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Represents a state of poor health |
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The state of complete physical mental and social well being and not merely the absence of disease or infirmity |
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The prevention and treatment of illness. |
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Preamble to the Constitution of the World Health Organization |
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In 1946, representatives of 61 countries attended the International Health conference in New York to ratify this. It is a specialized agency of the United Nations that deals with global health |
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Who is Health Care delivered by? |
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People who are drawn from different and often disparate disciplines including medicine, dentistry, nursing, laboratory science, pharmacy and other allied health professions which may include anesthesia technologists cardiovascular technologists, medical assistants, perfusionists or respiratory therapists. These people have different backgrounds and they have disparate training, but often work together ass interdisciplinary terms in order to deliver care to patients. |
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When we think of in-patient facilities we think of these. They are institutions that treat patients who are sick or injured. These are physical structures that house patients during treatment and allow clinicians to conduct diagnostic tests and perform management interventions and also perform specialized functions such as surgery and managing childbirth. There are also specialty services that focus on a particular aspect of care such as; orthopedics, pediatrics or women's services. Some focus on mental health or psychiatric care. |
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Historically, hospitals were.... |
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places for shelter, or aims-houses for the poor. |
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The Hospital Survey and Construction Act |
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In 1946, this law was passed (known as the Hilburton Act). It was sponsored by Senator Harold Burton of Ohio and Senator Lister Hill of Alabama. The law provided federal grants to improve hospital physical infrastructure and led to a significant augmentation of the infrastructure of facilities that provided in-patient care in the US. |
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May be administered by the city, county, state or at a federal level. |
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Privately Owned Hospitals |
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May be not for profit or may pursue profits like any other business. |
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How are patients admitted to a hospital? |
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They may go into an emergency room where they will be evaluated by a team of clinicians. If the clinicians feel that they are sick enough, they may be admitted into the hospital for care. Patients may also be directly admitted to hospitals from physicians offices. |
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Health care delivery in nursing and residential care facilities |
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These can be short term facilities where it is anticipated that patients will stay for a brief period of time before returning home or to their residences, or long-term facilities where patients may stay for an extended or indefinite period of time. |
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Example of a short-term facility |
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a post-surgical rehabilitation center. After surgery it may be deemed that a patient is too frail to return home and may need to spend some time in a rehabilitation center before gaining enough strength to return home. |
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Example of a long-term facility |
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An Alzheimer's unit in a nursing home. A patient will gradually progressive dementia may need to stay indefinitely in such a facility. Long-term care is classified by the level of care. For example: a patient with relatively few health needs may reside in an assisted living facility, whereas a patient with profound and significant health needs may need the services of a nursing home. |
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originally part of the welfare system and gradually shifted to become part of the current health care system. |
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In 1969 as this cost increased, the then Department of Health and Human Services drastically reduced coverage for nursing homes. A year later in 1970, the Miller Amendment established a new standard. Intermediate care facilities that didn't require the same amount of skilled nursing or resources thus required reduced levels of reimbursement. |
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another standard in the 1990's defined to provide care for patients discharged form hospitals who briefly needed a higher level of care that was provided to a majority of patients in a skilled nursing facility. These distinct levels of care have been delineated primarily from the cost effectiveness perspective. |
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Term
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Definition
another standard in the 1990's defined to provide care for patients discharged form hospitals who briefly needed a higher level of care that was provided to a majority of patients in a skilled nursing facility. These distinct levels of care have been delineated primarily from the cost effectiveness perspective. |
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When we think of these places we think of hospitals. |
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Examples of these are: physician's offices, dental offices, medical and diagnostic laboratories or other ambulatory health services. |
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May be focused on primary, family, or specialty care. |
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Typically includes family care, internal medicine, and pediatrics, but also may focus on a particular specialty. |
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May represent medical specialties such as gastroenterology, or cardiology, surgical specialties such orthopedics or neurosurgery, or may reflect mental health care in the outpatient setting. |
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When we think of these, we think of medical and diagnostic laboratories. Diagnostic laboratories are typically involved with imaging: x-rays, C-T scans (Computerized Axial Tomography or CAT scan), M-R-Is (Magnetic Resonance Imaging), and mammograms. |
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Ultrasound imaging centers... |
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are examples of diagnostic laboratories. |
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usually deal with biologic specimens such as blood, cytology [sigh-TALL-uh-jee], or bacteriologic specimens. |
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Specialized medical laboratories... |
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include D-N-A testing laboratories, medical pathology laboratories, parasitology [pair-uh-sigh-TALL-uh-jee] and mycology health laboratories, toxicology health testing, and facilities that deal with non-radiologic, non- x-ray testing services. |
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Examples of ambulatory health services include: |
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Definition
Ambulance services, home health care, blood and organ banks, hearing and vision screening facilities, smoking cessation programs, hospice services, and visiting nurse services. |
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The health care industry.... |
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Definition
is one of the largest industries in the US. In 2008, 14.3 million jobs for wage and salary workers came from this industry. The industry comprises of almost 600,000 establishments and about three quarters of these establishments are the offices of physicians, dentists, or other health practitioners in the outpatient setting. It is interesting to note that while hospitals constitute only one percent of all health care establishments, they employ thirty-five percent of all health care workers. |
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Employment in establishments in the health services sector--from 2008: |
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*87& of establishments & 42& of jobs are in the ambulatory health care services *hospitals comprise 1.3% of establishments but employ 34.6% of the people who work in the health care industry. * Nursing & residential care facilities are about 11% of the establishments and employ about 23% of workers in the health services sector. |
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What is a health care system? |
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An organization that delivers health care. There are many variations and iterations of health care systems worldwide but two general rules apply: health care systems promote good health in population, and health care systems balance the levels of actual care provided with the expectations of the population that they serve. |
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The different models of health care systems are? |
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Definition
At the one end is a purely public system where care is entirely conducted by the state. On the other end is a purely private health care system model where care is conducted entirely by independent privately funded organizations. In reality, health care systems often exist in a mixed model that falls somewhere between these two extremes. Even in countries with state run health care systems, a private system may co-exist in parallel, and the private system may offer a full spectrum of services, or services that are not available under the public system. |
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Public health care systems |
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May be organized at the federal level. For example, the Veteran’s Health Administration provides health care for veterans through a series of outpatient and inpatient facilities run by the US Department of Veterans Affairs, which is the US government’s second largest department.
Public health care systems may also exist as a partnership between federal and state governments. |
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Examples of Public Health Care Systems |
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* Medicaid-- which is available to some, but not all economically disadvantaged patients *The Children’s Health Insurance Program- which covers uninsured children. |
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An example of Public health care systems organized at the local level |
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The Multnomah County Health Department, which provides clinical and public health services in Portland, Oregon. |
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Privately owned commercial organizations |
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may also act as health care systems. These organizations may serve a single area or they may serve multiple geographic locations that may be contiguous or disparate. |
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The "2" types of private health care systems are: |
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not-for-profit and for-profit |
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Not-for-profit organizations |
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Do not operate with the intent to make profits for private gain. Generally if not-for-profit organizations do generate a surplus, the profit is used to further the goals of the organization. These organizations are governed by the principle of non-distribution. |
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Distribute surplus funds to shareholders or owners. |
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Health care systems can be measured using benchmarks. An appropriate choice of benchmarks is essential for an accurate evaluation. One framework of assessment that was developed in New Zealand looked at patient assessed value - that is, timeliness, cost to the patient, and the extent to which patients’ expectations are met - and also looked at performance, clinical intervention, and efficiency. Developing robust performance benchmarks is essential in order to understand how health care systems function. |
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