What is the health care delivery system
Download
1 / 20

What is the Health Care Delivery System - PowerPoint PPT Presentation


  • 444 Views
  • Updated On :

What is the Health Care Delivery System?. A mechanism for providing services that meet the health-related needs of individuals. Three levels of Health Care. Primary Secondary Tertiary. Primary Care.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'What is the Health Care Delivery System' - kimball


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
What is the health care delivery system l.jpg
What is the Health Care Delivery System?

A mechanism for providing services that meet the health-related needs of individuals.


Three levels of health care l.jpg
Three levels of Health Care

  • Primary

  • Secondary

  • Tertiary


Primary care l.jpg
Primary Care

  • Goal: To decrease the risk to a client (individual or community) of disease or dysfunction.

  • Approach: General health promotion. Protection against specific illnesses.


Secondary care l.jpg
Secondary Care

  • Goal: To alleviate disease and prevent further disability.

  • Approach: Early detection and intervention.


Tertiary care l.jpg
Tertiary Care

  • Goal: To minimize disability associated with chronic or irreversible conditions.

  • Approach: Restorative and rehabilitative activities to attain optimal level of functioning.


The u s system l.jpg
The U.S. System

Health care services are delivered and financed by three sectors:

  • The public (official, voluntary, and nonprofit agencies)

  • Public/private

  • Private (hospitals, extended-care facilities, hospices, schools, etc.)


Health care settings l.jpg

Hospital

Extended-care facilities

Home health care agencies

Hospices

Out-patient settings

Schools

Industrial Clinics

Managed care organizations

Community nursing centers

Rural primary care hospitals

Health Care Settings


Health care team members l.jpg
Health Care Team Members

Health care is delivered by a multidisciplinary team, all working together. Examples include:

  • Physician (MD)

  • Nurse (RN, LP/VN)

  • Nurse Assistant (CAN)

  • Registered Dietician (RD)


Economics of health care l.jpg
Economics of Health Care

The U.S. health care system has a diverse base:

  • 32% private insurance

  • 14.8% medicaid

  • 18.8% Medicare

  • 11.8% Other public programs

  • 17.4% Out of Pocket

  • 4.5% Other private


Private insurance model l.jpg
Private Insurance Model

  • Basis of U.S. system

  • Individual pays monthly premiums for coverage and receives access on an as needed basis


Managed care model l.jpg
Managed Care Model

  • Developed to provide coordinated care with an emphasis on prevention

  • A system of providing and monitoring care wherein access, cost, and quality are controlled before or during delivery of service


Hmos ppos and epos l.jpg
HMOs, PPOs and EPOs

  • Health Maintenance Organizations (HMOs) have a single point of entry. Entry into the health plan through a point designated by the plan.

  • Preferred Provider Organizations (PPOs) allow individuals to access health care from within a pool of providers.

  • Exclusive Provider Organizations (EPOs) are similar to PPOs except that care is intended to be delivered exclusively from within the selected pool of providers.


Federal insurance plans l.jpg
Federal Insurance Plans

  • Medicare: Provides health care coverage for elderly persons and disabled persons.

  • Medicaid: Federal and Local administered program that provides health care services for the poor.


Factors influencing health care l.jpg
Factors Influencing Health Care

  • Cost

  • Access

  • Quality


Cost issues l.jpg
Cost Issues

Many factors influence costs:

  • An oversupply of specialized providers

  • A surplus of hospital beds

  • The passive role assumed by most consumers.

  • The aging of the population.

  • The increased number of people with chronic illnesses.

  • Unnecessary use of services (e.g. additional diagnostic testing) and increase in health-related lawsuits.


Access issues l.jpg
Access Issues

Many factors influence an individuals ability to access the health care system:

  • Inadequate or cost of insurance

  • Cultural barriers

  • Limited access to ancillary services (e.g. child care, transportation)

  • Certain preexisting conditions making it difficult to obtain insurance

  • Shortage of providers in rural or inner city areas


Quality issues l.jpg
Quality Issues

Many factors influence the quality of care individuals receive:

  • The litigious environment and response toward defensive practice (e.g. ordering all possible tests).

  • The widely held American belief that more is better.

  • Lack of access to and continuity of services result in subsequent misuse of acute services.


Challenges l.jpg
Challenges

The U.S. Healthcare system faces some serious challenges:

  • Public’s disillusionment with providers

  • Public’s loss of control over health care decisions

  • Changes in practice settings

  • Decreased use of hospitals and related impact on quality of care

  • Ethical issues

  • Health care needs of vulnerable populations


Nursing s response to the challenges l.jpg
Nursing’s Responseto the Challenges

The nursing profession has responded to the multiple challenges in health care delivery by proposing a plan for reform.


Nursing s vision for the future l.jpg
Nursing’s Vision for the Future

To provide health care services that emphasize PREVENTION and PRIMARY HEALTHCARE for clients, thereby helping to reduce costs and increase the quality of health care


ad