Heath Care Systems

Mrs. OplandHealth Careers

Health Care Facilities

Hospitals

• Operated by Religious Organizations– Care given in accordance with religious beliefs

• Specialized Hospital– Provide care for specific illnesses– Health Care Workers highly trained

to meet the needs of theses groups

• Operated by Government– Operated by federal, state, and local

government agencies– Provide care for government service personnel

and their dependents– Veterans Administration hospitals, State

psychiatric hospitals, state rehabilitation centers

• Private– Has Shareholders – people who invest money

and expect a profit or return on their investment.

– Client have to pay to use these facilities

• Nonprofit – The goal is not to have a profit, but to return

any profit for improvements in the hospital

Long-term Care Facilities• Mainly provide care for elderly

patients called residents• Also provide care for individuals

with disabilities or handicaps and individuals with chronic or long-term illnesses

• May also be called a nursing home, geriatric care facility, or skilled care facility

Independent or Assisted Living Facilities

• Allows individuals who can care for themselves to rent or purchase an apartment in the facility

• Services such as meals, housekeeping, laundry, transportation, social events, and basic medical care are provided

• May offer day care….

Clinics

• Composed of a group of medical or dental doctors who share a facility and other personnel

• Examples: surgicenter, cancer center, outpatient centers

Laboratories

• Often a part of other facilities but may operate as a separate health care service

• Medical Laboratory: perform special diagnostic tests on blood or other body fluids to make a diagnosis.

• Dental laboratory: prepare dentures (false teeth) and many other devices used to repair or replace teeth

Emergency Care Services

• Provide care for ill and injured people as quickly as possible.

• Ambulances, rescue squads, emergency care clinics/centers, helicopter or airplane emergency services, emergency rooms often located in a hospital.

Home Health Care

• Prove care in a patient’s home• Used by disabled or elderly• Examples: nursing care, personal

care, therapy, homemaking

Rehabilitation Facilities

• Provide care to help patients with physical or mental disabilities obtain maximum self-care and function

• Services may include physical, occupational, recreational, speech and hearing therapy

Hospice• Special Care for clients who have a

terminal illness.• Goals of Hospice:

– Improve quality of life– Use pain meds effectively– Relieve symptoms– Prepare the person and his or her family for

death

Hospice

• Care can be given in the home or in a hospice facility

• Care is directed at allowing the person to die with dignity and in comfort

• Psychological, social, spiritual, and financial counseling are provided for both the patient and the family

Dental Offices

• Dental services can include general care provided to all age groups or specialized care

• Services may include teeth examination, filling teeth, prosthetics, x-ray, orthodontic services, minor surgery

Optical Centers

• Provide vision examinations, prescribe eyeglasses or contact lenses, and check for the presence of eye diseases.

Mental Health Facilities

• Treats patients with mental disorders and diseases

• Examples: guidance and counseling centers, psychiatric clinics, chemical abuse treatment centers, and physical abuse treatment centers

Industrial Health Care Centers

• Occupational health clinics found in large companies or industries

• Proved health care for employees of the industry or business by performing basic examinations; teaching accident prevention and safety; and providing emergency care

School Health Services

• Found in schools and colleges• Provide emergency care, perform

tests to check for health conditions, promote health education, and maintain a safe and sanitary school environment.

• May provide counseling

Government Agencies

Health Departments

• Provide health services as directed by the Department of Health and Human Services

• State and local (county and city)• Examples of services: immunizations,

inspections for environmental health and sanitation; communicable disease control; collection of statistics; health education; clinics for health care and prevention

Centers for Disease Control and Prevention - - CDC

• Concerned with causes, spread, and control of diseases in populations

Food and Drug Administration

- FDA -• Responsible for regulating food

and drug products sold to the public in the US

World Health Organization - WHO -

• International agency • Compiles statistics

and information on disease, publishes health information, and investigates and addresses serious health problems throughout the world

WHO Definition of Health

• Health is not merely the absence of disease, but total physical, social and psychological health

Occupational Safety and Health Administration - OSHA• Establishes and enforces standards

that protect workers from job-related injuries and illnesses

Voluntary or Nonprofit Agencies

• Supported by donations, membership fees, fundraisers, and federal or state grants

• Examples: American Cancer Society, American Diabetes Association, March of Dimes, American Red Cross,

• Provides funding for research directed at curing or treating the disease, and promotes public education

Health Insurance

Definition

• Health insurance plans help pay for the costs of health care

Terminology

• Premium: payment made to insurance company for health care coverage

• Deductibles: amounts that must be paid before the insurance company pays

• Co-insurance: requires that specific percentages of expenses are shared by the patient and insurance company

• Co-payment: a specific amount of money a patient pays for health care services

• HMO: Health Maintenance Organization– a monthly fee is paid for membership, fee stays the

same regardless of the amount of health care used.– Total care is directed at preventative care

• PPO: Preferred provider organization– a contract is formed between a company and a health

care provider to provide health care at a reduced rate– Employees are restricted to using a specific agency

• Medicare: government program that proveds health care for almost all individual over the age of 65 and for any person with a disability who has received social security benefits for 2 years– pays 80% of bill, patient responsible for 20%

• Medicaid: medical assistance program operated by individual states– Usually pays for trhe health care of individuals with

low incomes,l children who qualify for public assistance, and individuals who are physically disabled or blind

• Workers Compensation: health insurance plan providing treatment for workers injured on the job– Paid for by the employer– Reimburses the worker for wages lost because

of on-the-job injury

• Managed Care: all health care must have a purpose– A second opinion or verifidcation of need is

frequently needed before care is paid for

• Military Health Care– Also known as CHAMPUS/TRICARE– Health Care program for active and retired

military personnel and veterans.

Organizational Structure

• Encompasses a line of authority or chain of command

Mrs. Opland

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Trends in Health Care

Cost Containment

• Means trying to control the rising cost of health care

• Methods used to control costs – Diagnostic related groups (DRGs): patients with

certain diagnosis are classified as one payment group – a limit is place on the amount pay for services

– Combination of Service: done to eliminate duplication of service

– Outpatient Services: patients receive care without being admitted to the hospital or other care facility

• Mass or bulk purchasing: buying equipment and supplies in large quanities

• Early intervention & preventative care: providing care before acute or chronic disease occurs – preventing illness

• Energy conservation: monitoring the use of energy to control costs

Home Health Care

• With DRGs and shorter hospital stays there is a need for providing care in the home

Geriatric Care• Care for the elderly• Due to longer life spans, baby

boom generation• Omnibus Budget Reconciliation

Act: (OBRA): This act requires states to:– establish training and competency evaluation

programs for nursing and geriatric assistants:– Continuing education, periodic evaluation of

performance, retraining or retesting if a nursing assistant does not work for more than two years

– Compliance with Patient Rights

Telemedicine

• Involves the use of video, audio and computer systems to provide medical and/or health services

Alternative medical care

• Massage therapy• Aroma therapy• Accupuncture• Hypnosis• Herbal medicine• Bee stings• Rattle snake bites