Bodenheimer and Grumbach (2009) express that all healthcare systems strive to ensure patients receive the health care they require in a suitable place and time. However, they may all accomplish this through different methods to one another.
Two distinct formats a country may operate under is the Regionalized Model and the Dispersed Model (Bodenheimer & Grumbach, 2009). The Regionalized Model is a structured system where the primary, secondary and tertiary levels of care are discrete, and primary care is the foundation (Bodenheimer & Grumbach, 2009). An example of a country following this is New Zealand (Mossialos, Wenzl, Osborn, & Sarnak, 2016). In contrast, the Dispersed Model does not have a clear structure like the Regionalized Model, and the secondary and tertiary aspect of care is of more importance than primary care. Due to the focus on the higher levels of care, the amount of primary care available is reduced, so secondary and tertiary care practitioners may take on a role normally carried out by a primary care practitioner (PCP) in order to bring a balance (Bodenheimer & Grumbach, 2009). The United States of America is a country utilizing this format (Bodenheimer & Grumbach, 2009). Patients have the ability to transition between the healthcare levels when they require more specialized care (as cited in (Bodenheimer & Grumbach, 2009), and whether they are able to with restrictions or not are determined by the term, gatekeeping. This is the distinguishing factor