HSCI 678 Intro to US Healthcare System.ppt

The Continuum of Care Chapter 13, 14, 15, 16 17 Tracey Lynn Koehlmoos, PhD, MHA Continuum of Care Prenatal Care/Healthy Birth Health Promotion Primary Disease Prevention Diagnosis of Disease Treatment of Acute Disease Secondary Disease Prevention Tertiary Disease Prevention Treatment of Chronic Illness Rehabilitative Care Long Term Care Palliative Care Primary Care Diagnosis of illness, initial treatment Episodic care for common illness injury Prescription drugs for common illness Routine dental care (exams, cavities) Diagnosis of potentially serious physical or mental health conditions that require prompt referral for secondary or tertiary care Primary Care Providersby Specialty Other Primary Care Providers More than 23% of clinical PC visits are to FP’s PA’s, ARNP’s, Midwives, nurses, Chiropractors Issues in Primary Care Access Availability of providers 2:1 Specialists to PCP’s Reimbursement Lower rate Devaluing of care Self-referral to specialists Secondary Care Disease has crossed the clinical threshold Continuing care of chronic conditions In-patient, ambulatory, specialty surgery center, hospital ER Ambulatory Visits by Physician Type Access to Secondary Care Financial barriers (frequent treatment) 99 Million Americans have chronic disease; and that number is growing! By 2050, 167 million costing $906 billion Secondary care also includes hospitalizations with fairly common surgeries (hysterectomy, cardiac cath, childbirth) Issues in Secondary Care Growing need Limited access (financial, geographic, insurance) Many diagnostic and treatment services are moving/have moved to outpatient setting. (Shift in delivery system) Long Term Care Continuous care over a period of at least 90 days for acute and chronic conditions 12 million need LTC in US population 50% 65 yrs. (40% working adults, 3% kids) Includes mental and developmental disabilities Two measures: ADL’s: Activities of Daily Living (basic tasks) IADL’s: Instrumental Activities of Daily Living (more co