(HDS) Healthcare Delivery Systems Module Overview

Healthcare Delivery Systems 

Image of an adding machine with paper printoutsIntroduction

Healthcare costs have increased over time and are the subject of much debate. When an individual is ill should the individual go to an Urgent care facility or the local Hospital Emergency room? Is there a cost difference? Exactly what is the cost for the visit; is it the $20 co-pay? These are all relevant questions and you will have an opportunity to conquer this territory as we explore the differences between healthcare agencies, the factors affecting how care is delivered, and most importantly how to involve patients and families in the care process.

Essential Questions

  1. What are the different types of healthcare delivery systems, who qualifies for their services, and what are the services that these systems provide?
  2. What responsibilities does the consumer/patient have within the healthcare system and what steps can be taken to engage the patient/family in their own healthcare?
  3. How will emerging issues, i.e., technology, epidemiology, bioethics, and socioeconomics, impact healthcare delivery systems?
  4. What current trends in healthcare delivery are expected to impact the quality, cost, and availability of services and the need for healthcare personnel?
  5. How has technology influenced the healthcare system?
  6. What services are performed in healthcare delivery systems that help to ensure the delivery of quality healthcare?
  7. What can happen to people that do not have health insurance?

Module Minute

Image of a clock with words The Module MinuteHealthcare is provided to patients through public, private, government, and non-profit agencies. Publicly owned companies do not pay out dividends to stockholders while privately owned companies split the profit between the company owners. Government-operated facilities are supported by tax dollars and non-profit agencies depend 100% on donations to help the company. The delivery of patient care is impacted by several elements. Among them are cost, accessibility, increased aging population, demand, and quality of care delivered. Patients and families are encouraged to participate in their plan of care; Education is provided to inform patients of the importance of complying with the prescribed medical treatment plan to improve health outcomes. Electronic medical records, the obesity epidemic, and universal healthcare continue to impact the healthcare delivery system.

Keywords

Please review the following terms.

  1. Healthcare facility -  Places designed to care for sick populations, i.e., hospitals, clinics, and doctor's offices.
  2. General hospital - A facility that provides short-term care to various medical, surgical, and emergency populations.
  3. Specialty hospital - A facility providing care for special populations, including psychiatric and chronic disease populations.
  4. Convalescent centers - Facilities providing care to elderly or geriatric patients. These centers are known as nursing homes and long-term care facilities.
  5. Ambulatory care - A facility providing outpatient services that do not require an overnight stay.
  6. Rehabilitation center - A facility providing outpatient support for individuals requiring therapy services such as speech, occupational or physical therapy.
  7. Health Maintenance Organizations (HMO) - An organization that provides health care to voluntarily enrolled individuals and families by member physicians with limited referral to outside specialists. Services include hospitalizations, wellness, checkups, and education.
  8. Home healthcare - An agency providing services to patients in their homes, including nursing, therapy services, and personal care.
  9. Hospice - An agency providing care for terminally ill individuals either in the individual's home or as a specialty hospital.
  10. World Health Organization (WHO) - An international public health agency sponsored by the United Nations, responsibilities include providing global leadership through health research and statistical analysis of serious health problems throughout the world.
  11. U.S. Department of Health and Human Services (USDHHS) - The United States government’s principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves.
  12. National Institutes of Health (NIH) - A division of the USDHHS; Responsible for medical research on diseases.
  13. Centers for Disease Control and Prevention - A division of the USDHHS with the core responsibilities of detecting and responding to new and emerging health threats.
  14. Food and Drug Administration (FDA) - A federal agency responsible for the approval and regulation of food, drugs, and devices sold to the public and used for medical treatment.
  15. Agency for Health Research and Quality (AHRQ) - A division of the USDHHS with the core responsibilities of providing research that helps people make more informed decisions and improve the quality of health care services.
  16. Occupational Safety and Health Administration (OSHA) - A federal agency responsible for setting and enforcing standards that assure safe and healthful working conditions for employees.
  17. Non-profit agency - An agency supported by donations, fees for services, and federal or state grants (American Cancer Society, American Heart Association, March of Dimes).
  18. Preferred Provider Organization (PPO) - A health insurance option that restricts healthcare access to specific hospital(s) and doctor(s) at a discounted rate.
  19. Medicare - The Federal government program provides coverage for individuals over the age of 65, a select disability population, and those with end-stage renal disease (ESRD).
  20. Patient Protection and Affordable Care Act - A 2010 law establishing a goal to ensure that all Americans have access to affordable quality care while containing the cost required to deliver care.
  21. Tricare - A health care program for military service members.
  22. Health Insurance Portability and Accountability Act of 1996 (HIPAA) - A law that provides patients more control over their health information, sets limits on the use and release of personal medical records, and established a series of privacy standards for healthcare providers which provides penalties for those who do not follow these standards.
  23. Managed Care - A system of care in which patients agree to seek treatment from contracted physicians and to seek approval for payment before treatment as a method to control cost.
  24. Workers Compensation - Health insurance plans that provide care for those that are injured while on the job.

 

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