Health Care Delivery Notes

Health Care Delivery

Levels of Care in Inpatient Settings

• Acute Care Hospital:

  • Provides emergency care, surgeries, inpatient care.
  • Offers diagnostic testing and possibly outpatient care.

• Long Term Acute Care Hospital:

  • Patients have serious medical problems requiring continued medical treatment.
  • Typically lasts 20-30 days.

• Skilled Nursing Facility:

  • Provides a less intense level of care than a traditional hospital.
  • The stay can range from a few days to 100 days.

Long Term Residential Care

• Assisted Living:

  • Offers less nursing care than long-term care facilities.
  • Provides 24 hour assistance.
  • Assistance with medications and personal care is provided.
  • Meals are often provided.

• Memory Care:

  • Care for residents with cognitive issues.
  • 24 hour care provided by CNAs.
  • RN or LPN is available on the unit or on call.

• "Nursing Home":

  • Nursing care is provided around the clock.
  • Staffed by RNs, LPNs, and CNAs.

Outpatient Care

• Examples of Outpatient Care:
  • Ambulatory care centers
  • Observation units
  • Mental Health Services
  • Cardiac rehabilitation
  • Ambulatory Care clinics
  • Health Departments
  • Medical Offices
  • Home health care
  • Hospice

Delivery of Nursing Care

• Team Nursing:

  • A team that consists of nurses and assistive personnel
  • Traditional model

• Patient-Centered Care:

  • Patient has control of managing their care
  • Often seen in rehab facilities
  • Generally, fewer people are involved in giving care

• Primary Care Nursing:

  • One nurse is responsible for all aspects of nursing care
  • Common in ICUs

• Case Management:

  • Nurse functions in multiple roles to meet the overall needs of the patient.
  • Found in a variety of facilities; insurance, hospitals, LTC

Affordable Care Act

• Signed into law in 2010 to provide insurance to all Americans.
• Addresses four major issues:
  • Cost containment
  • Pre-existing conditions
  • Small business premiums
  • Lifetime benefit caps

Reimbursement Platforms

• Medicare:
  • Federal government insurance for people older than 65.
  • Uses payment schedule based on diagnosis-related groups (DRGs).
  • Parts A thru D
• Medicaid:
  • Federal-state program that provides health care for individuals below the poverty level as well as disabled individuals, children, and pregnant women.
• Private Health Insurance:
  • Insurance typically offered through an employer
  • Multiple health plans are provided