The Health Care Delivery System
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67 Terms
Health Care Delivery System
An integrated network of people, institutions, and resources designed to meet population health needs.
Traditional Levels of Health Care
Preventive, Primary, Secondary, Tertiary, Restorative, Continuing care.
Preventive Care
Care that prevents disease and reduces risk factors.
Examples of Preventive Care
Vaccinations, screenings, and lifestyle counseling.
Primary Care
The first point of contact for routine health care, prevention, and early treatment.
Examples of Primary Care
Annual physicals, immunizations, health screenings, and treatment of common illnesses.
Providers of Primary Care
Physicians, nurse practitioners (NPs), and physician assistants (PAs).
Where Primary Care is Provided
Clinics, doctor's offices, and community health centers.
Secondary Care
Specialty care, usually provided after referral from primary care.
Examples of Secondary Care
Cardiology, orthopedics, and endocrinology.
Tertiary Care
Highly specialized, advanced care for complex or life-threatening conditions.
Examples of Tertiary Care
Organ transplants, neurosurgery, trauma care, cancer treatment, and NICU care.
Where Tertiary Care is Commonly Provided
Large medical centers, teaching hospitals, and specialized hospitals.
Primary vs Secondary vs Tertiary Care
Primary = first contact; Secondary = specialist care; Tertiary = highly specialized advanced care.
Restorative Care
Care that helps patients recover and regain independence after illness, injury, or surgery.
Examples of Restorative Care
Home care, rehabilitation, and extended care facilities.
Rehabilitation
Care such as physical, occupational, and speech therapy that helps restore function after illness or injury.
Continuing Care
Ongoing support for people with chronic illnesses, disabilities, or age-related needs.
Examples of Continuing Care
Nursing centers, assisted living, respite care, adult day care, palliative care, and hospice care.
Respite Care
Temporary care that gives a patient's regular caregiver a break.
Assisted Living
Housing that allows independence while providing help with daily activities.
Adult Day Care
Daytime programs that provide social activities, meals, and health monitoring.
Palliative Care
Care focused on comfort, symptom relief, and quality of life for people with serious illness.
Hospice Care
Comfort-focused care for people with terminal illness.
Integrated Health Care Delivery
Coordinated, continuous care involving health professionals, leaders, and community members.
Emphasizes of Integrated Health Care
Primary care, preventive care, population health, collaboration, and health promotion.
Health Promotion
Helping people improve their health and reduce their risk of disease.
Population Health
Health outcomes of an entire group or population.
Discharge Planning
Planning for a patient's safe transition from the hospital to home or another care setting.
Discharge Planning Components
Assessing needs, coordinating follow-up care, arranging services, and teaching the patient and family.
Goal of Discharge Planning
Support recovery and prevent hospital readmission.
Start of Discharge Planning
Early in the patient's care, not only on the day of discharge.
Case Management
Coordinating a patient's care and services across the health care system.
Goal of a Case Manager
Coordinate appropriate care, resources, and services for the patient.
Health Literacy
A person's ability to obtain, understand, and use health information to make health decisions.
Importance of Health Literacy
Patients need to understand health information and instructions to manage their care safely.
Health Equity
Everyone has a fair opportunity to achieve their best possible health.
Health Disparity
A difference in health or access to health care among different groups.
Access to Health Care Factors
Cost, insurance, location, availability of providers, and other social or economic barriers.
Patient Satisfaction
A measure of the patient's experience with the care received.
Importance of Patient Satisfaction
It is an important measure of health care quality and is linked to Medicare reimbursement.
HCAHPS
A standardized survey that collects and publicly reports patients' experiences and satisfaction with hospital care.
What HCAHPS Measures
Patients' experiences with hospital care.
Importance of HCAHPS
It allows comparison of hospitals and is connected with quality and reimbursement.
Pay for Value
Health care organizations are financially rewarded for providing high-quality, effective care rather than simply providing more services.
Main Idea of Pay for Value
Better quality and outcomes are rewarded.
Capitation
A payment method in which a provider receives a set amount of money per patient for a set period of time.
Does Capitation Mean Set Number of Patients?
No, it means the provider receives a set payment per patient for a specific period.
Health Care Quality
Care that is safe, effective, and timely and produces good patient outcomes.
Competency in Health Care
Having the knowledge and skills needed to provide safe and effective care.
Major Issues Affecting Health Care Delivery
Health care costs and quality, patient satisfaction, nursing shortage, and competency.
4 Major Challenges Facing Nursing
Aging baby boomers, shortages/uneven distribution of providers, nurse retirements, and uncertainty of health care reform.
Contributors to Nursing Shortage
Burnout, an aging workforce, nurse retirements, and limited nursing-school enrollment.
Effects of Nursing Shortage on Patients
Higher nurse-to-patient ratios, errors, delays in treatment, readmissions, and decreased quality of care.
Effects of Nursing Shortage on Nurses
Increased workload, stress, fatigue, overtime, and burnout.
Effects of Nursing Shortage on Hospitals
It can reduce available beds and services and increase staffing costs.
Impact of Nursing Shortages in Rural Areas
They may already have limited access to health professionals and health care services.
Home Care
Health care and support provided to a patient in the patient's home.
Extended Care Facility
A facility providing ongoing care and assistance for people who need longer-term support.
Nursing Center
A facility providing 24-hour nursing care, rehabilitation, and personal assistance.
Goal of Restorative Care
Maximize independence and quality of life.
Goal of Continuing Care
Support chronic health needs and maintain quality of life.
Easiest Way to Remember Primary Care
Where the patient goes FIRST.
Easiest Way to Remember Secondary Care
SPECIALIST care.
Easiest Way to Remember Tertiary Care
Highly SPECIALIZED advanced care.
Easiest Way to Remember Restorative Care
RECOVER and regain independence.
Easiest Way to Remember Continuing Care
ONGOING or long-term support.