Transcript Health Care Systems

Private Health Care Facilities
Private Health Care Facilities
 Health care systems include the many agencies,
facilities, and personnel involved in the delivery of
health care.
 According to the U.S. Government, health care is one
of the largest and fastest-growing industries in the
United States.
 Most private health care facilities require a fee for
services.
Types of Facilities
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Hospitals
Long term care facilities
Medical Offices
Dental Offices
Clinics
Optical Centers
Emergency Care Centers
Laboratories
Home Health Care
Hospice
Mental Health
Genetic Counseling Centers
Rehabilitation
Health Maintenance Organizations (HMO’s)
Industry Health Care Centers
School Health Services
Hospitals
 One of the major types of health care facilities.
 Vary in size and types of services provided.
 Some are small and serve the basic need of a
community; others are large, complex centers offering
a wide range of services including diagnosis,
treatment, education and research.
Hospitals (Cont’d)
 Classified as private or proprietary (operated for
profit), religious, nonprofit, and government.
 Some are general hospitals treating a wide range of
conditions; others are specialty caring for only special
conditions or age groups.
Examples of Specialty Hospitals
 Burn Hospitals
 Pediatric Hospitals (or Children’s)
 Psychiatric Hospitals
 Oncology (cancer) Hospitals
Other Types of Hospitals
 Government- operated by federal, state, and local
government agencies.
 Ex. Veterans Administration hospitals, state
psychiatric hospitals
 College or University Hospitals provides services along
with research and education.
Long-term care facilities
 Provide assistance and care for elderly patients,
individuals with disabilities or handicaps, and
individuals with chronic or long term illness.
 Some facilities are called nursing homes or geriatric
homes.
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These are designed to provide basic physical and emotional
care to individuals who can no longer care for themselves.
Other Long term care facilities
 Extended care facilities or skilled care facilities –
these are designed to provide skilled nursing care
and rehabilitative care to prepare patients for
return to home environments or other long-term
care facilities.
 Independent living and assisted living- allow
individuals who can care for themselves, but
services such as meals, housekeeping, laundry,
transportation, and basic medical care, are
provided.
LTC’s cont’d.
 Most assisted or independent living facilities are
associated with nursing homes, extended care
facilities, and/or skilled care facilities.
 The need for long-term care facilities has increased
dramatically b/c of the large increase in the number of
elderly people.
 Therefore, many health career opportunities are
available in these facilities.
Medical Offices
 Vary from offices that are privately owned by only 1
doctor to large complexes that operates corporations
and employ many doctors and other health care
professionals.
Medical Offices
 Some Medical Doctors treat a wide variety of illnesses
and age groups (ie Family Practitioner, General
Practitioner, Primary Care Physician)
 Others specialize in and handle only certain age
groups or conditions (ie Pediatrics (infant and
children) Nephrologists (Kidney) Oncologist
(cancer)).
Medical Offices cont’d
 Some medical services obtained in these facilities:
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Diagnosis-determining the nature of an illness
Treatment
Examination
Basic Laboratory testing
Minor surgery
Dental Offices
 Vary in size from offices that are privately owned by 1
or more dentists to dental clinics that employ a
number of dentists.
 Dental services can include general care provided to all
age groups or specialized care offered only to certain
age groups or dental conditions
Clinics
 Aka satellite clinics or centers
 Composed of a group of medical or dental doctors who
share a facility.
 Examples include Surgical Centers (minor surgical
procedures), urgent care, rehabilitation.
 Health Departments offer- pediatric health care,
treatment for sexually transmitted diseases and
respiratory diseases (Tuberculosis) immunizations,
and other special services.
Optical Centers
 Individually owned by ophthalmologist (Medical
Doctor) or optometrist (licensed, nonmedical
practitioner).
 Or part of a large chain of stores.
 Provide vision examinations, prescribe eyeglasses or
contact lenses, and check for presence of eye diseases.
Emergency Care Services
 Provide special care for victims of accidents or sudden
illness.
 Facilities: Ambulance Services (both private and
governmental); emergency care clinics, emergency
rooms operated by hospitals; and helicopter or
airplane emergency medical services
Laboratories
 Often these are part of other facilities but can operate
as separate health care services.
 Laboratories perform special diagnostic tests such as
blood and urine tests.
 Dental Laboratories can prepare dentures (false teeth)
and other devices used to repair teeth.
Home Health Care
 Agencies that provide care in the patient’s home.
 Frequently used by the elderly and disabled.
 Examples of services include, nursing care, personal
care, therapy (physical, occupational, speech etc).
Hospice
 Agency that provides care for the terminally ill
(persons with life expectancies of 6 mos or less).
 Provided in patient’s home or hospice facility.
 Main goal is to make patient comfortable, so it
increase their quality of life. Allowing a that pt to die
with dignity and comfort.
Mental Health
 Facilities that treat pt’s w/ mental disorders and
diseases.
 Examples: guidance and counseling centers,
psychiatric clinics and hospitals, chemical abuse
treatment centers (dealing w/ drug and alcohol abuse)
Genetic Counseling Centers
 Independent facilities or shared facility
 Works with couples or individuals who are pregnant or
trying to get pregnant.
 Perform prenatal screening tests, check for genetic
abnormalities and birth defects, explain the results of
the tests, identify medical options when birth defects
are present.
Rehabilitation
 Facilities located in hospitals, clinics, and/or private
centers.
 Provide care for to help pt w/ physical or mental
disabilities obtain maximum self-care and function.
 Services include: physical, occupational, recreational,
speech, and hearing therapy
Health Maintenance Organizations
(HMO’s)
 Provide total health care directed toward preventative
health care.
 Includes: examinations, basic medical services, health
education, and hospitalization.
 Some operated by large industries or corporations;
others private agencies.
Industrial Health Care Centers
 Occupational health clinics found in large companies.
 Provide health care for employees of the industry or
business.
School Health Services
 Found in schools or colleges
 Provide emergency care for victims of accidents,
sudden illness; perform tests to check for health
conditions such as speech, hearing problems; they
promote health education; and maintain a safe and
sanitary school enviornment.
INFORMATION
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Government Agencies:
I.
World Health Organization (WHO)- an
international agency sponsored by the United
Nations.
a)
b)
c)
Compiles statistics and information on disease
Publishes health information
Investigates and addresses serious health problems
throughout the world
Gov’t Agencies Cont’d.
II. U.S. Department of Health and Human Services
(USDHHS)- a national agency that deals with the
health problems in the United States.
a.) National Institutes of Health (NIH)involved in research of disease.
b.) Centers for Disease Control and Prevention
(CDC)- concerned with causes, spread, and control of
diseases in populations .
USDHHS cont’d
c.) Food and Drug Administration (FDA)- a federal agency
responsible for regulating food and drug products sold to
the public
d.) Agency for Health Care Policy and Research (AHCPR)- a
federal agency established in 1990 to research the quality of
health care delivery and identify the standards of treatment
that should be provided by health care facilities.
e.) Occupational Safety and Health Administration (OSHA)establishes and enforces standards that protect workers
from job-related injuries and illnesses.
USDHHS cont’d
f.) Health Departments- (state and local; county and city)
provides health services directed by the USDHHS and also
provides specific services needed by the state or local
community.
-Examples- immunizations, inspections for
environmental health and sanitation, communicable
disease control, collection of statistics, health education
Voluntary or Nonprofit
Agencies
 Supported by donations, membership fees,
fundraisers, and federal or state grants.
 examples: American Cancer Society, American Heart
Association, March of Dimes, American Red Cross
Many organizations focus on one specific disease or group
of diseases.
Health Insurance Plans
 Offered by several thousand insurance companies.
 The amount of payment and the types of services
covered vary from plan to plan.
 Deductibles- are amounts that must be paid by the
patient for medical services BEFORE the policy begins
to pay.
Health Insurance Plan con’t
 Co-insurance- requires that a specific percentage of
your expenses are shared by the pt and insurance
company.
 Co-payment- a specific amount of money a pt pays for
a particular service, paid at time of service regardless
of the total cost of the visit.
Health Ins cont’d
 HMO- another type of health ins plan- monthly fee is
paid for membership, fee stays the same regardless of
cost of services. Total care provided is directed towards
preventative type health care.
 good bc most other ins plans do not cover preventative
care
 Bad bc insured required to use only HMO affiliated
providers.
Health Insurance Plan cont’d
 Preferred Provider Organization (PPO)- another type
of health ins plan usually provided by large industries
or companies to their employees.
 Industry contracts w/ certain health care agencies, and
employees are restricted to using these specific agencies,
but provided at a lower cost.
Health Insurance cont’d
 Medicare- a federal Gov't program, providing health
care to individuals 65 years or older, or any person w/ a
disability who has received social security benefits for
at least 2 years.
 2 types of coverage:
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Type A- hospital insurance
Type B- medical insurance
 Individual does pay a premium for type B and also an initial
deductible for services
Health Insurance cont’d
 Medicaid- operated by individual states- usually for
people with low incomes, children who qualify for
public assistance, and individuals who are physically
disabled or blind.
 State Children’s health insurance plan- (SCHIP)-
provides health care to uninsured children of working
families who earn too little for private insurance but too
much for Medicaid.
Health Insurance Plan cont’d
 Workers’ Compensation- provides treatment for
workers injured on the job. It also reimburses the
worker for wages lost b/c of on-the-job injury.
 TRICARE (formerly called CHAMPUS)- provides care
for active duty members and their families, survivors
of military personnel, and retired members of the
armed forces.
Organizational Structure
 Organizational structure always encompasses a line of
authority or chain of command. It should indicate
areas of responsibility and lead to the most efficient
operation of the facility.
 It is important for health care workers to identify and
understand their respective positions in a given facility’s
organizational structure.
Organizational Structure cont’d
 Health care workers must always take questions,
reports, and problems to their immediate supervisors,
who are responsible for providing necessary assistance.
 It is also important for health care workers to
understand the functions and goal of the organization.