Health Care Systems

1. Health Care Systems Health Care Facilities

2. Introduction Many different health care facilities deliver health care. ___ is one of the fastest and largest growing industries in the US. Employs over ___ workers in more than ___ careers. It is a ___ dollar per day business.

3. Hospitals • Vary in size and type of services provided: • General hospitals: Treat a wide range of conditions (___ and ___ ) and age groups. Examples • Specialty hospitals: care for certain conditions or age groups. Examples • Government hospitals: operated by ___ , ___ , and ___ government agencies; worldwide facilities for service personnel. Examples • University or college medical centers: provide services, ___ , and ___

4. Hospitals • Classifications based on funding received • Private or proprietary (operated for profit): usually by pt ___ and/or ___ that provide financial support. • Religious: religious support and patient fees • Nonprofit or voluntary: patient fees and ___ • Government: ___ monies and/or patient fees Assignment: call a hospital in the area and find out how what they are classified as…

5. Long-Term Care Facilities Provide care for ___ , people with ___ or ___ disabilities, and individuals with ___ or long-term illness Individuals receiving care are usually called ___ instead of patients

6. Long-Term Care Facilities • Nursing Homes or Geriatric Homes • Provide basic ___ and ___ care • Usually for individuals who cannot care for themselves • Help individuals with ADLs, provide a ___ and secure environment, and promote opportunities for ___ interaction

7. Long-Term Care Facilities • Extended Care or Skilled Care Facilities • Provide ___ nursing and ___ care • Prepare resident for return to ___ environment or other LTCF • Some have ___ units: provide rehab services for major illness or surgery, treatment for CA, or treatments such as HD or heart monitoring

8. Long-Term Care Facilities • Independent or Assisted Living Facilities • Individuals purchase or ___ units • Receive services such as ___ , ___ , laundry, ___ , ___ events, and basic medical care. • Most assisted or independent living facilities are associated with nursing homes, extended care facilities, and/or skilled care facilities to allow an individual to move readily from one level of care to the next when health needs change.

9. Long-Term Care Facilities • Special services of long-term care facilitates • Delivery of ___ to homes • Senior citizen or adult ___ centers • ___ activities for elderly Assignment: What are some long-term care options in the area?

10. Medical Offices ___ owned offices to large complexes operating as corporations and employing many ___ and other health care professions Services: ___ , treatment, examinations, basic ___ tests, minor ___ , and other similar care. Some treat wide variety of illness/ages; others specialize and deal with only certain age groups and conditions Assignment: What medical offices are in our local area?

11. Dental Offices • Private offices employing a group of ___ • Dental clinics now found in major ___ stores • Can provide general or specialized dental care • Often coincide with spas and ___ surgeons • Assignment: What are some options in the area?

12. Clinics Found in many types of health care Can refer to group of medical/dental doctors who share a facility and other personnel

13. Clinics • Other clinics operated by corporation or private groups and provide specialty care (outpatient) • Surgicenters (one-day/same-day sx) • Emergency care clinics (urgent care) • Rehab Clinics (PT, OT, ST) • Specialty Clinics (DM, WC, HD, infusion clinics) • Health Departments (STD, immunization, WIC, sanitations, etc) • Medical Centers and Colleges/Universities (med students)

14. Clinics • Assignment: What are some options in our area?

15. Optical Centers • Can be individually owned by an ___ or ___ or part of a large chain of stores • Provide vision exams, prescribe eye glasses or contact lenses, and check for the presence of eye disease Assignment: What are some options in our area?

16. Emergency Care Services • Provide special care for accident or sudden illness • Examples: • Ambulance services (private and gov’t) • Rescue squads (first responders) • Emergency care clinics (private) and centers (hospitals) • Helicopter or airplane emergency services Assignment: What are some options in our area?

17. Laboratories • Can be part of a facility or operate as a separate health care service • Medical Labs: • Perform diagnostic tests • Dental Labs: • Prepare dentures and other devices Assignment: What are some options in our area?

18. Home Health Care • Provide care in patient’s homes- called ___ • Examples of care: • Nursing • Personal Care • Homemaking • Therapy • Can be offered by ___ , hospitals, ___ agencies, ___ agencies, ___ agencies, etc Assignment: What are some options in our area?

19. Hospice Agencies • Provide care for terminally ill pts that have a life expectancy of ___ or less. • Provided in a person’s home or a ___. • Palliative care is offered, while allowing the person to die with dignity. • Provides psychological, spiritual, emotional, and financial assistance for ___ and ___. • Also provides support to the family ___. Assignment: What are some options in our area?

20. Mental Health Facilities • Deal with mental diseases and disorders • Examples: • Guidance and counseling centers • Psychiatric clinics and hospitals • Chemical abuse treatment centers for ____ abuse • Physical abuse treatment centers (___, ___, and ___ are examples) • Assignment: What are some options in our area?

21. Genetic Counseling Centers Can be independent or in another facility (hospital, clinic, MD office) Work with couples/individuals who are or are considering pregnancy Test and counsel on genetic disorders (ex: CF, Down’s Syndrome)

22. Rehabilitation Facilities • provide care directed t helping pt with physical or mental disabilities reach maximum ___ potential or function • Hospitals, clinics, private centers • Examples: Assignment: What are some options in our area?

23. Health Maintenance Organizations serve as health care delivery systems and offer types of health insurance Provide total health care directed toward ___ care for a fee that is usually ___ and ___ Some are operated by large industries or corporations; others are operated by small private agencies They use services of other health care facilities including:

24. Industrial Health Care Centers or Occupational Health Clinics • Located in large industries or companies • Provide health care for ___ of the company • Services: Assignment: What are some options in our area?

25. School Health Services found in ___ and ___ Emergency care for ___ illness Test for health conditions, such as: Monitor chronic health conditions Promote health education Maintain safe and sanitary school environment Counseling

26. Government Agencies • offered at international, national, state, and local levels • Most are tax-supported • WHO • USDHHS • NIH • CDC

27. Government Agencies FDA AJCPR OSHA State and Local Health Departments

28. Voluntary and Nonprofit Agencies • Supported by donations, membership fees, fundraisers, and federal or state grants • Provide health services at national, state, and local levels • Examples • ACS, AHA, ADA, AA, MOD, ARC • Many deal with one specific disease or group • Study disease, provide funding for research, promote public awareness/education, provide tx centers, etc

29. Health Insurance Plans

30. Introduction Health care ___ is a major concern of everyone who needs health services. This is increasing much faster than other costs of living. Most individuals rely on ___ to pay for health care costs; w/o this a medical situation could cause financial disaster

31. Health Insurance Plans • Offered by thousands of insurance agencies. • Common example is BCBS. • BCBS-LA • Many individuals have health insurance through ___. (paid in full or shared) • Private policies can also be purchased.

32. Health Insurance Vocabulary Premium Deductible Coinsurance Copayment HMO PPO

33. Medicare • ___ government health care plan • Provides health care for the following individuals: • Three types of coverage • A • B • D

34. Medigap Policies Health insurance plan that helps pay for expenses not covered by Medicare Policies are offered by private insurance companies and require payment of a ____ Provides options that allow enrollees to choose how much coverage they want to purchase

35. Medicaid Medical assistance program that is jointly funded by the ___ and ___ government but operated by individual states. Benefits and individuals covered vary by state Usually covers individuals with ___, children who qualify for public assistance, and individuals who are physically disabled or blind

36. Workers’ Compensation Provide treatment for workers injured on the job Administered by the state Payments made by employers and the state Provides for health care and lost wage

37. US Government Plans Provide care for all active ___ personnel and their ___ or survivors of personnel and retired members TRICARE

38. Managed Care Developed d/t rising costs of health care “health care with a purpose”, ie preapproval ___ care and ___ diagnosis is key Examples of preventive care: Agencies work together to provide care at the most reasonable cost (in-network)

39. HIPPA • 5 main components • Health care access, portability, and renewability • Preventing health care fraud and abuse, administrative simplification, and medical liability reform. • Tax-related health provisions

40. Organizational Structure

41. Introduction

42. Hospital Organizational Chart

43. Medical Office Organizational Chart