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Care & Levels of Care. LEVELS OF CARE. Primary health care Secondary health care Tertiary health care. Primary health care. The “first” level of contact between the individual and the health system. Essential health care (PHC) is provided.
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LEVELS OF CARE • Primary health care • Secondary health care • Tertiary health care
Primary health care • The “first” level of contact between the individual and the health system. • Essential health care (PHC) is provided. • A majority of prevailing health problems can be satisfactorily managed. • The closest to the people. • Provided by the primary health centers.
Secondary health care • More complex problems are dealt with. • Comprises curative services • Provided by the district hospitals • The 1st referral level
Tertiary health care • Offers super-specialist care • Provided by regional/central level institution. • Provide training programs
Types of referral In health centre practice, a referral was requested in two main situations: A) Emergency B)Routine. Routine referral was usually made to: • seek expert opinion regarding a patient • seek admission and management of a patient • seek facilities for investigation
Referral Levels • First referral level: Community hospitals • Secondary and tertiary levels: Regional, national, and university hospitals
Levels of Prevention • Primary prevention • Secondary prevention • Tertiary prevention
Primary Care • Primary health care refers to an approach to health and a spectrum of services beyond the traditional health care system. It includes all services that play a part in health, such as income, housing, education, and environment. • Primary care is the element within primary health care that focuses on health care services, including health promotion, illness and injury prevention, and the diagnosis and treatment of illness and injury.
Primary Care • The ultimate goal of primary health care is better health for all. • Key elements: • Reducing exclusion and social disparities in health (universal coverage reforms); • Organizing health services around people's needs and expectations (service delivery reforms); • Integrating health into all sectors (public policy reforms); • Pursuing collaborative models of policy dialogue (leadership reforms); and • Increasing stakeholder participation
Definition • PHC is essential health care that is a socially appropriate, universally accessible, scientifically sound first level care provided by a suitably trained workforce supported by integrated referral systems and in a way that gives priority to those most in need, maximises community and individual self-reliance and participation and involves collaboration with other sectors.
Functions • serves a dual function in the health care system: • Direct provision of first-contact services (by providers such as family physicians, nurse practitioners, pharmacists, and telephone advice lines) • Coordinate function to ensure continuity and ease of movement across the system, so that care remains integrated when require more specialized services
What Do We Need • Primary care provides a place to which people can bring a wide range of health problems. • Primary care is a hub from which patients are guided through the health system Primary care facilitates ongoing relationships between patients and clinicians • primary care would be restricted to a one-way delivery channel for priority health interventions; • Primary care opens opportunities for disease prevention and health promotion as well as early detection of disease • Primary care requires teams of health professionals. • Primary care requires adequate resources and investment
It includes the following: • Health promotion • Illness prevention • Care of the sick • Advocacy • Community development
Primary health care services often include: • Prevention and treatment of common diseases and injuries. • Basic emergency services. • Referrals to/coordination with other levels of care (such as hospitals and specialist care). • Primary mental health care. • Palliative and end-of-life care. • Health promotion. • Healthy child development. • Primary maternity care. • Rehabilitation services
The Basic Requirements for PHC The 8 A’s • Appropriateness • Availability • Adequacy • Accessibility • Acceptability • Affordability • Assessability • Accountability • the 3 C’s: • Completeness • Comprehensiveness • Continuity
Primary Prevention • Providing information and education about health issues, • Affecting societal changes that have an impact on health • Making appropriate referrals before illness occurs based on assessment of stressors and life changes. • Working with families to support family members and group functioning. • Working with community and legislative groups on issues related to health
Secondary Prevention • Intake screening and early case finding. • Home visit assessment • Supervising patients receiving medication • Suicide prevention services • Counseling on time-limited basis • Crisis intervention • Intervening with communities and organizations based on an identified problem
Tertiary Prevention • Promoting vocational training and rehabilitation • Organizing after care program for patients after discharge from the hospital. • Providing partial hospitalization options for patients.
