HEALTH CARE DELIVERY

SYSTEM
What is a Health Care Delivery System?
 It is a mechanism for providing services that meet the health-
related needs of individuals.
 Nursing is a major component of the U.S. health care delivery
system.
Types of Health Care Services

1) Primary: health promotion and illness prevention

2) Secondary: early detection and intervention

3) Tertiary: restorative and rehabilitative care

Health Care Settings

- Public Sector
 Federal Level
• U.S. Department of Health and Human Services
 State Level
• Department of Health
Local Level Health Units
 Communicable disease control

 Health records maintenance

 Individual health services

 Environmental health and safety Public health education

Care Settings - Private Sector
 Hospitals
 Extended care facilities
 Home health agencies
 Hospices
 Outpatient settings
 Schools
 Industrial clinics
 Managed care organizations
 Community nursing centers
 Rural primary care hospitals
Health Care Team
 Nurse (RN)
 Physician (MD, DO)
 Physician assistant (PA)
 Pharmacist (RPh)
 Dentist (DDS, DMD)
 Dietitian (RD)
 Social worker (SW)
 Respiratory therapist (RT)
 Physical therapist (PT)
 Occupational therapist (OT)
 Chaplain
 Unlicensed assistive personnel (UAP)
Roles of the Nurse
 Caregiver
 Teacher
 Advocate
 Manager
 Expert
 Case manager
 Team member
Economics of Health Care
 Private insurance
 Managed care
 primary care providers
 health maintenance organizations
 preferred provider organizations
 exclusive provider organizations

 Federal government insurance plans

 Medicare
 Medicaid
 Canadian health insurance
Factors Influencing the Delivery of Health Care

 Cost
 Access

 Quality
 Cost
- Four major factors increase the cost of health care
 An oversupply of specialized providers
 A surplus of hospital beds
 The passive role assumed by most consumers inequitable
financing of services
 Access - Limiting Factors
 Inability to obtain insurance
 Cultural barriers

 Shortages of health care providers

 Limited access to ancillary services

 Parents’ inability to take time from work to transport

children to health care providers
 Quality
 Estimated that 30%-40% of diagnostic/medical procedures
performed in U.S. are unnecessary
 Inappropriate use of resources
 A 1998 study revealed that 72% of nurses surveyed stated
that the quality of care at their hospital had declined due to
cost-containment measures.
Nursing’s Response to Health Care Challenges

 Nursing’s Agenda for Health Care Reform

 Standards of care
 Advanced practice
 Public versus private programs
 Public health
 Community health
 Long-term care