underemployed.
Conclusion
The purpose of this research was to focus on the healthcare system of Puerto Rico. We investigated Population characteristics, the economy, health status parameters, Financial Parameters, Access and Availability, Accountability, Planning, Patient Autonomy and Satisfaction. We found that all of these factors contributed to the level of healthcare available to the people of Puerto Rico. In addition, we determined how these factors influenced the effectiveness of the overall healthcare system on the island of Puerto Rico. We found that the healthcare system in Puerto Rico is broken but is still moderately effective.
References
The World Factbook -- Puerto Rico. Retrieved November 8, 2004 from; http://www.cia.gov/cia/publications/factbook/geos/rq.html#People
Puerto Rico: Estimated Number of Persons Living with AIDS at the End of 2002. Retrieved November 8, 2004 from; http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=HIV%2fAIDS&subcategory=Persons+Living+with+AIDS&topic=All+Ages
HIV / AIDS Among Hispanics. Retrieved November 8, 2004 from; http://www.cdc.gov/hiv/PUBS/Facts/hispanic.pdf
Puerto Rico: Total Number of Adults with Diagnosed Diabetes, 2002. Retrieved November 8, 2004 from;
http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=Health+Status&subcategory=Diabetes&topic=Total+Prevalence+of+Diagnosed+Diabetes
Puerto Rico: Total Number of Adults with Diagnosed Diabetes by Age Group, 2002. Retrieved November 8, 2004 from; http://www.statehealthfacts.kff.org/cgi-bin/healthfacts.cgi?action=profile&area=Puerto+Rico&category=Health+Status&subcategory=Diabetes&topic=Prevalence+of++Diabetes+by+Age+Group
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