Individual, Family and Community Health IV/ V Community Health

Official & Non-Official Agencies Official agencies (non-voluntary) Funded by tax dollars Run by federal, state, local (city/county) governments Federal – United States Public Health Service Investigate/control of infectious disease Protection from disease Interstate sanitation Health information Bureau of statistics An arm of Department of Health and Human Services

Official Agencies USPHS NIH … research (cancer, arthritis, childhood diseases, AIDS) FDA … protects public from harmful drugs; approves drugs for the market, HSA (Health Service Administration) … migrant, Indian health services; treatment of specific diseases (TB)

Official Agencies USPHS HSA (Health Service Administration) … health planning for the future CDC (Center For Disease Control and Prevention) … study/prevention of communicable disease; poison control center

Official Agencies Social Security Administration … administered by Health and Human Services Social Security … financial assistance, healthcare assistance, financial assistance for disabilities Medicare … national health insurance Medicaid … joint federal/state; disabled or AFDC

Agency Funding Federal … tax dollars State … legislature Local … city and/or county OCHD Vital statistics Immunization Family planning VD Pediatrics AIDS testing

Agency Funding Local … city and/or county Migrant Clinic Farm Worker Clinic Family Health Clinic

Non-official Agencies Also called voluntary Not regulated by government Private sector funding (United Way) Some paid employees, but many are volunteers American Red Cross Easter Seals American Cancer Society March of Dimes American Heart Association Cystic Fibrosis Foundation

What is Primary Care? The point at which the individual enters the health care system … Doctor’s office Hospital/emergency room Community health centers Urgent care centers

Functions of a Hospital Care of the sick/injured Prevention of disease Promotion of individual/community health Education Research

Classification of Hospitals Extended Care Facilities Classified by … Ownership Special services Length of stay

Classification … Ownership Public Private Federal (VA, military) State (University hospitals; Shands) Local (County/city; non in the area) Private For profit (ORHS, Florida Hospital) Non-profit

Classification … Special Services May be public or private Public … VA, Military, NIH Private non-profit … Shriner’s Burn Hospital Private for profit … Humana, HCA

Classification … Length of stay Acute care Long-term care Extended care

DRG’s Diagnostic Related Groups A math formula is used to arrive at a fee the government will pay for hospitalization Facility receives flat fee for length of stay DRG category (illness)

Methods of Payment For Health Care Personal Payment (private pay) Health Insurance Private Group Individual Health Plans Government-Sponsored Health Insurance Medicare (Social Security Medicaid (Medical Assistance)

Functions of Home Health Care Due to DRGs Patients are being discharged sooner and sicker Require follow-up care/nursing skills in home Care that is given includes ADLs VS Treatments/procedures Patient education Medication/Ivs

Functions of Extended Care Facilities Provide continuous skilled patient care following hospital discharge Can be short or long term Often used for rehabilitation Expected outcome is discharge home

Functions of Rehabilitation Services Can be done in ECF, special rehab facility, or a private setting Can be done in hospital on a special unit (BIRC – ORHS Lucerne) Rehabilitation can include physical, speech, hearing