Hadjistavropoulos SSG Chapter4

4 Health Psychology within
the Health-Care System
Chapter Summary
Due to different public and private funding arrangements, regulatory structures, and delivery modes,
health systems vary from country to country and shape the way health psychologists provide services
to their patients. Certain individuals, such as celebrities, can afford all healthcare services, regardless
of the country or type of health care system. Canada has a predominantly public coverage system in
which provincial governments provide medically necessary hospital, diagnostic, and physician ser-
vices. Due to restrictive public coverage, patient access to the services of health psychologists is lim-
ited, despite the fact that health psychologists can provide an array of services directly connected to
medical care. Despite these health system barriers, health psychologists are involved in every stage of
care, from primary and secondary to tertiary care.
When working with patients, health psychologists often need to consider whether patients are mis-
using medical services. There are two common types of misuse: overuse and delayed use. Health
psychologists also often assist patients with adherence to medical care. Adherence refers to patients
following treatment recommendations made by their health-care professionals. Since psychosocial
variables predict adherence, psychologists have an important role to play in assisting patients with
adherence to medical recommendations.
In addition, growing evidence suggests that there are effective psychological treatments to assist in-
dividuals with recovery and adaptation to medical conditions as well as to problems they encounter
within the health-care system. These psychological services can reduce health-care spending.
Fundamentals of Health Psychology, Second Edition

© Oxford University Press Canada, 2019
Essay Topics
1. What are the similarities and differences between health care in the US and health care in Canada?
Which system is makes it easier to access health psychology services? How could this be improved
in both countries? (pp. 72–80)
2. What are the personal and social factors that influence tendencies to seek health care? (pp. 80–85)
3. How can health psychologists help improve patient adherence? What about patient satisfaction?
(pp. 86–88)
4. Does providing psychological services to medical patients ultimately reduce health-care costs?
Support your answer. (p. 90)
Weblinks
http://www.hc-sc.gc.ca
Health Canada is the Federal department responsible for helping Canadians maintain and improve
their health, while respecting individual choices and circumstances.
http://www.hc-sc.gc.ca/hcs-sss/pubs/system-regime/2011-hcs-sss/index-eng.php
This section of the Health Canada website provides a variety of information on Canada’s health care
system—its history, the role of government, delivery of health-care services, and other related topics.
http://www.nih.gov/
The National Institutes of Health (NIH) website provides a variety of health-related information
and resources. The National Institutes of Health—part of the US Department of Health and Hu-
man Services—is the US government’s medical research agency.
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld
PBS Frontline episode titled “Sick Around the World,” which explores how five other capitalist de-
mocracies—the UK, Japan, Germany, Taiwan, and Switzerland—deliver health care, and how their
successes and failures might inform the US health care system.
Glossary
Beveridge systems Health systems financed through general taxation that involve a government
overseeing the co-ordination and integration of a broad range of health services for its entire popula-
tion; named after William Beveridge, the civil servant whose recommendations led to the creation of
the National Health Service in the United Kingdom.
Health system The complex array of governance, funding, administrative, and service delivery ar-
rangements established to deliver personal and population-based health services, all in an effort to
improve health and health-care outcomes.

Health maintenance organizations HMOs, or packaged health services of specific medical profes-
sionals and facilities offered by provider organizations.
Medical cost offset The net savings in medical costs resulting from an intervention.
Primary care First level of personal care for common conditions, focused on both prevention and
treatment, from which access to specialized care is co-ordinated.
Private health insurance systems Health systems in which the majority of payments are made
through individual or employment-based private insurance contracts.
Secondary care Health-care services provided by medical specialists and other health professionals
who generally do not have first contact with patients.
Social health insurance systems Health systems financed largely through compulsory employer–
employee insurance contributions regulated by the state.
Tertiary care Care provided in a facility that has specialized personnel and facilities for advanced
medical investigation and treatment.


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4 Health Psychology within

the Health-Care System

Fundamentals of Health Psychology, Second Edition

Fundamentals of Health Psychology, Second Edition

Fundamentals of Health Psychology, Second Edition

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