The Health Care Delivery System
What is the health care delivery system? An integrated network of people, institutions, and resources designed to meet population health needs.
What are the 6 traditional levels of health care? Preventive → Primary → Secondary → Tertiary → Restorative → Continuing care.
What is preventive care? Care that prevents disease and reduces risk factors.
What are examples of preventive care? Vaccinations, screenings, and lifestyle counseling.
What is primary care? The first point of contact for routine health care, prevention, and early treatment.
What are examples of primary care? Annual physicals, immunizations, health screenings, and treatment of common illnesses.
Who can provide primary care? Physicians, nurse practitioners (NPs), and physician assistants (PAs).
Where is primary care provided? Clinics, doctor's offices, and community health centers.
What is secondary care? Specialty care, usually provided after referral from primary care.
What are examples of secondary care? Cardiology, orthopedics, and endocrinology.
What is tertiary care? Highly specialized, advanced care for complex or life-threatening conditions.
What are examples of tertiary care? Organ transplants, neurosurgery, trauma care, cancer treatment, and NICU care.
Where is tertiary care 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.
What is restorative care? Care that helps patients recover and regain independence after illness, injury, or surgery.
What are examples of restorative care? Home care, rehabilitation, and extended care facilities.
What is rehabilitation? Care such as physical, occupational, and speech therapy that helps restore function after illness or injury.
What is continuing care? Ongoing support for people with chronic illnesses, disabilities, or age-related needs.
What are examples of continuing care? Nursing centers, assisted living, respite care, adult day care, palliative care, and hospice care.
What is respite care? Temporary care that gives a patient's regular caregiver a break.
What is assisted living? Housing that allows independence while providing help with daily activities.
What is adult day care? Daytime programs that provide social activities, meals, and health monitoring.
What is palliative care? Care focused on comfort, symptom relief, and quality of life for people with serious illness.
What is hospice care? Comfort-focused care for people with terminal illness.
What is integrated health care delivery? Coordinated, continuous care involving health professionals, leaders, and community members.
What does integrated health care emphasize? Primary care, preventive care, population health, collaboration, and health promotion.
What is health promotion? Helping people improve their health and reduce their risk of disease.
What is population health? Health outcomes of an entire group or population.
What is discharge planning? Planning for a patient's safe transition from the hospital to home or another care setting.
What does discharge planning include? Assessing needs, coordinating follow-up care, arranging services, and teaching the patient and family.
What is an important goal of discharge planning? Support recovery and prevent hospital readmission.
When should discharge planning begin? Early in the patient's care, not only on the day of discharge.
What is case management? Coordinating a patient's care and services across the health care system.
What is a case manager's goal? Coordinate appropriate care, resources, and services for the patient.
What is health literacy? A person's ability to obtain, understand, and use health information to make health decisions.
Why is health literacy important? Patients need to understand health information and instructions to manage their care safely.
What is health equity? Everyone has a fair opportunity to achieve their best possible health.
What is a health disparity? A difference in health or access to health care among different groups.
What can affect access to health care? Cost, insurance, location, availability of providers, and other social or economic barriers.
What is patient satisfaction? A measure of the patient's experience with the care received.
Why is patient satisfaction important? It is an important measure of health care quality and is linked to Medicare reimbursement.
What is HCAHPS? A standardized survey that collects and publicly reports patients' experiences and satisfaction with hospital care.
What does HCAHPS measure? Patients' experiences with hospital care.
Why is HCAHPS important? It allows comparison of hospitals and is connected with quality and reimbursement.
What does Pay for Value mean? Health care organizations are financially rewarded for providing high-quality, effective care rather than simply providing more services.
What is the main idea of Pay for Value? Better quality and outcomes are rewarded.
What is 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 a doctor has a set number of patients? No. It means the provider receives a set payment per patient for a specific period.
What is health care quality? Care that is safe, effective, and timely and produces good patient outcomes.
What is competency in health care? Having the knowledge and skills needed to provide safe and effective care.
What are major issues affecting health care delivery? Health care costs and quality, patient satisfaction, nursing shortage, and competency.
What are 4 major challenges facing nursing? Aging baby boomers, shortages/uneven distribution of providers, nurse retirements, and uncertainty of health care reform.
What contributes to the nursing shortage? Burnout, an aging workforce, nurse retirements, and limited nursing-school enrollment.
How can the nursing shortage affect patients? Higher nurse-to-patient ratios, errors, delays in treatment, readmissions, and decreased quality of care.
How does the nursing shortage affect nurses? Increased workload, stress, fatigue, overtime, and burnout.
How does the nursing shortage affect hospitals? It can reduce available beds and services and increase staffing costs.
Why are rural and underserved areas affected strongly by nursing shortages? They may already have limited access to health professionals and health care services.
What is home care? Health care and support provided to a patient in the patient's home.
What is an extended care facility? A facility providing ongoing care and assistance for people who need longer-term support.
What is a nursing center? A facility providing 24-hour nursing care, rehabilitation, and personal assistance.
What is the overall goal of restorative care? Maximize independence and quality of life.
What is the overall goal of continuing care? Support chronic health needs and maintain quality of life.
What is the easiest way to remember Primary Care? Where the patient goes FIRST.
What is the easiest way to remember Secondary Care? SPECIALIST care.
What is the easiest way to remember Tertiary Care? Highly SPECIALIZED advanced care.
What is the easiest way to remember Restorative Care? RECOVER and regain independence.
What is the easiest way to remember Continuing Care? ONGOING or long-term support.