Health Care Systems Health Careers September 17, 2009

Objectives 1. Private Health Care Facilities 2. Government Agencies 3. Voluntary or Non-Profit Agencies 4. Health Insurance Plans 5. Organizational Structure 6. Cost Containment 7. Home Health Care 8. Geriatric Care 9. Telemedicine 10. Alternative and Complementary Care

Health Care Systems Health Care Systems today include the many agencies, facilities, and personnel involved in the delivery of health care. According to the Bureau of Labor Statistics  Health care is the largest and fastest growing industries in the U.S.  Employs over 14 million people (2008)  200 different health careers  Health Care has become a 2 billion dollar a day industry (2004)

Private Health Care Facilities  Hospitals  Vary in size and types of service provided  Also classified as private or proprietary  Operating for profit  Can be religious, non profit, voluntary, or government  Depends on where the source of income comes from

Long Term Care Facilities Long Term Care Facilities: (Nursing Home, Geriatric)  Provide assistance and care for elderly patients.  Also Provide care for individuals with disabilities or handicaps.  Extended Care or Skilled Care Facilities:  Designed to provide skilled nursing care and rehabilitative care to prepare patients to return home. Geriatric Care: care for the elderly

Private Health Care Facilities Independent or Assisted Living:  Allow individuals who can care for themselves to live on their own by renting or purchasing an apartment in the facility.  If needed or wanted, services are provided:  Meals  Housekeeping  Laundry  Transportation  Social Events  Basic Medical Care

Medical Offices Vary greatly  Privately owned all the way to large complexes that operate as corporations  Doctors treat a wide range of illnesses  Other specialize

Dental Offices Vary in size Dental services can include general dental care and very specialized care  Examples??

Clinics Also called satellite clinics Varies in size Hospitals offer outpatient clinics Health Departments offer clinics Medical centers at colleges and universities offer clinics.

Optical Centers Can be individually owned by an ophthalmologist or optometrist or can be part of a wide variety of stores. Vision Examinations Prescribe glasses or contacts Also check for eye diseases

Emergency Care Facilities Fast traumatic care Ambulance, Helicopter Both private and governmental Frequently operated by fire departments

Laboratories Perform many tests for other facilities. May be in the hospital or clinic, but also could operate as a separate health care service.

Home Health Care Agencies Designed to provide care in a patient’s home. Used by elderly and disabled Services include  Nursing care  Personal care  Therapy  Homemaking Health departments, hospitals, private agencies, and non profit/volunteer groups can offer this care Trend is returning in this direction

Hospice Provide care for the terminally ill with life expectancies of 6 months or less. Care can be provided in the home or at the hospice facility. Psychological, social, spiritual, and financial counseling is provided.

Mental Health Facilities Treat patients with mental disorders and diseases. These facilities include:  Guidance and counseling centers  Psychiatric clinics and hospitals  Chemical abuse and treatment centers

Genetic Counseling Centers Independent facility or connected with another facility. Genetic counselors work with couples or individuals who are pregnant or considering a pregnancy. What do they do?  Perform prenatal screening  Check for genetic abnormalities  Birth defects  Explain results and options of the results  Consult with couples before pregnancy to try and identify any genetic diseases or disorders

Rehabilitation Facilities Located in hospitals, clinics, or privately owned Provide care for physical or mental disabilities to obtain maximum self-care. Examples:  Physical Rehabilitation  Occupational Rehabilitation  Speech Rehabilitation  Hearing Rehabilitation  Recreational Rehabilitation

Health Maintenance Organization Provide total care directed toward preventive health care. Often use the services of other health care institutions (only HMO affiliated) Type of health insurance – pay membership fee

Industrial Health Care Centers Found in large companies or industries Provide health care for their employees Basic Exams Teaching accident prevention

School Health Services Found in schools Emergency Care for victims Also perform screening for health conditions  Hearing  Vision  Speech  Scoliosis

Government Agencies World Health Organization U.S. Department of Health and Human Services National Institutes of Health Centers for Disease Control and Prevention Food and Drug Administration Agency for Health Care Policy and Research Occupational Safety and Health Administration State and Local Health Departments

World Health Organization (WHO) International Agency Sponsored by the United Nations Compiles statistics and information on disease Publishes the information Investigates and addresses serious health problems throughout the world.

U.S. Department of Health and Human Services National Agency Deals with health problems in the United States

National Institutes of Health (NIH) Researches on disease

Centers for Disease Control and Prevention CDC Concerned with the causes of disease Promotes healthy living Controls disease in populations Informs the public on any disease and helps regulate health issues

FDA: Food and Drug Administration Federal Agency responsible for regulating food and drug products sold to public. Most likely that if it is publically sold the FDA has approved it.  Excluding Supplements

Agency for Health Care Policy and Research Federal Agency established in 1990 Research the quality of health care delivery and identify standards of treatment that should be provided at health care facilities.

OSHA: Occupational Safety and Health Administration Establishes and enforces standards that protect workers from job related illness and injury.

State and Local Health Departments Minnesota Department of Health Winona County Community Health Services Provide specific services needed by the state and local community. Examples of services:  Immunizations  Inspections of environmental health issues  Communicable disease control  Collection of statistics  Clinics for health care and prevention

Voluntary and Nonprofit Agencies Organization typically studies disease it supports Provide special services to people with disease Provide funding for future research Supported by donations, fundraisers, grants, and membership fees Examples:  American Heart Association  American Cancer Association  National Foundation of the March of Dimes  American Red Cross

Health Insurance Plans Offered by thousands of agencies Help reduce the cost of health care Example:  Blue Cross Blue Shield  Health Partners

Terminology for Insurance Deductibles: the amount that must be paid by the patient before the insurance policy takes over. Co-payment: specific amount of money the patient pays for a particular service Co-insurance: requires that specific percentages or expenses are shared by patient and insurance company.  80 % insurance and 20% patient

Other Insurance Options PPO: Preferred Provider Organization  Insurance provided by company to their employees. Medicare:  Federal government program that provides health care for almost all individuals over the age of 65 or anybody that has been collecting Social Security.  Type A: Hospital and Long Term Care  Type B: Additional coverage for doctor’s services  Only pay 80% Medicaid:  Medical assistance program operated by individual states.  Low – Income  Children or disabled who qualify

Other Insurance Options Workers Compensation  Treatment for workers injured on the job  Pays for medical bills and wages lost Managed Care  An approach that has developed in response to rising health care costs.  Principle behind it  Health care must have a purpose  Do not go to the doctor for everything that happens

Organizational Structure Chain of command Who supervises who Should indicate areas of responsibility and lead to the most efficient operation of the facility.

Cost Containment Diagnostic Related Groups Combination of Services Outpatient Services Mass or Bulk Purchasing Early Intervention / Preventive Services Energy Conservation Telemedicine  Use of video, audio, and computer systems to provide medical / health care services  Mainly used by professionals

Alternative and Complementary Methods Ayurvedic Practitioners: ancient philosophy  Developed in India  Prescribe diet, herbal treatment, exercise, yoga, massage, minerals, and living practices Chinese Medicine:  Holistic based  Proper flow of energy promote health  Everything is connected

Alternative and Complementary Methods Chiropractics Care  Believe that the brain sends vital energy to all body parts through nerves and spinal cord. Homeopaths:  Body will heal itself Naturopaths  Natural Therapies  Fasting  Special Diets  Lifestyle Changes Many more

Vocabulary Wellness:  The state of being in optimum health.  Balance all parts of health  Prevention measures Holistic health  Care that promotes physical, emotional, social, intellectual, and spiritual well-being.  Treating the whole body  Uses methods of diagnosis and treatment in addition to “regular” western medical practices.