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Instructor’s Name Semester, 200_. Chapter Objectives. Define the term health care system. Trace the history of health care delivery in the United states from the mid-nineteenth century to the present. Discuss and explain the concept of the spectrum of health care delivery. - PowerPoint PPT Presentation
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Chap 13: Health Care System: Structure
Instructor’s Name
Semester, 200_
Chap 13: Structure
Chapter Objectives
• Define the term health care system.
• Trace the history of health care delivery in the United states from the mid-nineteenth century to the present.
• Discuss and explain the concept of the spectrum of health care delivery.
• List and describe the different levels of medical practice.
Chap 13: Structure
Chapter Objectives
• Distinguish between the different kinds of health care, including public health practice, medical practice, and long-term practice.
• List and characterize the various groups of health care providers.
• Explain the differences among allopathic, osteopathic, and nonallopathic providers.
• Define complementary and alternative medicine.
Chap 13: Structure
Chapter Objectives
• Explain why there is a need for health care providers.
• Prepare a list of the different types of facilities in which health care is delivered.
• Explain the differences among private, public, and voluntary hospitals.
• Explain the concept behind ambulatory care facilities.
Chap 13: Structure
Chapter Objectives
• Define home health care and explain the reason why this setting is being used more to deliver care.
• Explain what the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) does.
Chap 13: Structure
Health Care System: Structure• American Delivery System
– Variety of Providers– Variety of Settings
• Concerns– Informal Cooperation of Providers– Disease Treatment vs Health Care – Conglomeration vs System
Chap 13: Structure
Brief History of U.S. Health Care
Chap 13: Structure
Brief History of U.S. Health Care
18501850
TimelineTimeline
19971997
Chap 13: Structure
Brief History of U.S. Health Care
18501850
Before 1850 - Medical Treatment occurred in Before 1850 - Medical Treatment occurred in HomeHome
19971997
Chap 13: Structure
Brief History of U.S. Health Care
18501850
Treatment moved to Physician’s Office & HospitalTreatment moved to Physician’s Office & Hospital
1997199719001900
Home
Chap 13: Structure
Brief History of U.S. Health Care
18501850 1997199719111911
Home
Hospitals
1st Insurance
Chap 13: Structure
18501850
3.9% of GDP spent on Health Care3.9% of GDP spent on Health Care
1997199719111911
Home
Hospitals
19291929
1st Insurance
Brief History of U.S. Health Care
Chap 13: Structure
18501850
Age of MedicineAge of MedicineNIH EstablishedNIH EstablishedHill-Burton ActHill-Burton Act
1997199719111911
Home
Hospitals
1st Insurance
2.9% GDP
19301930 19501950
Brief History of U.S. Health Care
Chap 13: Structure
18501850
Medicare & MedicaidMedicare & Medicaid
1997199719111911
Home
Hospitals
1st Insurance
2.9% GDP
19301930 19651965
Age of Medicine
19501950
Brief History of U.S. Health Care
Chap 13: Structure
18501850
Cost ContainmentCost Containment- Health Systems Planning- Health Systems Planning
-Health Maintenance Organization Act-Health Maintenance Organization Act
1997199719111911
Home
Hospitals
1st Insurance
2.9% GDP
19301930 19651965
Age of Medicine
19501950
Medicare &Medicaid
1970s1970s
Brief History of U.S. Health Care
Chap 13: Structure
18501850
American HealthAmerican Health Security Act of 1993Security Act of 1993
1980s1980s19111911
Home
Hospitals
1st Insurance
2.9% GDP
19301930 19651965
Age of Medicine
19501950
Medicare &Medicaid
1970s1970s
Cost Containment
19971997
Brief History of U.S. Health Care
Chap 13: Structure
18501850
14% GDP 14% GDP
1980198019111911
Home
1st Insurance
2.9% GDP
19301930 19651965
Age of Medicine
19501950
Medicare &Medicaid
19701970
Cost Containment
Increased Costs
19921992
Brief History of U.S. Health Care
Chap 13: Structure
1993 National Survey
Major Concerns in the U.S.1. Medical Care Cost1. Medical Care Cost
2. Drug Abuse2. Drug Abuse
3. Budget Deficit3. Budget Deficit
4. Crime4. Crime
5. Unemployment5. Unemployment
6. AIDS6. AIDS
Chap 13: Structure
Health Care Spending
(Select countries: 1960 & 1997)
$0
$500
$1,000
$1,500
$2,000
$2,500
$3,000
$3,500
$4,000
$4,500
1960 1997
Australia
Canada
Finland
France
Ireland
Norway
Sweden
UnitedKingdonUnited States
Chap 13: Structure
Spectrum of Health Care Delivery• Public Health Practice
– education is primary component
• Medical Practice– primary– secondary– tertiary
• Long-term Practice– restorative care– long-term care
Chap 13: Structure
Public Health Practice• Education
– provides information– empowers– motivates
• Settings– Governmental health agencies– Voluntary health agencies– Social Services agencies– Schools– Business and industry
Chap 13: Structure
Spectrum of Health Care Delivery• Public Health Practice
– education is primary component
• Medical Practice– primary– secondary– tertiary
• Long-term Practice– restorative care– long-term care
Chap 13: Structure
Primary Medical Care
• Education
• Promotion of nutrition
• Safe water and sanitation
• Maternal and child health care
• Immunization
• Prevention and control of endemic disease
• Treatment
• Essential drugs
Chap 13: Structure
Secondary Medical Care• Specialized care
– provided by physicians
– hospital or outpatient
– emergency care
Chap 13: Structure
Tertiary Medical Care
• Highly specialized
• For those with unusual or complex conditions
• Specialized hospitals
• Academic health centers
Chap 13: Structure
Spectrum of Health Care Delivery• Public Health Practice
– education is primary component
• Medical Practice– primary– secondary– tertiary
• Long-term Practice– restorative care– long-term care
Chap 13: Structure
Long-term Practice
• Restorative care
• Long-term care
Chap 13: Structure
Health Care Providers
• Independent ProvidersAllopathic – specific remedies include drugs or medicationOsteopathic – recognition of reciprocal interrelationship
between the structure & function of the bodyNonallopathic– chiropractors, acupuncturists, naturopaths,
homeopaths
Chap 13: Structure
Health Care Providers
• Limited Care– have advance training in a health specialty and
are licensed to practice it
• Examples– dentists, optometrists, podiatrists, &
psychologists
Chap 13: Structure
Nurses• Licensed Practical Nurses (LPN) &
– 1-2 yrs of training & carry out non-technical duties
• Registered Nurses (RN)– associate or baccalaureate degree & state
license
• Bachelor of Science in Nursing (BSN)– prepared for additional activities involving
independent judgment
• Advanced Practice Nurse (APNs)
Chap 13: Structure
Registered Nurses
Nurse Practitioner
(NP)
NP CNSClinical Nurse
Specialist (CNS)
Nurse MidwifeNurse
Anesthetist
Chap 13: Structure
Allied & Professional Health Care Providers• Allied Health Care Professionals
– provide services that assist, facilitate, & complement work of physicians
– dietitians, physical therapists, medical technologists, EMTs, & speech therapists
• Public Health Professionals– work in public health clinics & voluntary
agencies– environmental health workers, administrators,
epidemiologists, health educators, & biostatisticians
Chap 13: Structure
Health Care Facilities
• Practitioner Offices – Privately owned practices
• Clinics
• Hospitals– Private– Public– Voluntary
• Ambulatory Care
Chap 13: Structure
Health Care Facilities
• Rehabilitation Centers– Long-term care options– Home health care
• Continuing Care– chronic, respite, hospice, & home care
• Accreditation
Chap 13: Structure
Chapter 13Chapter 13
Health Care System:Health Care System:
StructureStructure
