Accountability in the Health Care Industry

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A qualitative system of health care is one of the primary attributes of a developed country. While the USA healthcare was ranked as eleventh in terms of overall quality, it is the most expensive in the world. It is common knowledge that healthcare costs are the most common reason for personal bankruptcy (Gunderman, 2013). Therefore, the patients expect to have the best possible treatment for their money, and the ranking mentioned above points out, that they do not get it. The question arises, where are all these investments coming from? The transparent accountability for the entire health care system on all its levels is the only way to provide an answer. Although it is next to impossible to make such a complex and expensive system accountable at once, everyone is involved: from the Federal government to the single physician should do their best to improve on this issue.

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The term accountability is popular in many areas though it is somewhat ill-defined. To be accountable means to have obligations to answer the questions on every single decision and action. If the answer is unconvincing, the sanctions may follow. These sanctions are usually associated with laws and requirements, but in the case of health care, the term is broader. It includes professional code, public exposure that may lead to negative publicity, blackening the whole medical community. It is also worth specifying, what kind of accountability is meant.

The most commonly known notion of this term is financial accountability though there are also performance and political accountability. Financial accountability concerns the matter of usage of financial resources with the tools like auditing, budgeting, and accounting. Performance accountability means “demonstrating and accounting for performance in light of agreed-upon performance targets” (Harbour and Ball, 2003, p. 6), and the political or democratic accountability refers to “institutions, procedures, and mechanisms that seek to ensure that government delivers on electoral promises, fulfills the public trust, aggregates and represents citizens’ interests, and responds to ongoing and emerging societal needs and concerns” (Harbour and Ball, 2003, p. 7).

There are several reasons for accountability to be a matter of vital importance for the health care system. First of all, creating and maintaining accountability would improve the ratio of money spent on health care services and the quality of care. The accountability will provide evidence-based measurements of performance which would lead to the reduction of substandard care.

The accountability and financial transparency will also reduce the inefficient use of financial resources, which in its turn may result in reducing costs for the clients. Another reason for accountability to be implemented is that it improves the ability of employees to study, follow the standards, and be more responsible in general. The primary goal of following the standards is to reduce the irregularity in the provision of health care.

Accountability of employees is a crucial matter for any organization as it improves its performance in many ways. To begin with, the providers of health care have to estimate the measurement of every single employee’s accountability. They should be accountable for working according to the standards of their respective branch of health care or industry in general. The whole philosophy of the health care system should take into consideration the accountability of every single employee. Quality work is only possible in a comfortable environment, and creating one is a long-term goal (Brinkerhoff, 2003).

Moreover, the standards, mentioned above are also a topic of discussion for a professional community. These standards should be high yet achievable to encourage the employees to perform the best care. One of the basic quality measurements of hospital work, for instance, is the ratio of the expected deaths to heart attacks and actual ones (Herman, 2012).

The management team in its turn should be attentive to their fellow workers. First of all, to remind them, that they are accountable, secondly, to acknowledge them of their part in the industry’s success. In sum, the accountability of the health care system suggests communication between all its levels (Herman, 2012).

In addition to improving the system’s performance, accountability may also raise the level of its working culture. Certain elements of accountability such as common vision and belief are responsible for it. As was mentioned, accountability encourages the employees to study. They can see the measurements of their results and are motivated to work better (O’Hagan & Persaud, 2009). Since the distribution of the resources is also accounted for, the employees should be interested in its careful usage, giving maximum to their investors and clients (Portery & Malloch, 2010).

Accountability may also lead to developing new strategies for the management to be competitive. The primary goal of any competition in any industry is to reduce the prices for the clients. As the entire team of any health care provider would be on the same boat as each of their contributions is carefully counted, their mutual relations may also improve, raising the morale and once again improving their performance (Brinkerhoff, 2003).

With all its benefits, the maintaining of accountability may also cause certain negative effects. There are several issues like defensive behavior, arrogance, common for medical workers, or desire to transfer the blame. All of the listed are the scourges of any industry, and it is not clear if the accountability may help. Financing is a major issue for the management level, as they often tend to blame the higher authorities, while the regular employees tend to blame their immediate superiors, and the patients blame them all. It is another long-term goal of changing the system philosophy. The transformation of the entire mindset is required to overcome these problems.

The issue is well-known and studied. All numerous parties involved in health care have to change their behavior to more positive and responsible, as there is no other way to raise the quality of medical service. The steps to be taken to deal with a negative mindset are the following: parties should be only accountable for things they control; the results of the accounting should be challengeable while the efforts made by each sing employee should be rewarded. Another measure is that accountability must be adaptive. Still, the matter of accountability lies on every worker and the most challenging task is teaching them this fact.


In conclusion, I would like to say, that creating and maintaining accountability is a truly challenging yet vitally important task. It would involve every single physician or manager of the industry while the health care system is known for its closeness to outsiders. The medical workers have their standards and they do not like to be taught. Therefore, the implementation of accountability should be performed with attention to every party involved. The health care system should shift from its obsolete hierarchical structure and embrace the modern leadership way. While the process will be challenging and long-term, the result may exceed all expectations.


Brinkerhoff, D. (2003). Accountability and Health Systems – World Health Organization. Web.

Gunderman, R. (2013). The What Accountable Health Care Means. Web.

Herman, B. (2012). The 4 Dimensions of Hospital Accountability. Web.

O’Hagan, J. & Persaud, D. (2009). Creating a Culture of Accountability in Health Care. Web.

Portery, T., & Malloch, K. (2010). Quantum Leadership: Advancing Information, Transforming Health Care. Sudbury, Massachusetts, USA: Jones & Bartlett Learning.

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