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|As defined by
Hyman (1976) and summarized in Knox (1979), there are four basic types of administrative
structures, contexts, or planning. These are: (1) systems; (2) partnerships; (3)
alliances; and (4) individual actions. Of these four, the first three appear to be more
relevant to public health (PH) planning.
Systems planning relies on authority over all resources being saturated at the apex of a single structure. Both the practice of social medicine in Canada and the provision of health care and medical treatment by the U.S. Veterans Administration hospitals serve as good examples of this type.
Partnerships type planning can be seen in places like Sweden and the U.K. (the United Kingdom), where objectives and means are resolved through a series of bargaining and negotiation, with authority being divided among different government levels or agencies.
Alliances type planning depends primarily on voluntary agreements among individual citizens and profit-oriented health care providers, but with certain legal constraints imposed on these actors by government agencies. Such is the prevailing pattern in the United States, where regional health systems agencies are charged with developing area-wide plans and advising state agencies on regulatory matters.
The adoption of these different health administration and planning styles by various countries helps explain why PH and health risk assessment mean different things to people in different countries.