Chapter 1
Health Care in the United States
Gerdin: Health Careers Today, 7th Edition
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Learning Objectives
Lesson 1.1: Health Care in the United States
1. Discuss the history of medicine and the evolution of healthcare in the
United States.
2. Define health and components of the healthcare system and industry.
3. Describe differences between the medical model and wellness model.
4. Describe the different factors that have contributed to the rising cost of
health care and demand for healthcare reform.
5. Discuss the single-payer model and its advantages and disadvantages
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Health in the United States
• Medical model
• Illness requires treatment – sick care
• Wellness model
• Preventative health – shifting the focus to well care
• State of optimal well-being
• Demographic data
• Census (Age, Gender, Race/Ethnicity, etc.)
• Epidemiology
• It is the study of the nature, cause, control, and determinants of the
frequency of disease, disability, and death in a population
• Centers for Disease Control (CDC) ) is responsible for collecting and
interpreting healthcare statistics and data that is usually compiled from
local, county, and state health departments. As part of its data collection,
the CDC is able to determine the leading causes of death in the United
States
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Public Health
• Endemic
• Normal baseline of disease in a population / or geographic area
• Epidemic
• Increased presence of disease in a population or geographic area – oftentimes the
increase is sudden
• Pandemic
• Epidemic spread over several countries
• Morbidity
• Morbidity refers to the level of health and well-being.
• Mortality
• Mortality refers to the risk of death
Good News:
Healthier lifestyle has attributed significantly to the decrease since many of
the leading causes of death are associated to certain risk factors and, thus,
can be changed with lifestyle and behavioral changes
Healthcare Systems
• Hospitals
• Physician’s offices, clinics
• Health maintenance organizations
• Public healthcare
• Long-term care centers, nursing homes
• Specialty hospitals
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Healthcare Policy
• Challenges
• Accessible
• Affordable
• Uninsured, underinsured
• Health insurance
• Deductibles
• Co-insurance
• Co-payments
• Premiums
• Deductibles
• Affordable Care Act (ACA), March 2010:
• The ACA advanced healthcare reform by including provisions such as prohibiting
insurers from denying coverage for pre-existing conditions, subsidizing insurance
premiums, and providing incentives for businesses to provide healthcare benefits.
• It encouraged states to create health insurance exchanges, also called the Health
Insurance Marketplace, where uninsured adults or small businesses can buy insurance
from a range of private insurers.
• The ACA also expanded health insurance coverage by extending Medicaid coverage to
many low-income individuals and providing subsidies to health insurance exchanges
that cover individuals below 400% of poverty.
Healthcare Payer Models
•Proposed alternatives – numerous challenges
• Single-payer model
• Public agency would finance
• Healthcare delivery would remain private sector
• Funding a single-payer program would be done by
replacing the current system of multiple payers and paid
for with a new tax plan. Specifically, income tax and
corporate and sales taxes will most likely need to be raised
to supplement the fund
• Universal coverage
• All Americans covered by law
• Dental, vision
• At No cost
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Chapter 2
Healthcare Facilities and Organizations
Gerdin: Health Careers Today, 7th Edition
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Learning Objectives
Lesson 2.1: Healthcare Facilities and Organizations
1. Differentiate between inpatient and outpatient health care delivery
settings.
2. Understand the difference between acute care and ambulatory care.
3. Differentiate between the different types of outpatient health care
facilities, including the provider office, ambulatory care center, urgent
care center, retail clinic, home health care, and hospice care.
4. Discuss the various types of inpatient care, including acute care hospitals,
long-term care facilities, skilled nursing facilities, and assisted living
facilities.
5. Explain the importance of home health care and hospice care.
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Healthcare Facilities and
Organizations
• Hospitals
• Nursing and residential care facilities
• Medical offices, clinics
• Ambulatory care
• Outpatients
• Visits or encounters
• Acute care
• Inpatients
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Inpatient vs Outpatient Care
• Inpatient settings involve extended stays,
where patients receive care within a facility.
• Outpatient settings allow patients to receive
care without an overnight stay. It's crucial to
recognize the differences in the level of care and
services provided in these two settings.
Types of Inpatient Care:
• Inpatient care involves longer stays.
• Acute Care Hospitals: Intensive medical care for critical
conditions.
• Long-Term Care Facilities: Extended care for chronic illnesses
or disabilities.
• Skilled Nursing Facilities: Professional nursing care for
recovery.
• Assisted Living Facilities: Supportive housing for those
needing assistance.
Acute Care vs. Ambulatory Care:
• Acute care involves immediate, intense
treatment typically provided in hospitals for
severe illnesses or injuries.
• Ambulatory care, on the other hand, focuses on
outpatient services, emphasizing preventive
care, diagnostics, and treatments without
extended hospital stays.
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Acute care Facilities
• Medical conditions requiring immediate
treatment
• Around-the-clock care
• Hospitals
• 40% of all healthcare employees
• The Joint Commission (TJC)
• Accreditation of 78% of hospitals
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Acute care Facilities
• Long-term care facilities (LTCs)
• Stays over 30 days
• Skilled nursing facilities
• Intermediate care facilities
• Assisted living
• Home healthcare
• Bringing medical services to patients at home.
• Physical Therapy, Occupational Therapy, Infusions, Wound care
• Hospice care
• Palliative care
• Compassionate end-of-life care.
Importance of
Home Healthcare and Hospice Care
• Home healthcare extends medical services to
patients' homes, promoting comfort and
independence.
• Hospice care offers compassionate support during
the end-of-life journey, focusing on comfort and
quality of life for both patients and families.
Ambulatory Care Settings
• Same-day treatment
• Hospital-based
• Free-standing:
• Physician’s office
• Primary care
• Primacy care provider (PCP)
• Sole proprietorship
• Single Providers practice
• Partnership
• Group practice / Multiple Providers
Other Facilities
• Clinic
• Walk-ins
• Appointments
• Diagnostic facility
• Imaging (x-rays, MRI, CT Scans)
• Labs (routine blood work)
• Ambulatory surgery centers (ASCs)
• Urgent care clinics
• Provide immediate, non-emergency care.
• Retail health clinics
• Provide Convenient, basic healthcare services.
Summary
• Understanding these healthcare settings is pivotal as
it empowers us to navigate the complex and
interconnected web of services that contribute to the
well-being of individuals and communities.
• As future healthcare professionals, this knowledge
equips us to provide informed, patient-centered care.