Ati fundamental guidance examCHAPTER 1: HEALTH CARE DELIVERY SYSTEMS
A. Components of Health care systems
a. Participants
1. Consumers- clients
2. Providers
a. Licensed providers: registered nurses, license practica
...
Ati fundamental guidance examCHAPTER 1: HEALTH CARE DELIVERY SYSTEMS
A. Components of Health care systems
a. Participants
1. Consumers- clients
2. Providers
a. Licensed providers: registered nurses, license practical (or vocational) nurses (LPN),
advanced practice nurses (APN), medical doctors, pharmacists, dentists, dietitians,
physical/respiratory/occupational therapists, etc
b. Unlicensed providers: assistive personal
b. Settings
1. Hospitals, homes, skilled nursing, assisted living, schools, etc
c. Regulatory Agencies
1. US department of Health and Human Services
2. US Food and Drug Administration (FDA)
3. State and local public health agencies
4. State licensing boards
a. Determines laws/regulations that govern nursing in their state
b. ensure health care providers and agencies comply with state regulations
c. Issue/revoke nursing license
i. Nurses need a license in every state they practice in
5. Joint Commission (JCAHO)
a. Set quality standards for accreditation of health care facilities
6. Professional Standards Review Organizations- monitor health care services provided
d. Healthcare financing Mechanisms
1. Public federally funded programs
a. Affordable Care Act (Obamacare)
i. Increases access to healthcare for all individuals
ii. Decreasing healthcare costs
iii. Providing opportunities for uninsured to become insured at an affordable cost
b. States Children’s Health Insurance
i. Covers uninsured children up to 19 years old at a low cost to parents
Key:
- Most likely on test
- Motivational quotes
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Don’t stop until you are proud
c.
MEDICARE MEDICAID
Eligibility: >65 years old OR on disability
for more than 2 years OR have ALS OR on
dialysis
Part A: inpatient hospital, limited
skilled nursing care, home health
care
(hospital insurance)
Part B: outpatient care, diagnostic
services, OT/PT (medical insurance)
Part C: combination of parts A and B,
optional private insurance
(Medicare advantage plan)
Part D: prescription drugs
(medications)
Eligibility: low socioeconomic status, no
insurance
Federally and state funded
Individual states determine eligibility
requirements
e. Levels of Health Care
Preventative Focuses on educating and equipping clients to reduce or control risk
factors for disease
Primary Emphasizes health promotion and includes prenatal, well-baby care,
family planning, nutrition counseling, disease control
Secondary Diagnosis and treatment of acute illness and injury
Tertiary Provision of specialized and highly technical care
Restorative Intermediate follow-up care for restoring health and promoting selfcare
Continuing Addresses
