Health Care Systems.

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Presentation transcript:

Health Care Systems

HEALTH CARE Health care - one of largest and fastest growing industries in the United States Health care facilities include hospitals, LTCF’s, assisted living facilities, medical offices, dental offices, clinics, labs, industrial services, school health services

How are hospitals classified? By the services they provide The source of income received Private or Proprietary Religious Nonprofit or Voluntary Government

Classifications and types can overlap Types of hospitals General - treat wide range of conditions, age groups Specialty - care for specific conditions or age groups ( cancer, pediatric, psychiatric, rehab) Government - operated by government agencies (ex. Veterans Admin) University or college medical center - provide research, education, along with services Classifications and types can overlap

Assisted Living Facility (ALF) Individuals that can care for themselves but need assistance with meal preparation, housekeeping, laundry and transportation

Long Term Care Facility ( LTCF) Residential Care Facility - ex. Nursing home, helps residents with ADL’s, can provide care to those no longer able to care for themselves, promote opportunities for social interactions, Extended care or skilled care - designed to rehabilitate patient for return to home or another long term care facility, help patients recover from an illness or surgery

Medical Office - can be large or small, can include services that diagnosis, treat, provide exams, lab testing, minor surgery and other care. Examples - pediatric office, cardiology office, ob/gyn office Dental Office - can be an office of one dentist or a dental clinic that has many dentists

Clinics are also called satellite clinics or satellite centers - can be a group of doctors or can be operated by a private group who provide special care. Examples are surgical centers, urgent care, rehab clinics, substance abuse, outpatient, health department clinic, specialty clinics (dialysis center) Surgical Center or Surgicenter

Optical centers - provide vision exams, contact lens, glasses Emergency Care - Provide care for accidents and sudden illness. Examples, ER department in the hospital, rescue squads ( like the fire department ), ambulance services Laboratory - can be separate or a part of a facility, perform special diagnostic tests such as blood and urine tests Mental Health - help those with mental disorders, examples are chemical, physical, alcohol and drug abuse centers, counseling centers, and psychiatric clinics

Hospice - an agency that provides care to patients with a life expectancy of 6 months or less Home Health Care - provide care in a patient’s home, examples include respiratory, physical and speech therapy, and nursing care Genetic Counseling Centers Can perform prenatal screening, check for genetic abnormalities and birth defects Rehabilitation Facility - can be in a hospital, clinic, or private center. May include speech, occupational, hearing therapy.

Health Maintenance Organization (HMO) A provider of managed care. It is a type of health insurance and a health care system. Services include exams, basic medical services, hospitalization, or rehab services, aimed at preventive care Industrial Health Care Center also called Occupational Health Clinic Found in large companies or industries, may provide basic exams for their employees, accident prevention and safety and provide emergency care School Health Services Found in school and colleges, check for speech, vision and hearing problems, provide care in an emergency, maintain a safe school environment

Government Agencies

Centers for Disease Control and Prevention (CDC) Concerned with the causes, spread, and control of diseases in populations Food and Drug Administration (FDA): Regulate food and drug products sold to the public National Institutes of Health (NIH): Involved with research on disease

Occupational Safety and Health Administration (OSHA) Establish and enforce standards that protects workers from job related injuries and illnesses U.S. Department of Health and Human Services (USDHHS): A national agency that deals with health problems in the United States World Health Organization (WHO) An international agency sponsored by the United Nations. Investigate health problems throughout the world

https://quizlet.com/_5kgnri Quizlet Practice Government Agencies https://quizlet.com/_5kgnri

Voluntary Agencies Also called a nonprofit agency, can be at national, state or local level Supported by donations, fund raisers, membership fees, and/or grants Examples: March of Dimes, American Red Cross, Autism Speaks, American Diabetes Association

Health Insurance Plans To help pay for costs of health care, most people rely on health insurance plans. Premium - fee that the person pays for insurance coverage Deductible - amount out of pocket a person pays before insurance will pay Co-insurance - specific percentage of expenses are shared by the patient and ins company Co-payment - specific amount person pays at the time of service

Preferred Provider Organization (PPO) - insurance has a contract with certain providers, which are the doctors and hospitals the employee is to use. If employee uses a provider outside of network, employee may pay more A managed care that may be provided to employees of a large company or industry.

Federal Government Health Insurance Programs Medicare - for persons over the age of 65 and those with a disability that has received Social Security benefits Medicaid operated by each state but jointly funded by state and federal government

Workers’ Compensation - for workers injured on the job, it is paid for by employers and the state. It also covers lost wages because of an on the job injury TRICARE - a U.S. government health insurance plan for military personnel. The Veterans Administration provides for military veterans.

Managed Care A health care delivery system designed to reduce the cost of health care while providing access to care through designated providers. Provide quality care at the lowest possible cost. Person is restricted in their choice of providers. PPO’s and HMO’s are providers of managed care.

Health Insurance Plans and Organizational Structure Quizlet Review Health Insurance Plans and Organizational Structure https://quizlet.com/_5lgwo6

The Health Insurance Portability and Accountability Act This act was passed in 1996. Federal regulations that protect confidentiality of patient information and the ability to retain health insurance. Has five main components HIPAA

HIPAA

Patient Protection and Affordable Care Act Designed to expand access to affordable health coverage in the United States Signed into law in 2010 Young adults can be covered under their parents until 26 yo Requires insurance to charge the same premium to all applicants regardless of preexisting conditions

Organizational Structure All health care facilities have organizational structure It can be simple or complex Organizational structure is the line of authority, or chain of command Indicates areas of responsibility Should lead to the most efficient operation of the facility