1. Unit C Health Team Relations
Health Care Systems
Unit C
Health Team Relations

2. Introduction Many different 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

3. Hospitals Specialty Hospitals
Vary in size and type of service provided
General hospitals treat wide range of conditions
Typically our small town hospitals
Specialty Hospitals
Care for certain conditions or age groups
Examples: burn, oncology or cancer, pediatric or children, psychiatric, rehabilitation, and orthopedic
Example – Duke Children’s Hospital

4. 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
Example: Fort Bragg Army Hospital, Naval Hospital at Camp Lejeune

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

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

7. Long-term care facilities Nursing homes or geriatric homes
Provide basic physical and emotional care
Usually for individuals who cannot care for themselves
Help individuals with activities of daily living (ADL’s), provide a safe and secure environment, and promote opportunities for social interactions

8. Extended care or skilled care facilities
Provide skilled nursing and rehabilitative care – could be temporary for clients between hospital stay and returning to home.
Prepare resident for return to home environment or other long-term facility
Some have sub-acute units: provide rehabilitation services for major illness or surgery, treatment for cancer, or treatments such as dialysis or heart monitoring

9. Extended care 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

10. Medical Offices Services Diagnosis- determine illness
Treatment – helping to get well
Examinations
Basic laboratory tests
Minor Surgery
Specialties (Examples include: Pediatrics, Cardiology, and Obstetrics)

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

12. 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

13. Clinics
Other clinics operated by corporation or private groups and provide special care:
Surgical clinics or surgicenters
Emergency care clinics
Rehabilitation clinics
Specialty Clinics: Diabetes or oncology (cancer) clinics
Hospitals often operate clinics such as outpatient clinics

14. Clinics Health Departments offer clinics such as… Pediatric care
Sexually transmitted diseases
Respiratory diseases
Immunizations
Women’s health
Medical Centers also sponsor clinics

15. 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

16. 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

17. 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

18. Home Health Care Provide care in patient’s home Examples of care…
Nursing care
Personal care: bathing dressing, and so forth
Therapy: physical, occupational, speech, respiratory
Homemaking: food preparation, cleaning, washing, and so forth

19. 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

20. 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)

21. 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

22. 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

23. Health Maintenance Organizations HMO
Preventive health care
Examinations
Basic medical services
Health Education
Hospitalization
Rehabilitation services

24. 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

25. 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

26. Government Agencies World Health Organization (WHO)
International agency sponsored by United Nations
Compiles statistics and information on disease
Publishes health information
Investigates and deals with serious health problems throughout the world

27. United States Department of Health and Human Services
National Institutes of Health (NIH): research on disease
Centers for Disease Control and Prevention (CDC): causes, spread and control of diseases in populations
Food and Drug Administration (FDA): regulates food and drug products sold to the public

28. United States Department of Health and Human Services
Agency for Health Care Policy and Research (AHCPR): established in to research the quality of health care delivery and identify the standards of treatment that should be provided by health care facilities
Occupational Safety and Health Administration (OSHA): establishes and enforces standards that protect workers from job-related injuries and illnesses

29. Health Departments
Provide specific services needed by state or local community
Immunization for disease control
Inspections for environmental health and sanitation
Health education
Collection of statistics and health records

30. Nonprofit / Volunteer Agencies
Supported by donations, membership fees, fundraisers, and federal or state grants
Provide health services at national, state, and local levels
Focus on specific diseases or professions

31. 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- non profit healthcare organization for Health Occupations Students

32. Health Insurance Plans
Established to help pay for the cost of health care.
Thousands of individual insurance agencies
BlueCross/Blue Shield
Some insurance plans provide coverage through places of employment.

33. Terminology related to insurance
Premium- A fee the individual pays for insurance coverage, paid to the insurance company.
Deductible- Amount that must be paid by the patient for medical services before the policy begins to pay.
Co-insurance- requires that specific percentages of expenses are shared by the patient and insurance company.

34. 80-20 co-insurance – company pays 80% and the patient pays the remaining 20% co insurance – company pays 70% and the patient pays the remaining 30%

35. Co-Payment
A specific amount of money a patient pays for a particular service.
Ex $10 for each physician visit
Ex $50 for specialist visit
Ex $250 for emergency room visit

36. Health Insurance Plans
Health Maintenance Organizations (HMO)
Preferred Provider Organization (PPO)
Medicare
Type A
Type B
Medicaid
Workers’ Compensation
TRICARE
Managed Care

37. HMO Provides a managed care plan for health care sevices
Pay monthly fee for premium
Care directed toward preventive type health care and plan covers these screening visits
Disadvantage – must use HMO affiliated providers for health care. If provider is not on the list, client must pay for the visit.

38. Preferred provider organization (PPO)
Another type of managed care plan usually provided by large companies for their employees.
PPO forms contract with health care agencies to provide health care at reduced rates.
Employees are restricted to use these providers. Will have to pay to use provider outside the plan.

39. Medicare Provided by Federal Government
Individuals over 65 years of age, or persons with disabilities
Type A - hospital
Type B - medical
Type D – pharmaceutical

40. Medicaid
Medical assistance program funded by state and federal government, but operated by individual states
Low income, children who qualify for public assistance and individuals who are disabled or blind

41. Workers Compensation
Health insurance plan providing treatment for workers injured on the job
Administered by the state
Paid by employer
Reimbursement for lost wages

42. TRICARE US Government plan for all military personnel.
Provides care for all active duty members and their families, survivors of military personnel and retired members of the Armed Forces.
The Veterans Administration provides for the military veterans.

43. Managed Care
Approach that has developed in response to the rising cost of health care.
Principle behind this is that all health care provided must have a purpose.
Often require a second opinion
Focus on preventive and early diagnosis of disease
HMO’s and PPO’s are common types.

44. 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