Unit C Health Team Relations Health Care Systems Unit C Health Team Relations

Introduction Various health care systems deliver health care Health care is one of the largest and fastest growing industries in the United States Employs over 10 million workers in over 200 careers Two billion dollar per day business

Hospital Classification based on funding received Private – operated for profit – usually by pt. fees and/or organizations that provide financial support. Religious – religious support & Pt. fees Nonprofit or voluntary – Pt. fees & donations. Government – Tax monies and/or Pt. fees

General hospitals treat wide variety of conditions and age groups Provide diagnostic, medical, surgical and emergency care services.

Specialty Hospitals Care for certain conditions or age groups Examples: burn, oncology or cancer, pediatric or children, psychiatric, rehabilitation, and orthopaedic

Government Hospitals Operated by federal, state, and local government agencies World-wide facilities for government service personnel and their dependents Veteran’s Administration hospitals State psychiatric hospitals State rehabilitation centers

University or College Medical Centers Provide services, research and education Can be funded by private or government sources

Long Term Care Facilities (LTC or LTCF) Provide care for elderly, individuals with chronic of long-term illness Individuals receiving care are usually called residents instead of patients (or clients)

Nursing homes or geriatric homes Provide basic physical and emotional care Usually for individuals who cannot care for themselves Help individuals with activities or daily living (ADLs), provide a safe and secure environment, and promote opportunities for social interactions

Extended or skilled care facilities Provide skilled nursing and rehabilitative care Prepare resident for return to home environment or other long-term facility Some have subacute units: provide rehabilitation services for major illness or surgery, treatment for cancer, or treatments such as dialysis or heart monitoring

Extended or skilled care facilities Independent or assisted living facilities: individuals purchase or rent unit and can receive services such as meals, housekeeping, laundry, transportation, social events, and basic medical care

Medical Offices/clinics Services Diagnosis, tx, exams, labs, minor surgery Specialties (Examples include: Pediatrics, Cardiology, and Obstetrics) May be privately owned

Dental Offices/clinics Private offices to dental clinics employing several dentists Dental clinics now found in major retail/department stores Can provide general or specialized dental care

Clinics Satellite Clinics or Satellite Centers Found in many types of health care Can refer to group of medical/dental doctors who share a facility and other personnel Can be operated by corporation or private groups and provide special care

Clinic Types Surgical clinics or surgicenters: minor surgery Emergency care clinics: first aid to injured or ill pts. Rehabilitation clinics: physical, speech, occupational and etc.. Specialty Clinics: Diabetes or oncology (cancer) clinics Hospitals often operate clinics such as outpatient clinics

Clinics Health Departments offer clinics such as… Pediatric care Sexually transmitted diseases Respiratory diseases Immunizations Medical Centers also sponsor clinics

Optical Centers Can be individually owned by an ophthalmologist (eye doctor) or optometrist (eye specialist) or be part of a large chain of stores Provide vision examinations Prescribe eye glasses or contact lenses Check for the presence of eye diseases

Emergency Care Services Provide special care for accidents or sudden illness Ambulance services: private and governmental Rescue squads: frequently operated by fire departments Emergency care clinics ERs operated by hospitals Helicopter or airplanes

Laboratories Can be part of other facility or operated as separate health care service Medical laboratories: perform diagnostic tests Dental laboratories: prepare dentures and other devices

Home Health Care Provide care in patient’s home Services frequently used by the elderly and disabled Can be offered by health depts., hospitals, private, nonprofit & government agencies and volunteer groups

Examples Nursing care Personal care: bathing dressing, and so forth Therapy: physical, occupational, speech, respiratory Homemaking: food preparation, cleaning, washing, and so forth

Hospice Provide care for terminally ill persons with life expectancy of six months or less Care provided in person’s home or hospice facility Allows person to die with dignity and in comfort Provides psychological, social, spiritual, and financial counseling for both patient and family

Mental Health Facilities Deal with mental diseases and disorders Examples… Guidance and counseling centers Psychiatric clinics and hospitals Chemical abuse treatment centers for alcohol/drug abuse Physical abuse treatment centers (child or spouse abuse)

Genetic Counseling Centers Can be independent facility or within another facility. Consult with high risk families/pts Work with couples or individuals who are pregnant or considering a pregnancy.

Genetic Counseling Centers Perform prenatal (before birth) screening tests Checking for genetic abnormalities and birth defects Explaining the results of the tests Identifying medical options when a birth defect is present Helping individuals cope with the psychological issues caused by a genetic disorder

Rehabilitation Centers Provide care directed at helping patient with physical or mental disabilities obtain maximum self-care and function Can include hospitals, clinics, and/or private centers Services can include physical, occupational, recreational, speech, and hearing therapies

Industrial Health Care Centers Located in large industries or companies Provide care for employees of the industry Services: basic exams, teach accident prevention/safety, provide emergency care

School Health Service Found in schools and colleges and provide the following services… Emergency care for accidents and sudden illness Tests to check for health conditions: speech, vision, hearing, and so forth Promote health education Maintain safe and sanitary school environment Counseling, emergency care

3.02 Government agencies

1.03 Understand healthcare agencies, finances, and trends GHA International World Health Organization (WHO) founded in 1948 assess health trends compile statistics related to disease investigate health problems worldwide publish health information Government agencies are supported by taxes. Sponsored by the United Nations Compile statistics related to disease Publish health information Investigate health problems worldwide http://www.who.int/en/ 1.03 Understand healthcare agencies, finances, and trends

GHA National U. S. Department of Health and Human Services (USDHHS) investigate health problems in the United States prevent disease by immunizations provide comprehensive health services publish health information compile statistics related to disease http://www.hhs.gov/ 1.03 Understand healthcare agencies, finances, and trends

National Institutes of Health (NIH) GHA National National Institutes of Health (NIH) World’s leading research organization Research includes AIDS cancer Alzheimer’s diabetes arthritis heart disease http://www.nih.gov/ 1.03 Understand healthcare agencies, finances, and trends

Centers for Disease Control and Prevention (CDC) GHA National - Centers for Disease Control and Prevention (CDC) disease control disease prevention http://www.cdc.gov/ 1.03 Understand healthcare agencies, finances, and trends

GHA National - (USDHHS) Food and Drug Administration (FDA) - regulates safety of food and cosmetics - regulates safety and efficacy of drugs, biological products and medical devices http://www.fda.gov/ 1.03 Understand healthcare agencies, finances, and trends

GHA National - (USDHHS) Agency for Healthcare Research and Quality (AHRQ) Formerly called: Agency for Healthcare Policy and Research (AHCPR) investigate quality of healthcare delivery establish standards for healthcare treatment Established in 1991 Research quality of healthcare delivery Identify standards of treatment http://www.ahrq.gov/ 1.03 Understand healthcare agencies, finances, and trends

Occupational Safety and Health Administration (OSHA) GHA National ABC Occupational Safety and Health Administration (OSHA) Division of the US Department of Labor - create job safety standards - implement job safety standards http://www.osha.gov/ 1.03 Understand healthcare agencies, finances, and trends

Government Healthcare Agencies - State - (USDHHS) N. C. Department of Health and Human Services (NCDHHS) Functions to provide many services: Adoption Medicaid Deaf/blind services Mental health services Emergency services Pregnancy services Food and nutrition services Senior centers In-Homes Aides Vital records http://www.dhhs.state.nc.us/index.htm 1.03 Understand healthcare agencies, finances, and trends

GHA State - (USDHHS) N. C. Department of Health and Human Services - (NCDHHS) Functions to provide information: Disease and health information Safety End of life issues Teen issues Environmental health Wellness Minority health www.dhhs.state.nc.us/index.htm 1.03 Understand healthcare agencies, finances, and trends

GHA Local - (USDHHS, NCDHHS) County Health Department Services provided: Communicable disease control Laboratory services Health inspections Oral health Immunizations Woman and child health Provides information Health education Statistics related to health, birth and death 1.03 Understand healthcare agencies, finances, and trends

Private Healthcare Agencies Non-Profit Supported by donations fees fundraisers grants Usual focus: one disease or condition related group of disorders Examples Non-Profit Agencies are supported by donations, fees, fundraisers and grants. They usually focus on one disease or a related group of disorders. Non-profit agencies participate in research, public awareness and patient services. 1.03 Understand healthcare agencies, finances, and trends

Private Healthcare Agencies Non-Profit Participate in: Non-Profit Agencies are supported by donations, fees, fundraisers and grants. They usually focus on one disease or a related group of disorders. Non-profit agencies participate in research, public awareness and patient services. services education research 1.03 Understand healthcare agencies, finances, and trends

Nonprofit / Volunteer Agencies Examples… American Cancer Society American Heart Association American Respiratory Disease Association American Diabetes Association National Association of Mental Health National Foundation of March of Dimes American Red Cross HOSA

3.03 Health Insurance Plans

Insurance Terms Deductible: amount the patient must pay before the insurance starts to pay for services co-insurance: the percentage of the bill for services that the policy holder must pay co-payment (co-pay): a specific amount paid by the patient for each medical service, such as $15.00 for each doctor visit or each prescription filled

Healthcare Trends Cost Containment Measures Managed Care Designed to reduce the cost of healthcare Contacts with a specific group of providers Requires prior approval to see a specialist 1.03 Understand healthcare agencies, finances, and trends

Health Maintenance Organizations Provide total health care directed toward preventive care. Services: Preventive health care, basic medical services, health education, hospitalizations, rehabilitation.

Health Maintenance Organizations Mode of operation By large industries or corporations By private agencies Use services of other healthcare facilities including mental/dental offices, hospitals, rehab centers, home health care, clinics and laboratories.

Health Maintenance Organization (HMO) - Private Provide HC services for prepaid fee Stress prevention Cheaper to prevent than treat Disadvantage is limitations placed on which doctors and facilities can be used

Preferred Provider Organization (PPO) - private A group of doctors or hospital that agrees to provide HC at a reduced rate Usually offered by large companies Offers more flexibility to patients Pts pay lower rates if they select participating physician and facility

Medicaid Govt. Federally-funded health insurance low income, children, blind or disabled.

Medicare pts over age 65 Disabled people >2yrs social Security benefits End stage renal failure There are several types of Medicare Type A Type B Type C Type D

Type A Medicare Hospital Insurance Inpatient care, skilled nursing care and home health care. funded by Social Security taxes.

Type B Medicare Medical Insurance physician services, outpatient care, etc. Patient pays premium and 20% Medicare pays 80% for services.

Tricare AKA Champus Provides care for military dependents and retired members of the armed service.

Veterans Health Administration Mission Statement To fulfill President Lincoln's promise “To care for him who shall have borne the battle, and for his widow, and his orphan” by serving and honoring the men and women who are America’s veterans. http://www.va.gov

Worker’s Compensation Administered by the state Pays both the medical bills and the wages for employee injured on the job Payments are made by employers and the state

Summary Many different types of health care facilities Employ many types of health care workers Important to be aware of facilities and type of services Important to be aware of different insurance plans