Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Chapter 02 Health Care Systems

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 2:1 Private Health Care Facilities  Health care is one of the largest and fastest-growing industries in the United States  Will employ over 22.1 million workers in over 200 careers by 2020  2012 U.S. health care spending was over 2.7 trillion dollars

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Hospitals  General hospitals  Specialty hospitals  Government hospitals  University or college medical centers

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Name some hospitals in our area….

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Name some hospitals in our area….  1. Stafford Hospital  2. Quantico  3. Mary Washington healthcare  4. Spotsylvania Regional medical center

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. How big are they?

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.  1. Stafford Hospital: 100 beds  2. Quantico: clinic, hospital 30 beds  3. Mary Washington healthcare: 400 beds  4. Spotsylvania Regional medical center:100 beds

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Long-Term Care Facilities  LTC or LTCF provide assistance and care for residents  Residential care facilities  Extended care or skilled care facilities  Independent living and assisted living facilities

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Name some LTCF’s in our area

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.  Greenfields Assisted Living  Poets Walk  Golden Living  Marion Manor  Spring Arbor  Heartfields  The Crossings

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Medical Offices  Vary from offices privately owned by one physician to large complexes  Services include diagnosis, treatment, examination, basic lab testing, minor surgery  May offer general or specialized care

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Name some in our area…

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Dental Offices  Vary in size from privately owned by one or more dentists to dental clinics  Include general care for all ages and specialized care for certain age groups or dental conditions

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Clinics or Satellite Centers  Surgical clinics or surgicenters  Urgent, walk-in, or emergency care clinics  Rehabilitation clinics  Substance abuse clinics

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Clinics or Satellite Centers (continued)  Specialty clinics  Outpatient clinics  Health department clinics  Medical center clinics

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Optical Centers  May be individually owned or part of chain  Services include vision examination, prescription of glasses or contact lenses, screening for eye diseases

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Emergency Care Services  Special care for accident victims or those with sudden illness  Ambulance services  Rescue squads  Emergency care clinics  Emergency departments

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Laboratories May be part of other facilities or stand- alone Medical laboratories – Diagnostic tests Dental laboratories – Dentures and other devices

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Home Health Care  Provide care in a patient’s home  Frequently used by elderly and disabled  Provide nursing care, personal care, therapy, homemaking  Offered by health departments, hospitals, private agencies, government agencies, volunteer groups, nonprofits

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Hospice  Provide care for terminally ill persons  Care in a patient’s home or in a facility  Palliative care, psychological, social, spiritual, financial counseling to patient and family  Support for family members following patient’s death

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Mental Health Facilities  Treatment for patients with mental disorders or diseases  Examples include guidance and counseling centers, psychiatric clinics and hospitals, clinical abuse treatment centers, physical abuse treatment centers

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Genetic Counseling Centers  Independent facilities or located within another facility  Prenatal screening for couples or individuals who are pregnant or considering pregnancy  Check for genetic abnormalities and birth defects, explain results and options

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Rehabilitation Facilities  Located in hospitals, clinics, private centers  Care for patients with physical or mental disabilities  Therapies include physical, occupational, recreational, speech, hearing

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Health Maintenance Organizations  Health care delivery system and type of health insurance  Preventive care for a fixed, prepaid fee  Services include examinations, basic medical services, health education, hospitalization, rehabilitation

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Industrial Health Care Centers  Also called occupational health clinics  Located in large companies or industries  Health care for employees  Services include examinations, accident prevention and safety, emergency care

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. School Health Services  Located in schools and colleges  Provide emergency care in case of accident or illness, tests for health conditions, health education, maintenance of a safe and sanitary environment, counseling

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Take a slip of paper:  1. Name your State.  2. research a hospital in your state  3. Answer the following:  Name of Hospital, how big is it, any specialty units they may have, address, give 2 facts about this hospital

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 2:2 Government Agencies  Government services are tax supported  World Health Organization (WHO)  U.S. Department of Health and Human Services (USDHHS)  National Institutes of Health (NIH)  Centers for Disease Control and Prevention (CDC)

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 2:2 Government Agencies (continued)  Food and Drug Administration (FDA)  Agency for Healthcare Research and Quality (AHRQ)  Occupational Safety and Health Administration (OSHA)  Health departments

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 2:3 Voluntary or Nonprofit Agencies  Supported by donations, membership fees, fund-raisers, and grants  Health services are provided at national, state, and local levels  Examples include American Cancer Society, American Red Cross, Autism Speaks

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 2:3 Voluntary or Nonprofit Agencies (continued)  Organizations often focus on specific diseases  Study the disease  Provide research funding  Educate the public  Provide special services to those with the disease  Staffed by health care workers and volunteers

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 2:4 Health Insurance Plans  Health care costs are rising faster than other costs of living  Most people rely on health insurance plans to pay for health care  Without insurance, the cost of an illness can result in financial disaster

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Insurance Terminology  Deductible  Co-insurance  Co-payment

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Types of Plans  Employer-sponsored or group insurance plans  Health maintenance organization (HMO)  Preferred provider organization (PPO)  Medicare  Medigap  Medicaid

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Types of Plans (continued)  Children’s Health Insurance Program (CHIP)  Worker ’ s compensation  TRICARE  U.S. government plans for military personnel and their families  Managed care plans

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Health Insurance Portability and Accountability Act (HIPAA)  Five components  Health care access, portability, renewability  Preventing health care fraud/abuse  Tax-related health provisions  Application and enforcement of group health plan requirements  Revenue offsets

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Patient Protection and Affordable Care Act  Law of 2010 changing health care insurance regulation  Provisions include  Guaranteed issue  Expanded Medicaid eligibility  Improved benefits for Medicare

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 2:5 Organizational Structure  Line of authority or chain of command  Indicates areas of responsibility  Essential for most efficient operation of facility  Structure determined by size and needs of organization  Refer to Figures 2-5 and 2-6 in Text

Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 2:5 Organizational Structure (continued)  Lines of authority must be clearly indicated in any organizational structure  Workers must identify and understand their position in the structure  Workers must take problems, reports, and questions to their immediate supervisor