L
EARNING
O
UTCOME
1
Differentiate health care services based on primary, secondary, and tertiary
disease prevention categories.
Concepts for Lecture
2. Primary prevention consists of health promotion and illness preven-
tion. Health promotion emphasizes client participation in order to
3. Secondary prevention consists of diagnosis and treatment. These
services are offered in hospitals, freestanding diagnostic and treat-
4.
The goal of tertiary prevention, which consists of rehabilitation, health
restoration, and palliative care, is to help an individual move to his or her
previous level of health or to the highest level he or she is capable of,
L
EARNING
O
UTCOME
2
Describe the functions and purposes of the health care agencies outlined in
this chapter.
Concepts for Lecture
1. Government agencies are established at the federal, state, and local
levels to provide public health services.
Physicians’ offices are primary care settings providing routine
C
HAPTER
6
HEALTH CARE DELIVERY SYSTEMS
S
UGGESTIONS FOR
C
LASSROOM
A
CTIVITIES
•
Provide the students with a list of health care
services and ask them to classify the services
as primary, secondary, or tertiary prevention.
S
UGGESTIONS FOR
C
LINICAL
A
CTIVITIES
S
UGGESTIONS FOR
C
LASSROOM
A
CTIVITIES
• Ask each student to write a short paper on a
health care agency, further exploring the purpose
and function.
•
Invite a panel of speakers from retirement or
assisted living centers, day-care centers, crisis
centers, and self-help groups to discuss the
purpose and functions of these groups.
28 CHAPTER 6 / Health Care Delivery Systems
Hospitals (governmental or nongovernmental) may be for–profit
or not-for-profit facilities. Hospitals may provide acute inpatient,
outpatient, or ambulatory care services; emergency room services;
todial care. Extended care facilities have programs that are oriented
to the needs of the older adult because chronic illness occurs most
often in this age group.
Retirement and assisted living centers are intended to meet the
needs of individuals who are unable to remain at home but do not
work, and others provide care for adults who cannot be left home
alone but do not need to be in an institution. These centers provide
care involving socializing, exercise programs, and stimulation.
Rural primary care hospitals, created by several federal acts, re-
ceive federal funding to remain open and provide the breadth of ser-
CHAPTER 6 / Health Care Delivery Systems 29
L
EARNING
O
UTCOME
3
Identify the roles of various health care professionals.
Concepts for Lecture
1. Providers of health care, also known as the health care team or
health care professionals, are nurses and individuals from other dis-
ciplines who coordinate skills to assist clients and the client’s sup–
Alternative (complementary) care providers provide care not
the purchase and preparation of foods.
Occupational therapists (OTs) assist clients with impaired func-
tion to gain skills to perform activities of daily living.
Paramedical technologists include laboratory, radiological, and
nuclear medicine technologists, among others. Their roles depend on
problems treating movement dysfunctions by means of heat, water,
exercise, massage, and electric current. Physical therapy aides also
work with PTs and clients.
Physicians and health care providers are responsible for the
medical diagnosis and for determining the therapy required by a per-
S
UGGESTIONS FOR
C
LASSROOM
A
CTIVITIES
•
Invite a panel of health care professionals—
such as physical, occupational, and respiratory
therapists; a paramedical technologist; and a
social worker—to describe their roles and
functions.
the care of clients with cardiopulmonary problems.
Social workers counsel clients and their support persons regard-
ing problems in day–to–day living such as assisting with financial
L
EARNING
O
UTCOME
4
Describe the factors that affect health care delivery.
Concepts for Lecture
1. Factors that affect health care delivery include the increasing number
of older adults, advances in technology, economics, women’s health,
uneven distribution of services, access to health insurance, the home-
less and the poor, the Health Insurance Portability and Accountabil-
training of specialized personnel. In addition, use of computers is
commonplace in health care agencies, permitting increased storage
and retrieval of data. The World Wide Web and Internet have in-
til recently, women’s health care focused on reproductive aspects of
health, disregarding many health care concerns unique to women.
Investigators are recognizing the need for research that examines
women equally to men in health issues.
Uneven distribution of health services exists in the United States
S
UGGESTIONS FOR
C
LASSROOM
A
CTIVITIES
• Have the students debate whether health care is a
right or privilege.
•
Invite guest speakers to address health care
delivery to the elderly, the poor, and the
homeless in your community.
S
UGGESTIONS FOR
C
LINICAL
A
CTIVITIES
CHAPTER 6 / Health Care Delivery Systems 31
ic. Physical, mental, social, and emotional factors create health chal-
lenges for the homeless and the poor. Limited access to health care
services significantly contributes to the general poor health of the
homeless and poor in the United States.
L
EARNING
O
UTCOME
5
Describe the frameworks for the delivery of nursing care.
Concepts for Lecture
1. Today’s health care consumers have greater knowledge about health
2. Consumers have also become aware of how lifestyle affects health.
3. By the year 2020, it is estimated that the number of U.S. adults over
4. Scientific knowledge and technology related to health care are
changing and improving constantly.
6. The women’s movement has been instrumental in changing health
7. Serious problems in the distribution of health services exist in the
8. Another problem plaguing individuals is access to health insurance.
10.
The characteristics of North American families have changed considera-
L
EARNING
O
UTCOME
6
Compare various systems of payment for health care services.
S
UGGESTIONS FOR
C
LASSROOM
A
CTIVITIES
• Have students debate whether health care is a
right or a privilege.
•
Invite guest speakers to address health care
delivery to the elderly, the poor, and the
• Have students collect current articles in the
32 CHAPTER 6 / Health Care Delivery Systems
Concepts for Lecture
1. Medicare is a national and state health insurance program for adults
over 65 years of age. The Medicare plan is divided into two parts.
Part A provides insurance toward hospitalization, home care, and
2. Medicaid is a federal public assistance program paid out of general
3. Supplemental Security Income benefits are available for individuals
with disabilities, those who are blind, and also individuals not eligi-
4. The State Children’s Health Insurance Program (SCHIP) was estab-
lished by the U.S. government to provide insurance coverage for
5. Congress established the prospective payment system to curtail
6. There are two types of private insurance plans: not-for-profit and
for-profit. Private health insurance pays either the entire bill or, more
7.
Health care group plans provide blanket medical service in exchange for
a predetermined monthly payment. These plans include health mainte-
nance organizations, preferred provider organizations, preferred provider
arrangements, independent practice associations, and physician/hospital
organizations.
A preferred provider organization (PPO) consists of a group of
providers and perhaps a health care agency that provides an insur-
S
UGGESTIONS FOR
C
LASSROOM
A
CTIVITIES
• Invite a guest speaker knowledgeable about
Medicare Part D to discuss this addition to Medi-
care.
how this coverage might influence the type of
bill clients and insurance companies.
