1. 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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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)

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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

28. 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

29. 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

30. 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

31. 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