2 Chapter Objectives Define the term health care system. Trace the history of health care delivery in the United States from the mid-nineteenth century to the present.Discuss and explain the concept of the spectrum of health care delivery.List and describe the different levels of medical practice.
3 Chapter ObjectivesDistinguish between the different kinds of health care, including public health practice, medical practice, long-term practice, and end-of-life practice.List and characterize the various groups of health care providers.Explain the differences among allopathic, osteopathic, and nonallopathic providers.Define complementary and alternative medicine.
4 Chapter ObjectivesExplain why there is a need for health care providers.Prepare a list of the different types of facilities in which health care is delivered.Explain the differences among private, public, and voluntary hospitals.Explain the concept behind ambulatory care facilities.
5 Chapter Objectives Briefly discuss the options for long-term care. Explain what the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) does.
6 Health Care System: Structure American delivery systemNo national health care systemVariety of providersVariety of settingsConcernsInformal cooperation of providersDisease treatment vs. health careConglomeration vs. system
8 Brief History of U.S. Health Care Timeline18501997
9 Brief History of U.S. Health Care Before 1850: Medical treatment occurred in home18501997
10 Brief History of U.S. Health Care Treatment moved to physicians’ offices and hospitalsHome185019001997
11 Brief History of U.S. Health Care 1st InsuranceHospitalsHome185019111997
12 Brief History of U.S. Health Care 3.9% of GDP spent on health care1st InsuranceHospitalsHome1929185019111997
13 Brief History of U.S. Health Care Age of MedicineNIH establishedHill-Burton Act1st InsuranceHospitalsHome2.9% GDP18501930195019111997
14 Brief History of U.S. Health Care Medicare & Medicaid1st InsuranceHospitalsAge of MedicineHome2.9% GDP196518501911193019501997
15 Brief History of U.S. Health Care Cost Containment- Health Systems Planning- Health Maintenance Organization Act1st InsuranceHospitalsAge of MedicineHomeMedicare &Medicaid2.9% GDP1970s185019111930195019651997
16 Brief History of U.S. Health Care American HealthSecurity Act of 19931st InsuranceCost ContainmentHospitalsAge of MedicineHomeMedicare &Medicaid2.9% GDP1980s185019111930195019651970s1997
17 Brief History of U.S. Health Care 14% GDP,managed care1st InsuranceCost ContainmentAge of MedicineIncreased CostsHomeMedicare &Medicaid2.9% GDP18501911193019501965197019801992
18 Major Concerns in the United States 1. Medical care cost2. Drug abuse3. Budget deficit4. Crime5. Unemployment6. AIDS
19 Health Care Spending (Select countries: 1960 & 1997)
20 Spectrum of Health Care Delivery Spectrum of health care: Refers to the types of health care providedPublic health practiceEducation is primary component.Medical practicePrimarySecondaryAcuteSubacuteTertiary
21 Spectrum of Health Care Delivery Long-term practiceRestorative careLong-term careEnd-of-life practiceCare provided to those who have less than six months left to liveHospice service
22 Public Health Practice EducationProvides informationEmpowersMotivatesPractice aimed at preventionSettingsGovernmental health agenciesVoluntary health agenciesSocial services agenciesSchoolsBusiness and industry
23 Primary Medical Care Front line Education Promotion of nutrition Safe water and sanitationMaternal and child health careImmunizationPrevention and control of endemic diseaseTreatment of common diseases and injuriesProvide essential drugs
24 Secondary Medical Care Specialized careProvided by physiciansHospital or outpatientAcute care: Short termSubacute: Provides specialty servicesEmergency care
25 Tertiary Medical Care Highly specialized and technological For those with unusual or complex conditionsSpecialized hospitalsAcademic health centersTypes of illnesses: AIDS, cancer, and heart disease, and surgery
26 Long-Term Practice Restorative care Long-term care Health care provided to patients after surgery or other forms of treatmentLong-term careHealth care provided to patients with chronic illness
27 End-of Life Practice Health care provided shortly before death Hospice careSupport care services that provide holistic care for dying persons, their families, and loved ones
28 Health Care ProvidersOver 200 different careers in the health care industryFive different categoriesIndependent providersLimited care providersNursesAllied health care professionalsPublic health professionals
29 Health Care Providers Independent providers Allopathic Osteopathic Specific remedies include drugs or medication.OsteopathicRecognition of reciprocal interrelationship between the structure and function of the body.
30 Nonallopathic (Alternative Medicine) Chiropractors, acupuncturists, naturopaths, homeopathsFive general categoriesAlternate medical systemsMind/body interventionsBiologically based therapyManipulative methodsEnergy therapy
31 Health Care Providers Limited care (restricted care) Examples Have advance training in a health specialty and are licensed to practice itExamplesDentists, optometrists, podiatrists, and psychologists
32 Nurses Licensed Practical Nurses (LPN) Registered Nurses (RN) 1 to 2 years of training and carry out nontechnical dutiesRegistered Nurses (RN)Associate or baccalaureate degree and state licenseBachelor of Science in Nursing (BSN)Prepared for additional activities involving independent judgmentAdvanced Practice Nurse (APN)
34 Allied and Professional Health Care Providers Allied health care professionalsProvide services that assist, facilitate, and complement work of physiciansNonphysician practitioners, physician assistants, dietitians, physical therapists, medical technologists, EMTs, speech therapists, and midwivesPublic health professionalsWork in public health clinics and voluntary agenciesEnvironmental health workers, administrators, epidemiologists, health educators, and biostatisticians
35 Health Care Facilities Practitioner officesPrivately owned practicesClinicsHospitalsPrivateSpecialtyPublicVoluntaryAmbulatory care
36 Health Care Facilities Rehabilitation centersLong-term care optionsHome health careContinuing careChronic, respite, hospice, and home careAccreditation