DNP 840 TOPIC 1 DQ 1

DNP 840 TOPIC 1 DQ 1

DNP 840 TOPIC 1 DQ 1

With attention to Figure 7-1, “Basic Components of a Healthcare Delivery Service,” in Advanced Practice Nursing: Essential Knowledge for the Profession, consider the following discussion question. There are four basic functional components of a health care delivery system. Discuss two components which will impact the implementation of your project site.

The four components of the healthcare delivery system are finance, insurance, delivery, and payment, each acting as a continuum affecting the individual’s access to healthcare (Denisco, 2021). Fortunately, although for-profit hospitals and clinics may have issues with some clients paying bills, profit margins are maintained due to third-party providers and insurance payments (Denisco, 2021). However, most clientele needs more medical coverage because the Direct Process Improvement (DPI)plan site is a nonprofit clinic. Hence, the clinic services, medical supplies, and overhead are paid primarily through donations or reimbursements from Medicare or Medicaid. Thus, the two components of the healthcare delivery system which may have the most substantial impact on the DPI include finance and providers.

Stakeholders often indirectly affect provider care in massive hospital conglomerates (Denisco, 2021). For example, some insured patients may require prior authorization from the insurance provider before receiving certain medications or diagnostics. Insurance companies may receive discounts for referrals to companies or service providers, thus directing utilization. However, in a nonemergent situation, providers accept payments and provide care once the deductibles are met. Unfortunately, the financially insecure patient may not have the luxury of receiving nonemergent care due to financial constraints, and the impoverished nature of their current existence limits care options; with the DPI’s setting offering services that mitigate the exorbitant healthcare spending that their lack of primary prevention access imposes. 

In part, many financially insecure patients are unaware of the availability of Medicare or Medicaid benefits (Denisco, 2021). Medicare and Medicaid are financing services allowing patients to receive care at a subsidized or cost-free rate. For diabetic patients, these services enable them to obtain diagnostic and preventative treatment, decreasing the probability of adverse outcomes. Hence, as portions of the DPIs intervention is to initiate medical nutrition therapy, including dietician referral, financing is one of the healthcare delivery components that will vastly affect its implementation. 

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Clinic social and community health workers tirelessly advocate for patients to receive the financing needed to increase the likelihood of provider services, the second component of the four processes of the healthcare delivery process affecting the DPI (Denisco, 2021). Although clinicians at the DPI site are volunteer workers, laboratory, vision, dental and podiatrist screenings may require costs not covered by the clinic. For example, the MNT strongly encourages lipid and glycemic values. Fingerstick glucose and Hba1c services are provided in the clinic; however, the patient lipid panels must be outsourced to local labs with free services. This healthcare delivery factor will ultimately affect the DPI process, as some patients do not qualify for government insurance (finance) and need the means to pay for the delivery services. The DPI will not prescreen for the ability to pay for MNT services; therefore, delivery and finances may affect the implementation of the intervention. 


Denisco, S. M. (2021). Advanced practice nursing: Essential knowledge for the profession (4th ed.). Jones & Bartlett Learning.


 I agree with you that are finance, insurance, delivery, and payment are four components of the healthcare delivery system. The coordination of these components guarantee successful healthcare service delivery (Usak et al., 2020). Therefore, healthcare organizations have mechanisms that ensure that the four components of the healthcare delivery system are functional. Finance is a critical component that facilitates healthcare delivery system. Finance enable running of healthcare facilities. Financial resources are used in employing and sustaining competent workforce (Ekwunife et al., 2022). Insurance is also important component that ensure healthcare services are accessible to underprivileged population. Payment may be an optional component of the healthcare delivery system for non-profitable healthcare facilities. Other hospital with huge bills and the need to improve their infrastructure may rely on payments. These payments can be made from money received from patients and consultation charges. Provision of quality healthcare services requires collective stakeholder contribution. Different stakeholders are located in different components of the healthcare delivery system. 


Ekwunife, O. I., Onubogu, C. U., Aribodor, O. B., Anigbogu, K. C., Ogwaluonye, U. C., Ekwunife, C. A., … & Nwaorgu, O. (2022). Approaching healthcare delivery through a new lens: a crowdsourcing challenge to identify health-related social innovations to increase universal health coverage in Nigeria. BMJ Innovations8(3).

Usak, M., Kubiatko, M., Shabbir, M. S., Viktorovna Dudnik, O., Jermsittiparsert, K., & Rajabion, L. (2020). Health care service delivery based on the Internet of things: A systematic and comprehensive study. International Journal of Communication Systems33(2), e4179.

The healthcare delivery system is intricate, with many components ensuring adequate patient healthcare services. Understanding the system’s features and how each can impact a project is essential for successful implementation. This essay will discuss two components that will affect the performance of a project site, the impact of bureaucracy on patient quality and safety outcomes and the associated challenges and rewards.

The four essential components of a healthcare delivery system are access, organization, delivery, and financing. Of these components, access and delivery are the two which will have the most significant impact on the implementation of a project site. The ability to acquire services in a timely and cost-effective manner is defined as access to healthcare. For this project site to be productive, patients must have access to the services they demand. This can be achieved by ensuring that services are given in a suitable location and within a reasonable distance of the patient’s home (Baumann & Cabassa 2020). It is also critical to ensure that the services are cheap and that transportation is provided if necessary.

The delivery of healthcare services is the second component that will impact the implementation of a project site. This involves providing quality services on schedule and in a setting that promotes patient safety and comfort. It is critical to ensure that service personnel has the requisite knowledge and abilities and that the appropriate equipment is accessible. It is also vital to guarantee that the services are delivered in a safe and secure environment.


Baumann, A. A., & Cabassa, L. J. (2020). Reframing implementation science to address inequities in healthcare delivery. BMC Health Services Research, 20, 1-9.

Talevski, J., Wong Shee, A., Rasmussen, B., Kemp, G., & Beauchamp, A. (2020). Teach-back: A systematic review of implementation and impacts. PloS one, 15(4), e0231350.


 I agree with you that access, organization, delivery, and financing are the four essential components of a healthcare delivery system. Every component is critical in providing quality healthcare services. Therefore, healthcare facilities ensure that stakeholders are located in the whole healthcare delivery system. Understanding the system’s features and how each can impact a project is essential for successful implementation (Ransing et al., 2020). Stakeholders have adequate and reliable information on their respective essential components of a healthcare delivery system. As a result, their understanding of system features helps in change implementation. Access and delivery are two components with the most significant impact on the implementation of a project site. Accessible healthcare facilities attend to many patients (Wood et al., 2019). Therefore, healthcare facilities accessible from a good road and other transport networks are beneficial. Also, most patients are attracted to healthcare facilities with exceptional healthcare service delivery. Hence, healthcare institutions prioritize employing competent healthcare professionals.  Qualified workforce guarantees outstanding performance.


Ransing, R., Adiukwu, F., Pereira-Sanchez, V., Ramalho, R., Orsolini, L., Teixeira, A. L. S., … & Kundadak, G. K. (2020). Mental health interventions during the COVID-19 pandemic: a conceptual framework by early career psychiatrists. Asian journal of psychiatry51, 102085.

Wood, C. S., Thomas, M. R., Budd, J., Mashamba-Thompson, T. P., Herbst, K., Pillay, D., … & Stevens, M. M. (2019). Taking connected mobile-health diagnostics of infectious diseases to the field. Nature566(7745), 467-474.

This week’s lesson teaches that there are four functional components of a healthcare system. The components are finance, insurance, delivery, and payment and they all overlap to some degree based on the type of healthcare organization (DeNisco, 2021). Financing represents how individuals cover healthcare costs. These costs can be covered in various ways but more often it is covered by a person’s employer. Healthcare costs can increase rather quickly hence most people have some form of insurance. The type of healthcare coverage is dependent on the type of insurance. In this model, delivery represents the multiple disciplines that provide care. Lastly, payment refers to how providers get paid for their services and the out-of-pocket costs patients must pay for services. 

The DNP project site is at a federal agency that provides services to Veterans. Therefore, the way that the components overlap is different than most private sector institutions. One component that will impact the project site is finance. In the Veterans Administration System, a model called Veterans Equitable Resource Allocation (VERA) is used. This model allocates resources to regional networks based on where Veterans go for their care and how sick the patients are in a particular region (United States Government Accountability Office, 2019). The budget in this system is a fixed sum meaning if financial resources are given more to one region other regions will see a decrease in allotments. Given that the project site is in the largest medical center and there is a high level of complex medical services provided, there are many financial resources allocated at the practice site.    

Another component that impacts the project site is delivery. With the Veterans Choice Act, Veterans have a choice on whether they get their care with the Veteran Administration (VA) system or the private sector (Health, 2016). Therefore, it is critical that care delivery is safe, accessible, and optimal. If the healthcare system does not meet these demands and there is decline in Veterans choosing the VA system, the less funding would be needed. Hence, my project focuses on using virtual reality to impact pain levels. Overall, as evidence shows, if using this technology produces better pain management then Veterans might be more satisfied with this care delivery approach.


DeNisco, S. (2021). Advanced Practice Nursing (4th ed.). Jones & Bartlett Learning.

Health, R. (2016). Balancing demand and supply for veterans’ health care: A summary of three RAND assessments conducted under the veterans choice act.

United States Government Accountability Office. (2019). VA Needs to ImproveI ts Allocation and Monitoring of Funding. U.S. Government Accountability Office (U.S. GAO).


the success of healthcare system depends on the perfection undertaken in its four components. The four functional components of a healthcare system are finance, insurance, delivery, and payment. Financing entails funding healthcare activities (Oleribe et al., 2019). Healthcare organizations receive funding from different stakeholders including the government. Financial resources are important in facilitating successful running of healthcare facilities. Healthcare costs can increase rather quickly hence most people have some form of insurance. Health insurance coverage increases access to quality and affordable healthcare services (Darwish et al., 2019). Similarly, the coordination between healthcare providers and insurers enable the provision of quality healthcare services to many. Government-sponsored funding healthcare programs such as Medicaid and Medicare have impacted healthcare service delivery in U.S. hospitals. Most members from underprivileged population who had limited access to healthcare services are now accessing these services courtesy of Medicaid and Medicare. Payment is important in financing healthcare operations. Non-profitable organizations may not receive payments from their patients.


Darwish, A., Hassanien, A. E., Elhoseny, M., Sangaiah, A. K., & Muhammad, K. (2019). The impact of the hybrid platform of internet of things and cloud computing on healthcare systems: opportunities, challenges, and open problems. Journal of Ambient Intelligence and Humanized Computing10, 4151-4166.

Oleribe, O. O., Momoh, J., Uzochukwu, B. S., Mbofana, F., Adebiyi, A., Barbera, T., … & Taylor-Robinson, S. D. (2019). Identifying key challenges facing healthcare systems in Africa and potential solutions. International journal of general medicine, 395-403.

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