History of health care

Unit 2

Introduction

The Health Care industry employs over 10 million workers in over 200 different health careers.

Introduction

Health care has become a

2-billion-dollar-a-day business.

$2,000,000,000.00

Many different types of facilities make up this network of health care systems.

I. Types of Facilities

A. Hospitals: vary in size as well as services provided.

1. Small: serve communities

2. Large: serve larger areas & provide different services

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A. Hospitals: fall under different income classifications :

Private or Proprietary

(for profit)

Religious

(funds by religious affiliation)

Nonprofit

(funds used for institution only)

Government

(funded by government)


A. Hospitals: types of hospitals:

General – treat all age groups & conditions; provides diagnostic, medical, surgical, and emergency care services; usually private

(Health Central Hospital) (Orlando General

Hospital)



Specialty – provide care for special conditions or age groups; private; donations

(Shriner’s Burn Center – Cincinnati)

(MD Anderson Cancer Centers)

(Arnold Palmer Hospital For Children)

(Winnie Palmer Hospital For Women)



Government – operated/funded by federal, state and local governments

(Veteran’s Administration “VA Hospital”)

(State Psychiatric Hospital - Chattahoochee)



University/College Medical

Centers – provide hospital services; research & education facility as well; can be funded privately, donations, or government sources (research)



University/College Medical

Centers – Examples:

University of Miami (Miami)

University of South Florida (Tampa)

Johns Hopkins University (Baltimore, Maryland)

Cleveland Clinic (Ohio – School of Medicine)


B. Long-Term Care: provide assistance/care for elderly patients called “residents.” They can also provide care for persons with disabilities and/or chronic long-term illness.


B. Long-Term Care: Types:

- Nursing/Geriatric Homes : provide basic care for those who can no longer care for themselves; assist with ADL’s (activities of daily living); provide safe/secure environment; social interaction



- Extended/Skilled Care : provide skilled nursing care and rehabilitative services to prepare residents to return home or to other LTC facility



- Extended/Skilled Care : Subacute

Units: provide Services to residents who need rehabilitation to recover from major illness

(surgery, cancer, dialysis, heart disease, stroke)

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Independent/Assisted Living : individuals who can care for themselves (ADL’s) can rent or purchase apartment in facility

(meals, housekeeping, laundry, transportation, social events, basic medical care are provided)

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Independent/Assisted Living : most are associated with nursing homes; this allows resident to move from one facility to the other as conditions warrant

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B. Long-Term Care:

Many career opportunities are available in long term care for health care workers.

Regulated by AHCA and OBRA

AHCA=Agency for Health Care Administration

OBRA = Omnibus Reconciliation Act of 1987


C. Medical Offices: can vary to only have a single doctor or a group of doctors; can be a general practice or specialty practice

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C. Medical Offices: Types:

General Practice: treats all ages and all conditions

“Family Doctor”

“General Practitioner”

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C. Medical Offices: Types:

Specialty Practice: specializes in one particular age group or type of treatment given

Pediatrics

Cardiology

Obstetrics

Orthopedics


C. Medical Offices: Offer several different opportunities for employment. Administration , nursing, bookkeeping, billing, medical coding . offices can be found in different locations to include; office buildings, standalone offices and even malls.


D. Dental Offices: can vary in size; one dentist, group of dentist

(DDM=Doctor of Dental Medicine)

(DDS=Doctor of Dental Services)

Dentists’ offices can also be found in many different places to include professional office buildings, standalone offices and even malls.


E. Clinics: Health care facilities which can provide different types of care. Can be dental or medical or (veterinary).


E. Clinics: Types:

- Surgical: perform minor surgeries, also called outpatient or “oneday” clinics; patient is sent home same day after surgery


E. Clinics: Types:

- Urgent Care: provide first aid or emergency care to ill or injured patients; not equipped to treat critically ill patients


E. Clinics: Types:

- Rehabilitation: offer physical occupational, speech therapies for patients after injury or illness


E. Clinics: Types:

- Specialty: offer care for patients with specific diseases (diabetes, cancer), disorders (stroke) or injuries (head injury)


E. Clinics: Types:

- Outpatient: offer procedures to patients who are then not admitted to the hospital – go home. Different than surgical clinics in that procedures are not only surgeries

(endoscopy, colonoscopy)


E. Clinics: Types:

- Health Department: may offer treatment for pediatric patients; sexually transmitted diseases; respiratory diseases; immunizations and other services

(pharmacy)


E. Clinics: Types:

- Medical Center: Usually located in colleges and universities; often offer FREE medical care and treatment to provide learning experiences for medical students.


F. Optical Centers: can be individually owned by ophthalmologist (M.D. or D.O.) or optometrist (O.D.); or part of large chain of stores

(Lens Crafters,

Pearle Vision, etc.)


G. Emergency Care Services: provide care for victims of accidents or sudden illness by highly trained medical professionals

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G. Emergency Care Services:

Types:

Private ambulance services

Rescue squads (Fire Dept.)

Emergency/Urgent Care Clinics

Emergency Rooms

Aircraft (helicopters/airplanes)

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H. Laboratories: can be part of larger facility, such as hospital, clinic or college/university, or can be stand-alone

Pathologist

Laboratory technicians

Phlebotomist

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I. Home Health Care: provide care in patient’s home

Nursing care

Personal care

Therapy

Homemaking


J. Hospice: care for patients who have less than 6 months to live as a result of a medical condition

Care can occur in the patient’s home or in Hospice care centers

The family of the patient is ALSO cared for.

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K. Mental Health: Types:

Counseling centers

Psychiatric clinics

Chemical abuse

Physical abuse

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L. Genetic Counseling:

Prenatal (before birth) tests

Checking for abnormalities & birth defects

Identify all medical options

Assist parents in coping with genetic disorders of child


M. Rehabilitation: can be located in hospitals, clinics or be standalone entity; the goal of rehabilitation is to have the patient reach their maximum potential, given their specific medical condition.


N. Health Maintenance

Organizations (HMO’s): provide total health care directed toward preventative health care; some

HMO’s are run by large corporations with many employees (lowers costs)


O. Industrial Health Care

Centers: found in large companies; provide healthcare for employees of the company; focus on accident prevention and safety


P. School Health Services: found in many schools and colleges; many different levels of services provided

II. Government Agencies

Government Agencies: are financially supported by taxes.

National and international organizations exist around the world which monitor health and health care-related issues.

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A. World Health Organization

(WHO): international agency sponsored by the United Nations

Statistics & info about diseases

Publishes health info

Investigates/addresses serious health threats around the world


B. U.S. Dept. of Health and Human

Services (USDHHS): national agency

- Deals with health problems within the United States


C. National Institutes of Health

(NIH): national agency

- Division of USDHHS involved in research of diseases


D. Centers for Disease Control and

Prevention (CDC): national agency

- Division of USDHHS concerned with causes, spread, and control of diseases in populations


E. Food and Drug Administration

(FDA): national agency

- Responsible for regulating food and drug products sold to the public


F. Agency For Health Care Policy and Research (AHCPR): national agency established in 1990

- Responsible for researching the quality of health care delivered and identify standards of treatment for health care facilities


G. Occupational Safety and Health

Administration (OSHA): national agency

- Establishes & enforces standards that protect workers from job related injuries and illnesses

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H. Health Departments: national agency; falls under USDHHS

Community based

Gather statistics, trends

Prevention education

Immunizations

III. Health Insurance Plans

In order to pay for costs associated with health care most people rely on health insurance plans.

There are THOUSANDS of insurance plans , but most work under same basic idea: You pay premium to insurance company and insurance covers costs.


The amount of payment and type of services covered by the insurance company you have may vary. Not all insurances are the same and no two insurance plans are alike . Some cover more, some cover less than others.


Terms to know:

Deductible: amount paid by patient for medical services before policy begins to pay

Example: $500 out-of-pocket before insurance pays anything


Terms to know:

Co-insurance: expenses for medical care are shared between the patient and the insurance company

Example: 80/20 plan: insurance pays 80%, you pay remaining 20%


Terms to know:

Co-payment: also known as “copay” this is the amount of $ you pay for a particular service regardless of total cost of service

Example: $25 per visit; whether for a physical or more serious illness


A. Medicare: government programs that provides health care for individuals over the age

of 65 and for any person who has been disabled for at least two years


A. Medicare: Types:

- Part A: covers hospital services and care provided by an extended care facility, or home health care agency after hospitalization

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A. Medicare: Types:

Part B: covers doctor’s visits, outpatient treatments, therapy and other health care

A deductible is paid for Medicare

Part B

Part B only pays 80%

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B. Medicaid: medical assistance program operated by individual states. Persons covered by this program vary from state to state.

Low income

Children who qualify

Physically disabled or blind


B. Medicaid: provides inpatient and outpatient hospital services, physician’s medical and surgical care, lab, x-ray, well-baby and well-child care, including immunizations


C. Worker’s Compensation: provides treatment for workers injured on the job. Funded by employers and each individual state


D. TRICARE: U.S. Government health insurance program.

Provides care for all active duty personnel and their families, survivors of military personnel, and retired members of the military

IV. Organizational Structure

All health care facilities must have an organizational structure . This is the line of authority, or chain of command within a facility. This organizational structure of a facility should indicate areas of responsibility.


The higher you are on the organizational structure of an institution or facility, the more responsibility you will have.


Superintendent

Asst. Superintendent

School Principal

Asst. Principal Asst. Principal Asst. Principal

Teacher Teacher Teacher Teacher Teacher Teacher

Student Student Student Student Student Student Student Student Student Student Student Student


Hospital

Administrator

Chief Nursing

Officer

Nurse Manager

RN RN RN

LPN LPN LPN

CNA CNA CNA CNA CNA CNA

LPN LPN LPN

CNA CNA CNA CNA CNA CNAt


CNA CNA CNA CNA CNA CNA CNA CNA CNA CNA CNA CNA

LPN LPN LPN LPN LPN LPN

RN RN RN

Nurse Manager

Chief Nursing

Officer

Hospital

Administrator

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History of health care

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