What fourth period element is represented by the dot structure shown? 
Definitions:
Fragmented Services
A situation where health care services are disjointed or divided, leading to potential gaps in care and patient management.
Cost Inefficiencies
Occurs when resources are not used in the most economically efficient way, leading to wastage and higher expenses.
Poor Health Outcomes
Negative states of health resulting from various factors, including disease, injury, and lifestyle choices, that affect an individual's quality of life.
Health Care Delivery
The provision of health services to individuals or communities by healthcare professionals.
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