health -care providers structure / operation
DESCRIPTION
Health -Care Providers Structure / Operation. Health -Care Facilities. Primary Care General Practice General paediatrics Dental Care Visiting Nurses Secondary Care Ambulatory Specialists Tertiary Care Hospitals / Long Term Care P roviders. General Practice. - PowerPoint PPT PresentationTRANSCRIPT
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Health-Care ProvidersStructure/Operation
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Health-Care Facilities
• Primary Care– General Practice– General paediatrics– Dental Care– Visiting Nurses
• Secondary Care– Ambulatory Specialists
• Tertiary Care– Hospitals/Long Term Care Providers
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General Practice
• Population wide care• Registration• Prevention/Treatment• Social Role of Physician• Density per 1000 population– CZ 0,7; Germany 0,65; Greece 0,28; – Norway 0,81; Sweden 0,62; UK 0,79; USA 0.3
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Challenges
• Aging population• Changing competencies– Nursing care– Physiotherapy
• GP + Technology
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Reimbursement
• Salaried GP• Fee for service• Capitation payment
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Ambulatory Specialists
• Position– Hospitalits– Independent
• Reimbursement– Salaried– Fee for service– Payment per case
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HospitalsBeds/1000 popul Employee/bed Nurse/bed
CZ 7,11 1,87 0,76
Germany 8,25 1,81 0,81
Netherlands 4,69 3,61 1,01
Norway 3,35 6,39 2,55
UK 3,34 6,45 NA
USA 3,08 6,25 2,27
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Hospital structure
• Local ( Internal medicine +)• Regional ( average 10 specialties) • University Hospitals• Special Hospitals• Ownership– State/Municipality– Church– Private non for profit– Private for profit
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Hospital department
• Outpatient– Acute – Clinics
• Inpatient– ICU – centralised/decentralised– Standard wards
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Director
CMO
Head of Dept.
Ward Physician
Physicians
CNO
Head Nurse – Dept.
Ward Sister
Nurses/Porters
Head Therapists
Unit therapists
COO/CFO
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Outpatient Care
• No formal limitation to patients• Low level of centralisation of Acute Care• Time management
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Hospital reimbursement
• Budgeting• FFS• Case mix - DRG
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Long Term CareBeds/1000 population
Beds/1000 seniors
Employees/1000 population
Employees/1000 seniors
CZ 6,5 43,3 3,6 2,4Germany 10,3 50,3 7,8 3,8Netherlands 10,4 68,5 11,7 7,7Norway 9,3 62,9 19,2 13UK 8,8 55,4 NA NAUSA 5,4 41,9 15,4 11,9
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Medical Records vs. Medical Students
• Legal protection of contents – confidentiality• Only with the patient´s consent• Electronic/paper• Entries to be signed and confirmed by a
hospital employee• High level of protection– Patients ID (personal number)– Dg + treatment
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Infection Prevention
• Vaccination• Clothing• Hand Hygiene– Hospital obliged to arrange– Hand + stethoscopes
• Special situations– Face masks– Pregnant students
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Hospital Security and Patient Safety
• Individual badges• Doors• Awareness – strangers• Special precautions– Psychiatry– Paediatrics, neonatology– Infectious diseases
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