Historical Trend Analysis-2249051


The American healthcare system has seen significant transformations throughout its existence. The major events and advancements in the history of healthcare regulation will be discussed in this essay, with a focus on accessibility, affordability, and quality across three distinct centuries: the 1800s, 1900s, and 2000s (Bhatia, 2019). These historical trends are important for healthcare administrators to understand because they provide insight into the evolution of the quality movement and its impact on the US healthcare system.

Trends and Regulations

The healthcare services landscape is complex, with cost, quality, and accessibility being the three main determinants of quality. The sustainability and efficacy of healthcare systems are assessed using these three essential pillars. The ability for people to get the healthcare they need or the availability and reach of healthcare services, is referred to as access. Standards of care are called quality, and they emphasize that patient-centered, safe, efficient, timely, and equitable healthcare services are essential. Affordability and sustainability of healthcare delivery are the main topics of concern when discussing cost, which is the financial component of healthcare services. The evolution of the healthcare system and its capacity to serve the varied needs of its populace can be greatly understood by examining trends and laws about access, quality, and cost (Abubakar, et. al 2022).

Health Care Access

Possessing access to healthcare enables individuals to get the treatment they need. An important historical turning point in the 1800s was the founding of the American Medical Association (AMA) in 1847 (Camison, 2022). By establishing professional standards and pushing for advancements in public health, the AMA had an impact

on access even as it worked to regulate the medical profession. Establishing the foundation for social safety net programs like Medicare and Medicaid, the Social Security Act of 1935, a landmark piece of legislation from the 1900s, significantly increased access to healthcare for vulnerable populations (Zanoni, 2020). The Affordable Care Act (ACA) of 2010 greatly improved access to care in the 2000s by requiring insurance coverage and outlawing discriminatory practices by insurers. These noteworthy occurrences demonstrate how far the nation has come in increasing access to healthcare.

Health Care Quality

The provision of medical services that are timely, efficient, patient-centered, safe, effective, and equitable is what defines quality healthcare. Since it guarantees that patients receive the best care and results, quality care is a fundamental component of the healthcare system. Over several historical eras, several legislative acts, regulatory bodies, and quality initiatives have shaped the American healthcare system’s pursuit of quality. The focus on enhancing infection control and hygiene in the 1800s set the groundwork for contemporary quality practices (Vermeil, 2019). With the introduction of standards and accreditation surveys to raise the caliber of care, the Joint Commission’s founding in 1951 signaled a significant shift in the 1900s.

The extensive use of electronic health records (EHRs) and the rise of evidence-based medicine in the 2000s both enhanced quality by promoting clinical decision-making and information exchange. The trend analysis reveals a sustained drive to raise the standard of healthcare services over time, indicating a growing emphasis on data-driven, evidence-based approaches in the twenty-first century (Han, et al 2020).

Health Care Cost

  Healthcare costs are critical to the functioning of the healthcare system because they include all monetary aspects related to the provision of medical services. Effective cost management is essential because it affects healthcare providers as well as patients. Various legislative acts, regulatory agencies, and quality initiatives from various historical eras have impacted the regulation and control of healthcare costs in the United States. There was a noticeable shift in medical practice toward specialization in the 1800s, which occasionally resulted in higher healthcare costs because more healthcare professionals were needed (Pelling, 2023).

By paying for the costs of medical services, the introduction of Medicare in 1965 and the growth of private insurance programs had a significant impact on healthcare costs in the 1900s (Levitt, et. al 2021). A greater focus on cost-effectiveness and value-based care initiatives was implemented in the 2000s to reduce healthcare costs. The trend analysis emphasizes how difficult it is still to control healthcare costs and how creative solutions are required to guarantee the accessibility and long-term viability of healthcare services.

Trend Analysis

Examining trends and regulations in healthcare access, quality, and cost can provide a comprehensive understanding of how healthcare practices and regulations have evolved over the last few decades. Since the early 1800s, access to healthcare has significantly expanded, largely due to the passage of legislation like the Affordable Care Act (ACA) in the 2000s (Pescosolido, 2021). Quality has increased dramatically since the Joint Commission and other regulatory organizations were founded in the 1900s with an emphasis on patient safety and effective healthcare delivery. Value-based care became more popular in the 2000s, but there is still a problem with healthcare cost containment.Based on my professional experience, these trends are evident in the increasing focus on patient-centered care and the utilization of technology to improve healthcare delivery. Lewkowicz (2020) notes that the utilization of electronic health records (EHRs) has resulted in enhanced clinical decision-making and information exchange, thereby improving the quality of care. The continuous efforts to keep accessibility, quality, and affordability in check in healthcare practice and regulation show how dynamic and ever-evolving the American healthcare system is.


In summary, the historical trend analysis shows that the quality, affordability, and accessibility of the American healthcare system have all improved dramatically. Healthcare has improved due in part to the milestones and regulations that have been discussed. It is now more affordable, more accessible, and of higher quality. To improve the American healthcare system even more and carry on the quality revolution, however, continuous efforts and innovations are necessary.


Jones, C. J. (2022). Theoretical Applications of Executive Behavioral Control and Emotional Distress Amongst At-Risk Youth (Doctoral dissertation, Capella University).

Levitt, L. (2021). The language of health care reform. JAMA325(3), 215-216.

Pescosolido, B. A., & Boyer, C. A. (2021). American Health Care System: Reforms for Access, Outcomes and Cost Amid Legal, Legislative and Political Disputes. The Wiley Blackwell companion to medical sociology, 537-555.

Bhatia, A., Krieger, N., & Subramanian, S. V. (2019). Learning from history about reducing infant mortality: contrasting the centrality of structural interventions to early 20th‐century successes in the United States to their neglect in current global initiatives. The Milbank Quarterly97(1), 285-345.

Abubakar, I., Dalglish, S. L., Angell, B., Sanuade, O., Abimbola, S., Adamu, A. L., … & Zanna, F. H. (2022). The Lancet Nigeria Commission: investing in health and the future of the nation. The Lancet399(10330), 1155-1200.

Camison, L., Brooker, J. E., Naran, S., Potts III, J. R., & Losee, J. E. (2022). The history of surgical education in the United States: past, present, and future. Annals of Surgery Open3(1), e148.

Zanoni, A. (2020). Poor Health: Retrenchment and Resistance in Chicago’s Public Hospital, 1950s-1990s (Doctoral dissertation, Rutgers The State University of New Jersey, School of Graduate Studies).

Vermeil, T., Peters, A., Kilpatrick, C., Pires, D., Allegranzi, B., & Pittet, D. (2019). Hand hygiene in hospitals: anatomy of a revolution. Journal of Hospital Infection101(4), 383-392.

Han, R. H., Schmidt, M. N., Waits, W. M., Bell, A. K., & Miller, T. L. (2020). Planning for mental health needs during COVID-19. Current psychiatry reports22, 1-10.

Pelling, M. (2023). Medical practice in early modern England: trade or profession?. In The Professions in Early Modern England (pp. 90-128). Routledge.

Lewkowicz, D., Wohlbrandt, A., & Boettinger, E. (2020). Economic impact of clinical decision support interventions based on electronic health records. BMC Health Services Research20(1), 1-12.