Ch.2 Dynamics o/HC: Behavioral health services

diagnostic (HC service 1/3)

imaging and testing procedures used to determine the cause of discomfort and disease

therapeutic (HC service 2/3)

changing the health status of patients overtime through direct care, treatment, counseling, or health education

preventative (Hc service 3/3)

measures taken to prevent discomfort/disease

US HC system

• private: you pay for your own insurance

  • advantages: freedom in choosing H.C providers, immediate care, and you pay for what you need

  • disadvantages: differences in coverage based on socioeconomic status (discrimination) and insurance/H.C linked to job

Australia HC system

• blanket public coverage and private

  • advantages: can chose for better care and everyone has some coverage

  • disadvantages: overwhelmed public system

health promotion (1/5 categories of health services)

education to help patients reduce the risk of illness, maintain optimal function, follow healthy lifestyles
ex. hospitals that offer prenatal nutrition classes

disease prevention (2/5 categories of health service)

public health programs designed to reduce the risk of injury or illness in the workplace or for the general public
ex. city health dept. checking for and removing lead pipes

diagnosing and treatment of illness (3/5 health services)

identifying and treating injury or disease, most often used in service, most often provided in hospital/ambulatory setting, physician visits, lab tests, diagnostic scans, x-rays, etc.

rehabilitation (4/5 health services)

restoration of a person to normal or near-normal function after physical or mental illness can take place in many settings
ex. home, centers, rehabs, hospitals, outpatient clinics, and long-term care facilities

chronic care (5/5 health services)

ongoing care for chronic health conditions that require long-term monitoring usually involves a multidisciplinary team with PCP and specialists
ex. patient with diabetes may require adjustments in diet(dietician), medication, and physical activity team

Healthcare Facilities

where people involved in the healthcare industry work and where patients can receive care

federally qualified health centers (FQHC)

federally funded primary care health centers
provide preventative, medical, dental, and mental health services to low income, minority and homeless individuals in underserved areas
include public and private non profit organizations governed by a board

patient centered medical home (PCMH)

primary care provider (physican or APRN) coordinates healthcare for individual patients

privately funded free medical clinics (FMC)

non-profit, community based or faith-based organizations
provide care with little to no charge to low income individuals who are uninsured and residents in country where clinic is located

national association of free and charitable clinics (NAFC)

US non-profit organization that supports local and regional organizations and volunteers who provide mental, dental, pharmacy, and behavioral healthcare to those disadvantaged or uninsured (receive little to no state federal funds)

hospitals

key resource and center of the US healthcare system- professional heart of all medical practice

hospital development

factors:
- advances in medical science
- advances in medical education
- nursing as a profession

hospital organization

3 methods of categorization
- function or type of
- length of stay
- ownership or source of financial support

public hospital

government owned, financed and operated
aka: essential hospitals and health systems(provide care to vulnerable populations with limited or no access to healthcare due to finances, insurance status, or health condition

non profit hospital

organized for purposes other than generating profit; receive tax exemptions and must provide community benefit
all public are non-profit but not all non-profit are public

for profit hospital

aim to make money for the owner
patients have insurance, private insurance, or medical assistance
ex. proprietary hospitals (saint claires)

community hospitals

short-term, general, and specialty hospitals (chilton medical center)

state hospitals

long-term hospitals that treat chronic illness (the university hospital)

federal hospitals

usually for military, veterans, american indians and alaska natives

religious hospital

owned and operated by religious organizations

ambulatory care

provided outside of institutional settings
most frequent contact

behavioral health

emotions and actions that affect overall well being (mental illness and substance use disorders)

NIMH

NIH subsidiary that conducts mh disorder research

• national institute of MENTAL health (1949)

pharamceuticals

used to alter specific brain functions that are responsible for psychotic symptoms, depression, and anxiety

Community mental health act of 1963

enacted community mental health centers

Community mental health centers

institutions for the treatment of people with mental health problems in the community

deinstitutionalization

movement of mentally disabled people from public or private institutions such as psychiatric hospitals, back to the family or into community-based homes

drug addiction and opioid crisis

spiked in 2001; increased access to medication-assisted treatment and behavioral health treatment

protecting access to medicare act of 2014

prevented a scheduled payment reduction for physicians and other practitioners who treat medicare patients

behavioral health clinics

private health insurance limited treatment of mental illness and substance abuse

mental health parity and addiction equity act of 2008

federal law that requires that health insurance policies include coverage for mental health illness, including out patient counseling

patients bill of rights

developed by american hospital association (1973)
- states the responsibilities of the hospital and staff towards patients and their families

Patient - care - partnership

partnership

replaced the bill of rights in 2003; includes 6 expectations for patients during hospitalization

6 patient-care partnership expectations

1) high-quality hospital care
2) a clean and safe environment
3) patient involvement in their own care
4) protection of patient privacy
5) help when leaving the hospital
6) help with billing claims

informed consent

patient must give permission in advance, for a healthcare provider to deliver services
- h.c provider must educate a patient about the risks, benefits, and alternatives of a given procedure or intervention
- patient must be competent to make a voluntary decision about whether to undergo the procedure or intervention

HHS mission

to enhance and protect the health and well-being of all Americans
- providing for effective health and human services
- fostering advances in medicine, public health, and social services

HHS structure

1) public health
2) biomedical research
3) disease control and prevention
4) indian health services
5)medicare and medicaid
6) food and drug safety
7) mental health services

social security act of 1935 + 1965

1935 - federal funding of state health dept. for maternal and child health services

1965 - established medicare and medicare

11 HHS agencies

• public health

• biomedical research

• disease control and prevention

• Indian health services

• Medicare and medicaid

• food/drug safety

• mental health

• FDA - food and drugs