Influence of Healthcare Regulation on the System Analysis Report

This report examines the influence of healthcare regulations on the system, with a specific focus on the role of gatekeepers within healthcare organizations. It defines health regulations as procedures that assist healthcare professionals in providing proper patient care and preventing diseases. The report highlights the gatekeeper's role, typically associated with HMO plans, and their responsibilities, including academic admissions, news editing, and financial advising. It discusses the regulations requiring gatekeepers to approve specialist appointments and hospitalizations, along with the advantages such as selecting specialists and controlling admissions. Furthermore, the report suggests potential modifications to these regulations, particularly in critical situations where time is of the essence. The conclusion emphasizes the importance of regulations in maintaining quality and effectiveness within healthcare systems. The report references key academic sources to support its arguments.

Running head: HEALTHCARE
INFLUENCE OF HEALTHCARE REGULATION ON THE SYSTEM
Name of the Student
Name of the University
Author Note

1HEALTHCARE
Health regulations have been defined as a set of procedures that have been found to
help the professionals associated with a healthcare system. These regulations will help the
professions in providing proper care to the patients (Greenfield, Foley and Majeed, 2016).
These regulations will help in preventing the disease which is becoming pandemic or
epidemic. HMO has been defined as the Health Maintenance Organization, which limits the
coverage of care for doctors on how to work in contact with HMO. Most of the health
insurers are licensed to proceed with business and operations in various states whereas HMO
is only licensed for a particular state.
This study will focus on the healthcare regulations associated with a gatekeeper
associated with a particular healthcare organization. Gatekeeper is a designation given to a
person who is in charge of the treatment of a patient. Gatekeeper is anyone who is appointed
to anyone who gets health insurance coverage as an HMO plan (Barequet, Tur-Sinai and
Barequet 2019). The gatekeeper serves various roles including academic admissions, news
editing and financial advising for the patient. According to one regulation associated with the
gatekeepers, physicians are required to get permission before they can hospitalize a patient.
This is because of the fact that unless they get permission, they cannot hospitalize a patient.
From the patient’s perspective, it can be stated that a patient also needs to get approval from
the primary care service before getting appointed under a specialized physician. These two
regulations have been found to be applicable to the gatekeepers associated with a medical
institute. The main advantage of the first regulation is that it allows the gatekeeper to select
the best specialist for the patient. Unless he/she permits a patient to get appointed a specialist,
a patient can never get admitted by themselves. Another advantage lies in the fact that the
patient needs to get approval from a service (HMO) before being admitted to a hospital for a
particular treatment (James Morone and Daniel C. Ehlke 2010). However, the regulations can
have some modifications in terms of its principles. The gatekeepers who are associated with a

2HEALTHCARE
health regulation better understand these modifications. The regulations can be improved by
reducing the strictness of permission grants before hospitalizing a patient. This is because,
when a patient is in a critical condition, there may be less time available for the physician to
get approval and then ask the patient to get hospitalized. Therefore, it can be stated that the
gatekeepers should be given the privilege to take the right decision based on the situation.
Thus, it can be said that the modifications in the regulations need to be on these terms in
order to provide the best quality care to the patient.
The functioning of every professional associated with an organization, be it business
and be it medical, has to follow certain rules and regulations to maintain the quality and
effectiveness of their functioning. This paper successfully provided a brief of a health
regulation associated with a gatekeeper and discussed its influence on the healthcare systems.

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References
Barequet, D., Tur-Sinai, A. and Barequet, I., 2019. Health policy regulations pertaining to
advanced surgical devices—their socio-economic effects on ophthalmology practice. Israel
journal of health policy research, 8(1), p.13.
Greenfield, G., Foley, K. and Majeed, A., 2016. Rethinking primary care’s gatekeeper
role. Bmj, 354, p.i4803.
James A. Morone and Daniel C. Ehlke (2010). Health Politics and Policy 5th Edition. 5th ed.