HEALTH CARE SERVICES

-The health care industry is moving toward health care practices that emphasizes managing health rather than managing illness -the health services pyramid is a model of improving health care -the pyramid shows that the population based health care services provide the basis for preventive services. -achievements in the lower tier of the pyramid contribute to improvement of health care delivered at the higher level of pyramid

Tertiary health care Secondary health care Primary health care Clinical preventive services Population based health care

Levels of health care -the health care system has six level- preventive, primary, secondary, tertiary, restorative and continuing care 1.Preventive and primary health care services -settings which deliver these services include schools, physicians or health care providers office, occupational health clinic, nursing centers etc. -major theme is health promotion

-the focus of health promotion is to keep people healthy through personal hygiene, good nutrition, clean environment, regular exercise and positive health attitudes -health promotion programmes lower the overall visit of health care by reducing the incidence of disease -primary level of health care include medical and health care service as well as health education, nutritional counseling, MCH care, family planning etc.

-health care providers build interventions that lead to improved health out come for an entire population -sub centre, primary health centre, community health centre 2. Secondary care ( District hospitals) -the secondary level of care is the traditional acute acre setting in which patients who have signs and symptoms of disease are diagnosed and treated by the health care provider Settings a)hospitals-emergency department, critical care unit, inpatient outpatient unit etc.

b) Psychiatric facilities-patient who have psychiatric problems are treated at psychiatric facilities c) Rural hospitals 3.Tertiary health care -eg. Medical college hospitals 4. restorative care -it include settings in which patients who are recovering from illness or disability receive rehabilitation and supportive care

-care is necessary until patient return to their previous level of function -the goal is to assist individual to regain maximal level of function Services provided are a) Home care -provide professional and para professional services to patient and their families at their homes. Services provided include health maintenance, education, illness prevention, diagnosis and treatment and rehabilitation

b) Rehabilitation -combined and coordinated use of medical, social, educational and vocational measures for training and retraining the individual to the highest possible level of functional ability -it occurs in many health care settings like specific rehabilitation institutions, out patient settings and home

c) Extended care facilities -provide intermediate, medical, nursing care for patients recovering from acute illness or patient with chronic illness or disabilities -because hospital discharge their patients sooner, there is a great need of intermediate care setting

5) Continuing care -continuing care describe a variety of health, personal and social services provided over a prolonged period of time, who are disabled, who suffer a terminal illness and not functionally independent -it is available within institutional settings ( nursing centers, nursing home) retirement communities(adult day care and senior centers)

Services provided are a) Nursing centers or facilities -it provide 24 hour intermediate and custodial care for residents of any age with chronic or debilitating illness -care provided usually include rehabilitation, dietary, recreational, social and religious services

b) Assisted living -it refers to an attractive long term care setting with a homier environment and greater resident autonomy -patient require some assistance with ADL, but remain relatively independent within a partially protective setting -a group of residents live together, but each resident has his or her own room and share dining and social activity areas

c) Respite care -service that provide short term relief or time off for persons providing home care to an ill, disabled older adult -the family care giver is able to leave the home and a responsible person stays in the home to care for the loved one

d) Adult day care centers -provide a variety of home and health service to specific patient population who live alone or with family -services offered during the day allow family members to maintain their lifestyle and employment and still provide home care for their relatives -services include transportation, assistance with personal care, nursing and therapeutic services, meals and recreational activities

e) Hospice -system of family centered care that allow patient to live and remain at home with comfort, independence and dignity while alleviating the strain caused by terminal illness -focus is palliative care -patient enter into hospice at their terminal phase of the illness and staff members provide care that ensure death with dignity in the patients home

1.Preventive and primary health care services -sub centre , PHC, CHC 2. Secondary care - District hospitals 3.Tertiary health care Medical college hospitals 4. restorative care -home care, rehabilitation, extended care facilities

5) Continuing care -nursing centers, assisted living, adult day care centers, respite care, hospice care