copyright © 2008 delmar learning. all rights reserved. unit 1 community health care
TRANSCRIPT
Copyright © 2008 Delmar Learning. All rights reserved.
Unit 1
Community Health Care
Copyright © 2008 Delmar Learning. All rights reserved.
Objectives
• Spell and define terms.• List the five basic functions of health
care facilities.• Describe four changes that have taken
place in health care in the last few years.
• Describe the differences between acute care and long-term care.
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Objectives
• Name the departments within a hospital.• Describe the functions of the
departments within a hospital.• Explain three ways by which health care
costs are paid.• State the purpose of health care facility
surveys.
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Introduction
• Health care facilities have five basic functions:– Provide services for the ill and injured– Prevent disease– Promote individual and community health– Educate health care workers– Promote research in medicine and nursing
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Overview of Health Care
• Health care emphasizes patient-focused care
• Many changes have occurred in health care in the last few years
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Overview of Health Care
• There are several reasons for these changes– People are living longer– Technology is becoming more advanced– Health care costs have increased– Many ethical questions that must be
answered by health care providers and consumers
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Overview of Health Care
• Managed care means the insurance company will:– Not permit certain procedures or diagnostic
tests until they have been approved by the insurer.
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Overview of Health Care
• Managed care means the insurance company will:– Negotiate with specific physicians,
hospitals, pharmacies, and other care providers to render services at a lower cost to the company’s members.
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Overview of Health Care
• Managed care means the insurance company will:– Approve only a certain number of days of
hospitalization for specific diagnoses.– Require that specific procedures be done
on an outpatient basis rather than having the patient admitted to the hospital.
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Needs of the Community
• Health care is needed throughout life• Short-term or long-term care includes:
– Preventive – Emergency – Surgery– Rehabilitation – Hospice care
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Preventive Care
• Prenatal care – Care of mother during pregnancy
• Well-baby checkups and immunizations• Health education to teach individuals
how to avoid disease and injury• Physical examinations throughout life
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Emergency Care
• Short-term care given for sudden illness or injury
• Surgery– To repair an injured body or remove a
diseased organ
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Rehabilitation
• To help a patient regain abilities after an illness or injury
• Long-term care– For persons who have chronic or incurable
conditions
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Hospice Care
• For patients who are dying and their families
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Needs of the Community
• People receiving health care are called health care consumers – Identified by type of care they need
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Needs of the Community
• Patient – Persons in acute care facilities, such as
hospitals
• Client – Persons receiving care in their own homes
• Resident– Persons in long-term skilled care facilities
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Types of Health Care Facilities
Short-Term Care Long-Term CareHospitals Skilled care facilities
Urgent care facilities Adult day care
Surgicenters Assisted living facilities
Rehabilitation centers
Psychiatric hospitals
Outpatient clinics Respite care
Psychiatric hospitals
Physician’s offices Home care
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Long-term Acute Care Hospitals
• Fully licensed hospitals in which a lengthy stay is anticipated
• Provide a higher level of care than other chronic care settings
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Long-term Acute Care Hospitals
• Patients must have a medically-complex condition– Need acute care services– Have a good chance of improvement
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Magnet Hospitals
• Magnet Program for Excellence in Nursing Services – Based on quality indicators and nursing
practice standards
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Magnet Hospitals
• Program is voluntary and recognizes hospitals for nursing excellence
• Hospitals who have been awarded magnet status are usually progressive– Desirable places to work
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Community Health Care Services
• Hospitals– Most hospitals are licensed to care for
patients of all ages and with a variety of problems
– Some hospitals take care of patients with special conditions or care for specific age groups
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Community Health Care Services
• Pediatric hospitals– Care for children from birth to 18 years
• Psychiatric hospitals– Provide care for persons with mental illness
• Rehabilitation hospitals– Provide restorative services to patients
following disease, illness, or injury
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Community Health Care Services
• Hospital organization – Provide the most efficient delivery of
service– Major departments established within each
facility • Care for patients with specific conditions• 24 hours a day, 7 days a week
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Community Health Care Services
• Hospital organization– Surgical department
• Cares for patients before, during, and after surgery
– Pediatric department• Cares for sick and injured children
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Community Health Care Services
• Hospital organization– Obstetric department
• Cares for newborns and their mothers
– Emergency department• Cares for victims of trauma, natural disasters,
or medical emergencies
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Community Health Care Services
• Hospital organization– Critical care department
• Cares for seriously ill patients who require constant monitoring and care
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Community Health Care Services
• Hospital organization– Medical department
• Cares for patients with medical conditions such as pneumonia or heart disease
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Community Health Care Services
• Hospital organization– Larger hospitals – Many specialized units staffed by nurses
and therapists • Trained to care for persons with specific
problems
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Specialized Services
• Dietary • Pharmacy • Diagnostic
– Pathology (study of disease)– Diagnostic imaging and radiology– Laboratory
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Specialized Services
• Rehabilitation services– Physical therapy– Occupational therapy– Speech therapy– Respiratory therapy– Social services
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Specialized Services
• Environmental services– Housekeeping– Maintenance– Laundry
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Specialized Services
• Business services• Medical records department• Volunteer services• Pastoral services
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Financing Health Care
• Health care is paid for by:– Insurance– Out-of-pocket payments– Medicaid
• State and federal government program• Pays for persons of any age who do not have
financial resources for health care
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Financing Health Care
• Medicare is a federal government program– Pays a portion of health care costs for
persons 65 years and older
• For younger persons permanently disabled and qualify for benefit
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Financing Health Care
• Medicare payment is based on:– Diagnosis related groups (DRGs)
• Actual cost of care is not considered
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Financing Health Care
• Rather, Medicare set the payment rates:– Based on data from studies that
determined the average length of stay– Required for various medical diagnoses,
procedures, and treatments
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Regulatory Agencies
• Joint Commission for Accreditation of Healthcare Organizations (JCAHO)– Inspects and accredits health care agencies– Participation is voluntary – Hospitals are not eligible to receive
Medicare payment unless they are JCAHO accredited
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Regulatory Agencies
• Occupational Safety and Health Administration (OSHA)– Surveys health care facilities– Protects health and safety of employees
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Quality Assurance
• All health care facilities have a program called quality assurance (QA)– Identifies problems and finds solutions for
improvement