CHAPTER 1 Introduction to Healthcare Delivery Systems

1 CHAPTER 1 Introduction to HealthcareDelivery Systems1 ObjectivesAfter reading this CHAPTER , you should be able to: Outline the dynamics affecting today s Healthcare industry Identify some major challenges that affect the Delivery ofhealth care in the United States Enumerate the various Healthcare settings in which patientscan receive care Distinguish the various types of patient populations Delineate various professions within the Healthcare industryand determine requirements for entry into the career field Categorize the various types of physician specialties Compare the three levels in which Healthcare services :Brogan 6/24/08 6:37 PM Page 1 Jones and Bartlett Publishers, LLC.

2 NOT FOR SALE OR DISTRIBUTION. Distinguish the concepts of licensure, accreditation, and certification Describe the functions of various Healthcare accreditingagencies Identify the various Healthcare agencies under the Departmentof Health and Human Services Identify and describe the functions of common health organi-zations and associationsMain Terms2 CHAPTER1: Introduction TOHEALTHCAREDELIVERYSYSTEMSThe Healthcare industry began as a predominantly volunteer orcharitable system where patients paid little to no money for treatmentand services. Since its beginnings, this industry has undergone somemajor changes.

3 Health care has now evolved into a business entitythat requires strategic planning, financial management, operationalcontrol, and functional specialties to maintain its Healthcare industry is now one of the largest industries in theUnited States, employing over 13 million workers with a projectedincrease of over 3 million new jobs by the year 2014 (BLS, 2007).This overwhelming growth has caused health care to be one of themore stable and flexible industries for employment. As the industryAccreditationAmbulatory care facilityAncillaryCertificationComplement ary therapiesDeemed statusElectronic health recordGeriatricHome healthHospiceHospitalInpatientLicensureL ong-term careNaturopathicOutpatientPalliative careRespite :Brogan 6/24/08 6:37 PM Page 2 Jones and Bartlett Publishers, LLC.

4 NOT FOR SALE OR , there will be an increased demand for qualified and skilledworkers to fill positions that require specialized skills and advancedtechnical knowledge. There are several other dynamics and challengesthat will also affect this growth pattern in health DynamicsMany changes in Healthcare structure continuously shape the indus-try, creating and improving job functions. Factors such as technologi-cal advances, the aging population, complementary therapies, andincreasing costs will have an impact on the growth of the advances are improving patient care and aiding diag-nostic, therapeutic , and ancillary processes.

5 Physicians and otherclinical personnel are able to make more precise and better-informed decisions due to improved diagnostic techniques such asthree-dimensional ultrasounds, which allow a multidimensionaland clearer viewing of internal body structures. Clinical and ancil-lary personnel are able to streamline many workflow and documen-tation processes due to the development of the electronic healthrecord (EHR). EHR technology allows multiple and simultaneoususers to view medical records from mobile locations, which makespatient care more efficient and speeds reimbursement processes(Amatayakul, 2004).

6 The Aging PopulationThe life expectancy for a citizen is years of age, according tothe National Center for Health Statistics (2004). As the average lifeexpectancy age increases, the elderly population, which is the largestgroup of Healthcare consumers, will also grow. As a result of thisgrowth, Healthcare usage will increase because the natural functioningof the body deteriorates with aging and the risks of acquiring chronicand/or systemic diseases such as hypertension, diabetes, and kidneyfailure Dynamics :Brogan 6/24/08 6:37 PM Page 3 Jones and Bartlett Publishers, LLC. NOT FOR SALE OR illnesses such as the ones mentioned earlier require continuousand prolonged treatment.

7 Therefore, the need for geriatricspecialists,especially in highly populated elderly communities, will grow. Thisincrease will, in turn, trigger the need for clinical professionals trainedin the treatment of conditions that most often affect the TherapiesTraditional western medicine focuses on treatment of a disease or ill-ness instead of the patient as a whole. Other options known as com-plementary therapiesincorporate a holistic approach to patient carewhereby they assess and treat the physical, mental, emotional, andspiritual needs of an individual. Some of these alternative therapiesinclude acupuncture, message therapy, colon cleansing, and Chinese art of acupuncture has been practiced for thousands ofyears in many eastern countries, yet has only been used for a little over150 years in the United States.

8 Acupuncture is the application of fine4 CHAPTER1: Introduction :Brogan 6/24/08 6:37 PM Page 4 Jones and Bartlett Publishers, LLC. NOT FOR SALE OR at specific points, which are dependent on a patient s condi-tion and symptoms. Before inserting needles into an individual, theacupuncturist conducts a thorough review of the patient s symptomsin order to determine the underlying cause of the symptoms (Balch &Stengler, 2004).Acupuncture is used to treat a number of illnesses and conditions,including: Back pain Sciatica Muscle pain and weakness Arthritis Migraines and headaches Tendinitis Toothaches Allergies Asthma Skin conditions Diabetes Urinary conditions Premenstrual syndrome Menopausal symptoms Nausea and vomiting Morning sickness Digestive problems Infertility Addictions Weight problems Depression and anxietyDue to increased support by Healthcare organizations and associationsand acceptance by medical professionals and patients, this therapy isbecoming a mainstay in the culture.

9 Some third-party payers arenow reimbursing for acupuncture services, especially those servicesrelated to the treatment of substance abuse and dependence. Enroll-ment in acupuncture programs is growing and will most likelyincrease as more patients seek such TherapyMassage therapy promotes health and healing through touch; thera-pists stimulate and manipulate certain muscles and tissues throughoutHealthcare Dynamics :Brogan 6/24/08 6:37 PM Page 5 Jones and Bartlett Publishers, LLC. NOT FOR SALE OR body to provide specific health benefits. There are over 80 types ofmassage (see Table 1-1) that have varying techniques, philosophies,and benefits.

10 Massage is often used for relaxation, but it is also usedmedicinally to treat a variety of ailments, including: Pain Tension Stress Anxiety Insomnia Muscle strain Premenstrual syndrome Pregnancy complications Arthritis Immune system disorders Acquired immune deficiency syndrome/human immunodeficiencyvirus (AIDS/HIV ) Gastrointestinal problems Cardiovascular conditions Backaches6 CHAPTER1: Introduction :Brogan 6/24/08 6:37 PM Page 6 Jones and Bartlett Publishers, LLC. NOT FOR SALE OR a result of increased demand for massage therapy services, the pro-fession is experiencing favorable growth.