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Wow, this is a multi-faceted question!

Participants in the heath care delivery system include:

  1. The patient is the center of health care. Without the patient (who has rights to say yea or nay to any care), there can be no "health care delivery".
  2. The personal physician, who directs the care.
  3. In some USA areas, the personal physician has split duties; if a patient enters a hospital, the patient is seen by a "hospital physician" as assigned by the primary physician. The hospital physician treats only in-patient while the primary continues to be the personal physician but does not deliver care in the hospital.
  4. The hospital, nursing home, rehab hospital, or other institution continues care with the patient residing in a centralized delivery area, such as "the hospital".
  5. The primary care hospital physician, or team of physicians provide direct care or supervise other doctors who deliver care.
  6. Nurses within a hospital or other institution carry out the physician's orders as well as deliver nursing assessment and nursing care.
  7. Supportive staff such as lab techs or X-Ray techs are also part of the health team.
  8. The administrators of hospitals or institutions make sure that the rules of Federal, State, Health Department, The Joint Commission, and insurance companies are known and followed. Administrators handle "surveys" in which governing agencies review records for compliance and other infractions of set rules.
  9. The insurance company has become an "entity" in healthcare, deciding who gets what care through approval or denial of services. However, patients need care and historically, hospitals provided care without thought about payment. In recent years, hospitals try to avoid treating non-covered patients or procedures because of concern over their budgets and profits. Both patients and institutions are at the mercy of insurance companies.

To list the responsibilities of each participant would be best answered as a separate question.

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Q: What is the participants in the health care delivery system?
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