The document summarizes the organization of health care delivery in the United States at the federal, state, and local levels. At the federal level, health care is overseen by the Department of Health and Human Services (HHS) which contains 11 operating divisions that focus on various health issues. States each operate their own health care departments and access services locally through private practices, clinics, and hospitals. The overall goal is to ensure all Americans have access to health care.
The Philippine Health Agenda 2016-2022 aims to achieve three guarantees: universal health insurance, a functional service delivery network, and services for all life stages and diseases. It outlines strategies to advance health promotion, cover all Filipinos against financial health risks, harness human resources, invest in health data and technology, increase accountability and transparency, improve responsiveness to patients, and elicit multi-sectoral support for health. The agenda seeks to attain health-related UN Sustainable Development Goals by 2022.
This document outlines the Duterte administration's health agenda to achieve universal health coverage in the Philippines. The key goals are to:
1) Establish functional service delivery networks to ensure access to quality health services.
2) Attain and sustain universal health insurance to protect Filipinos from health-related financial risks.
3) Protect Filipinos from the triple burden of disease through guaranteed health services and community interventions.
National Health Policy Introduction, NHP 1983, NHP 2000, NHP 2002, NHP 2017, Seven Priority areas, Sustainable Developmental (SDGs), Public and Private health system in India, National Health Mission (NHM),Sustainable Development Goals (SDGs), International Pharmaceutical Federation Development Goal (FIP),
Decentralization
Tools of Policy making
Financing Health care
Public-Private Partnership
Health Research
International Organizations
Equity
Health Reforms in Developing Countries
Stake Holders
This document outlines the key aspects of primary health care according to the WHO and the Declaration of Alma-Ata. It discusses the eight essential elements of primary health care, including health education, treatment of endemic diseases, immunization, and maternal/child health. The four pillars of primary health care are also defined as active community participation, inter-sectoral linkages, appropriate technology use, and support mechanisms. Primary health care aims to be accessible and affordable while addressing the major health problems in a community through promotion, prevention, treatment, and rehabilitation services.
The inaugural Philippines Healthcare will focus on investment opportunities in the Philippines healthcare sector as well as examine the developments in healthcare plans and policies by government, market access opportunities for pharma and technology, new healthcare facility projects, upgrades and expansions and increasing efficiencies of existing facilities.
Philippines is currently focused on speeding up health facilities and upgrades, meeting the needs and growing demand for health specialists, training to ensure competency and quality of healthcare services and ensuring the availability of drugs throughout the country.
The conference will have discussions on policy and regulation updates, investment opportunities, projects and developments to strengthen Philippines healthcare infrastructure and delivery.
It will be held in Manila and will have representations from government, hospitals, insurance companies, pharma companies, health technology and medical device providers and other related stakeholders.
Health Promotion and Disease Prevention under the Aquino Health Agenda by Use...HealthJustice Philippines
The document discusses the Philippine health situation and efforts to promote health and prevent diseases under the Aquino Health Agenda. It outlines the current burden of non-communicable diseases in the Philippines, which are among the top causes of mortality. It also discusses the implementation of universal health care in the country to improve health outcomes through expanding access to essential health services. A key part of this is addressing non-communicable diseases by implementing strategies around prevention and control of risk factors like tobacco use, unhealthy diets, and physical inactivity.
The Philippine health care system is composed of public, private, and social health insurance models. The Department of Health is the lead agency and oversees a network of hospitals, offices, and attached agencies. In 1991, health services were devolved from the national to local government level. The health system aims to provide universal access through primary, secondary, and tertiary levels of care. Challenges include high costs, barriers to access, and health workforce shortages.
The Philippine Health Agenda 2016-2022 aims to achieve three guarantees: universal health insurance, a functional service delivery network, and services for all life stages and diseases. It outlines strategies to advance health promotion, cover all Filipinos against financial health risks, harness human resources, invest in health data and technology, increase accountability and transparency, improve responsiveness to patients, and elicit multi-sectoral support for health. The agenda seeks to attain health-related UN Sustainable Development Goals by 2022.
This document outlines the Duterte administration's health agenda to achieve universal health coverage in the Philippines. The key goals are to:
1) Establish functional service delivery networks to ensure access to quality health services.
2) Attain and sustain universal health insurance to protect Filipinos from health-related financial risks.
3) Protect Filipinos from the triple burden of disease through guaranteed health services and community interventions.
National Health Policy Introduction, NHP 1983, NHP 2000, NHP 2002, NHP 2017, Seven Priority areas, Sustainable Developmental (SDGs), Public and Private health system in India, National Health Mission (NHM),Sustainable Development Goals (SDGs), International Pharmaceutical Federation Development Goal (FIP),
Decentralization
Tools of Policy making
Financing Health care
Public-Private Partnership
Health Research
International Organizations
Equity
Health Reforms in Developing Countries
Stake Holders
This document outlines the key aspects of primary health care according to the WHO and the Declaration of Alma-Ata. It discusses the eight essential elements of primary health care, including health education, treatment of endemic diseases, immunization, and maternal/child health. The four pillars of primary health care are also defined as active community participation, inter-sectoral linkages, appropriate technology use, and support mechanisms. Primary health care aims to be accessible and affordable while addressing the major health problems in a community through promotion, prevention, treatment, and rehabilitation services.
The inaugural Philippines Healthcare will focus on investment opportunities in the Philippines healthcare sector as well as examine the developments in healthcare plans and policies by government, market access opportunities for pharma and technology, new healthcare facility projects, upgrades and expansions and increasing efficiencies of existing facilities.
Philippines is currently focused on speeding up health facilities and upgrades, meeting the needs and growing demand for health specialists, training to ensure competency and quality of healthcare services and ensuring the availability of drugs throughout the country.
The conference will have discussions on policy and regulation updates, investment opportunities, projects and developments to strengthen Philippines healthcare infrastructure and delivery.
It will be held in Manila and will have representations from government, hospitals, insurance companies, pharma companies, health technology and medical device providers and other related stakeholders.
Health Promotion and Disease Prevention under the Aquino Health Agenda by Use...HealthJustice Philippines
The document discusses the Philippine health situation and efforts to promote health and prevent diseases under the Aquino Health Agenda. It outlines the current burden of non-communicable diseases in the Philippines, which are among the top causes of mortality. It also discusses the implementation of universal health care in the country to improve health outcomes through expanding access to essential health services. A key part of this is addressing non-communicable diseases by implementing strategies around prevention and control of risk factors like tobacco use, unhealthy diets, and physical inactivity.
The Philippine health care system is composed of public, private, and social health insurance models. The Department of Health is the lead agency and oversees a network of hospitals, offices, and attached agencies. In 1991, health services were devolved from the national to local government level. The health system aims to provide universal access through primary, secondary, and tertiary levels of care. Challenges include high costs, barriers to access, and health workforce shortages.
Disease Prevention and Health Care Promotion in the Philippine Development Pl...HealthJustice Philippines
This document discusses disease prevention and health care promotion in the Philippine Development Plan from 2011-2016 and the Post-2015 Development Agenda. It outlines that the Philippine plan aims for inclusive growth through improving education, health services, and protecting people from economic shocks. The health sector agenda focuses on improving access to services, environmental protection, nutrition, and injury prevention to ultimately improve health status. It also details the universal health care strategy of expanding insurance coverage, improving quality of services, and scaling preventive health programs. For post-2015, it notes ongoing health challenges like limited budgets, unequal access to care, and issues with social programs in remote areas, proposing solutions like growing the health industry and further improving affordable, accessible services.
Healthcare challenges & solutions in indiakripak93
This document discusses the key challenges facing India's healthcare system and potential solutions. The main challenges are the large burden of infectious and chronic diseases, high maternal and child mortality rates, lack of universal access to healthcare, shortage of resources, and inadequate healthcare financing. Proposed solutions include strengthening public health programs, improving access to healthcare in rural areas, providing incentives for medical professionals to work in underserved areas, leveraging public-private partnerships, and increasing public financing of healthcare.
This document discusses quality improvement in health care in developing countries. It defines quality as the degree of excellence and doing the right thing in the right way. Quality is viewed from the perspectives of clients, service providers, and managers. Elements of quality include structure, process, and outcomes. Improving quality requires addressing factors like resources, training, and cultural norms. While resource constraints are an issue, high quality care is still possible with limited resources. Ensuring quality providers through training is important for improving health outcomes in developing nations like Nepal. Economic benefits of quality include individual and social gains like increased productivity and reduced costs.
The document discusses various aspects of health policy in the Philippines, including its history, goals, and strategies. It outlines the country's epidemiological transition over time from communicable to non-communicable diseases. It also summarizes the government's plans to achieve universal health care through expanding PhilHealth coverage, improving health facilities, deploying more health workers, and ensuring financial protection for citizens' health needs. The ultimate goals are to achieve public health targets while providing accessible, quality care and minimizing out-of-pocket costs.
Medical Governance and Health Policy in the PhilippinesAlbert Domingo
An overview of key concepts and present trends in medical governance, health policy, and health sector reform in the Philippines, presented by Dr. Albert Domingo at the De La Salle Health Sciences Institute - College of Medicine on Sep. 26, 2013 for the subject "Perspectives in Medicine".
Includes the broad concept of medical governance as applied to various settings, from the point of care between provider and client/patient, to national and global health systems. Also touches on the practice of evidence-based healthcare as applied to the scale-up of innovations necessary to accelerate reform implementation, with grounding in the operational realities of implementation arrangements faced by sector managers on a day-to-day basis.
Suggested Citation:
Domingo, Albert Francis E. "Medical Governance, Health Policy, and Health Sector Reform in the Philippines: An Overview of Key Concepts and Present Trends." De La Salle Health Sciences Institute (DLSHSI). DLSHSI College of Medicine, Dasmarinas, Cavite. 26 Sep. 2013. Lecture.
This document provides an overview of primary health care principles including:
- The Alma-Ata Declaration of 1978 established primary health care as the key to achieving Health for All. It defined primary health care and outlined principles.
- Principles of primary health care include equitable distribution of resources, community participation, intersectoral coordination, and use of appropriate technology.
- Primary health care aims to provide essential health services universally and affordably through primary-level facilities as the first point of contact for communities.
- India has evolved its primary health care system over time to strengthen delivery of services in alignment with the goals of Alma-Ata and Health for All.
The document discusses the roles of navigators and producers in health insurance exchanges and identifies key issues regarding how they will interact. Navigators are intended to help educate consumers and facilitate enrollment under the Affordable Care Act, while producers currently sell insurance on behalf of issuers and will likely play an important role in exchange success. The document outlines several important issues for states to consider regarding oversight, licensing, accountability, and defining the scope of navigator responsibilities.
The document discusses Nepal's free healthcare policy introduced in 2006. It aims to provide equal access to healthcare for all citizens, especially the poor, as a fundamental right. The policy provides free services like consultations, treatments, surgeries and essential drugs at health centers and hospitals. However, there are challenges in implementing the policy like ensuring quality of care, identifying the poor, training health workers and monitoring the system. Proper budgeting, resources and evaluations are needed to improve healthcare access for all Nepalis as intended by the policy.
Kalusugang Pankalusugan - Introduction and Thrustrhugamu
The document outlines the Aquino Health Agenda in the Philippines, which aims to achieve Universal Health Care through four strategic thrusts: 1) expanding health insurance to provide financial risk protection, 2) attaining health-related development goals by focusing on reducing mortality, 3) improving access to quality healthcare facilities, and 4) strengthening health governance. A key part of the plan is mobilizing Community Health Teams to assess and address the needs of poor families identified by the national household targeting system. The end goal is to ensure all Filipinos, especially the disadvantaged, have equitable access to affordable and quality healthcare.
Department of Health Program Directions and Priorities Towards MDGs 4 and 5Michelle Avelino
The document outlines the Department of Health's (DOH) current efforts, status, and directions regarding achieving Millennium Development Goals 4 and 5 in the Philippines. It discusses programs established to improve maternal and child health, including emergency obstetric care facilities, integrated service packages, training programs, and monitoring systems. It notes accomplishments, ongoing challenges, and a proposed approach to scaling up family planning and maternal, newborn and child health programs through collaboration with partners.
Alma-Ata Conferance 2018, Global Conference on Primary Health Care. From Alma-Ata towards universal health coverage and the Sustainable Development Goals. Astana, Kazakhstan, 25 and 26 October 2018
Community diagnosis is vital in health planning, evaluation and needs assessment, several types of indicators are valid to be used for community diagnosis including Socio-economic, demographics, health system, and living arrangements.
Health care delivery system in the philippinessharina11
The document discusses the Philippine health care system, factors affecting it, and the application of nursing informatics. It defines key terms like health care delivery and describes models of health systems. The Philippine system is complex with public, private, and social security components. Health facilities are divided into primary, secondary and tertiary levels. Nursing informatics uses technology to support clinical practice, administration, education and research. It gives examples like electronic medical records, scheduling, and distance learning.
The document discusses India's primary health care system and community health care. It begins by defining health, healthcare, and community. It then outlines the levels of healthcare delivery and describes how primary health care in India evolved from recommendations made by various committees. The key aspects of primary health care delivery in India include its basis in the 1978 Alma-Ata Declaration, focus on rural areas through a three-tier system, and emphasis on community participation and equitable access. The document also discusses community health centers, voluntary health agencies, and international organizations involved in India's health care system.
Attaining Millennium Development Goals 4 and 5 through Kalusugang Pangkalahat...Michelle Avelino
Presentation of Dr. Francisco Z. Soria, Jr., officer-in-charge and vice president, Quality Assurance Group of the Philippine Health Insurance Corporation at the PhilHealth Maternal, Newborn and Child Health Summit
The role and scope of pharmacists in community settings a review of developin...pharmaindexing
This document discusses the role and scope of pharmacists in community settings in developing countries. It outlines that community pharmacists play important roles beyond dispensing medications, such as counseling patients, managing medication records, identifying drug interactions, and providing health promotion services. The document argues that community pharmacists are well-positioned to help improve patient adherence and health outcomes. An expanded role for community pharmacists includes services like counseling, health screenings, and smoking cessation programs that can benefit public health.
Presntation by Zorayda E. Leopando, MD, MPH
Professor of Family and Community Medicine University of the Philippines Manila at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012
Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
Universal Health Care: The Philippine journey towards accessing quality healt...Albert Domingo
Presentation delivered by WHO Consultant for Health Systems Strengthening Dr Albert Domingo at the University of Santo Tomas, on the occasion of UHC Day 2018.
Lecture a discusses how health care in the US is regulated through accreditation, regulatory bodies, and professional associations. The Joint Commission is a major nonprofit accrediting body that establishes standards and accredits hospitals and other organizations through reviews and core measure reporting. Other accrediting organizations include URAC and the National Committee for Quality Assurance. Regulatory agencies like the Food and Drug Administration enforce standards to protect consumers. Professional associations represent various health professions and promote quality through certification, education, and advocacy.
The document provides an overview of different frameworks for conceptualizing health systems. It describes the World Health Organization's definition of a health system as including all organizations, people, and actions aimed at promoting, restoring, or maintaining health. It also outlines WHO's six building blocks of a health system: service delivery, health workforce, information, medical products/vaccines/technology, financing, and governance. Additionally, it summarizes key components of health systems from the perspectives of the World Bank, including financing, payment, organization of service delivery, regulation, persuasion, politics, ethics, and values.
Disease Prevention and Health Care Promotion in the Philippine Development Pl...HealthJustice Philippines
This document discusses disease prevention and health care promotion in the Philippine Development Plan from 2011-2016 and the Post-2015 Development Agenda. It outlines that the Philippine plan aims for inclusive growth through improving education, health services, and protecting people from economic shocks. The health sector agenda focuses on improving access to services, environmental protection, nutrition, and injury prevention to ultimately improve health status. It also details the universal health care strategy of expanding insurance coverage, improving quality of services, and scaling preventive health programs. For post-2015, it notes ongoing health challenges like limited budgets, unequal access to care, and issues with social programs in remote areas, proposing solutions like growing the health industry and further improving affordable, accessible services.
Healthcare challenges & solutions in indiakripak93
This document discusses the key challenges facing India's healthcare system and potential solutions. The main challenges are the large burden of infectious and chronic diseases, high maternal and child mortality rates, lack of universal access to healthcare, shortage of resources, and inadequate healthcare financing. Proposed solutions include strengthening public health programs, improving access to healthcare in rural areas, providing incentives for medical professionals to work in underserved areas, leveraging public-private partnerships, and increasing public financing of healthcare.
This document discusses quality improvement in health care in developing countries. It defines quality as the degree of excellence and doing the right thing in the right way. Quality is viewed from the perspectives of clients, service providers, and managers. Elements of quality include structure, process, and outcomes. Improving quality requires addressing factors like resources, training, and cultural norms. While resource constraints are an issue, high quality care is still possible with limited resources. Ensuring quality providers through training is important for improving health outcomes in developing nations like Nepal. Economic benefits of quality include individual and social gains like increased productivity and reduced costs.
The document discusses various aspects of health policy in the Philippines, including its history, goals, and strategies. It outlines the country's epidemiological transition over time from communicable to non-communicable diseases. It also summarizes the government's plans to achieve universal health care through expanding PhilHealth coverage, improving health facilities, deploying more health workers, and ensuring financial protection for citizens' health needs. The ultimate goals are to achieve public health targets while providing accessible, quality care and minimizing out-of-pocket costs.
Medical Governance and Health Policy in the PhilippinesAlbert Domingo
An overview of key concepts and present trends in medical governance, health policy, and health sector reform in the Philippines, presented by Dr. Albert Domingo at the De La Salle Health Sciences Institute - College of Medicine on Sep. 26, 2013 for the subject "Perspectives in Medicine".
Includes the broad concept of medical governance as applied to various settings, from the point of care between provider and client/patient, to national and global health systems. Also touches on the practice of evidence-based healthcare as applied to the scale-up of innovations necessary to accelerate reform implementation, with grounding in the operational realities of implementation arrangements faced by sector managers on a day-to-day basis.
Suggested Citation:
Domingo, Albert Francis E. "Medical Governance, Health Policy, and Health Sector Reform in the Philippines: An Overview of Key Concepts and Present Trends." De La Salle Health Sciences Institute (DLSHSI). DLSHSI College of Medicine, Dasmarinas, Cavite. 26 Sep. 2013. Lecture.
This document provides an overview of primary health care principles including:
- The Alma-Ata Declaration of 1978 established primary health care as the key to achieving Health for All. It defined primary health care and outlined principles.
- Principles of primary health care include equitable distribution of resources, community participation, intersectoral coordination, and use of appropriate technology.
- Primary health care aims to provide essential health services universally and affordably through primary-level facilities as the first point of contact for communities.
- India has evolved its primary health care system over time to strengthen delivery of services in alignment with the goals of Alma-Ata and Health for All.
The document discusses the roles of navigators and producers in health insurance exchanges and identifies key issues regarding how they will interact. Navigators are intended to help educate consumers and facilitate enrollment under the Affordable Care Act, while producers currently sell insurance on behalf of issuers and will likely play an important role in exchange success. The document outlines several important issues for states to consider regarding oversight, licensing, accountability, and defining the scope of navigator responsibilities.
The document discusses Nepal's free healthcare policy introduced in 2006. It aims to provide equal access to healthcare for all citizens, especially the poor, as a fundamental right. The policy provides free services like consultations, treatments, surgeries and essential drugs at health centers and hospitals. However, there are challenges in implementing the policy like ensuring quality of care, identifying the poor, training health workers and monitoring the system. Proper budgeting, resources and evaluations are needed to improve healthcare access for all Nepalis as intended by the policy.
Kalusugang Pankalusugan - Introduction and Thrustrhugamu
The document outlines the Aquino Health Agenda in the Philippines, which aims to achieve Universal Health Care through four strategic thrusts: 1) expanding health insurance to provide financial risk protection, 2) attaining health-related development goals by focusing on reducing mortality, 3) improving access to quality healthcare facilities, and 4) strengthening health governance. A key part of the plan is mobilizing Community Health Teams to assess and address the needs of poor families identified by the national household targeting system. The end goal is to ensure all Filipinos, especially the disadvantaged, have equitable access to affordable and quality healthcare.
Department of Health Program Directions and Priorities Towards MDGs 4 and 5Michelle Avelino
The document outlines the Department of Health's (DOH) current efforts, status, and directions regarding achieving Millennium Development Goals 4 and 5 in the Philippines. It discusses programs established to improve maternal and child health, including emergency obstetric care facilities, integrated service packages, training programs, and monitoring systems. It notes accomplishments, ongoing challenges, and a proposed approach to scaling up family planning and maternal, newborn and child health programs through collaboration with partners.
Alma-Ata Conferance 2018, Global Conference on Primary Health Care. From Alma-Ata towards universal health coverage and the Sustainable Development Goals. Astana, Kazakhstan, 25 and 26 October 2018
Community diagnosis is vital in health planning, evaluation and needs assessment, several types of indicators are valid to be used for community diagnosis including Socio-economic, demographics, health system, and living arrangements.
Health care delivery system in the philippinessharina11
The document discusses the Philippine health care system, factors affecting it, and the application of nursing informatics. It defines key terms like health care delivery and describes models of health systems. The Philippine system is complex with public, private, and social security components. Health facilities are divided into primary, secondary and tertiary levels. Nursing informatics uses technology to support clinical practice, administration, education and research. It gives examples like electronic medical records, scheduling, and distance learning.
The document discusses India's primary health care system and community health care. It begins by defining health, healthcare, and community. It then outlines the levels of healthcare delivery and describes how primary health care in India evolved from recommendations made by various committees. The key aspects of primary health care delivery in India include its basis in the 1978 Alma-Ata Declaration, focus on rural areas through a three-tier system, and emphasis on community participation and equitable access. The document also discusses community health centers, voluntary health agencies, and international organizations involved in India's health care system.
Attaining Millennium Development Goals 4 and 5 through Kalusugang Pangkalahat...Michelle Avelino
Presentation of Dr. Francisco Z. Soria, Jr., officer-in-charge and vice president, Quality Assurance Group of the Philippine Health Insurance Corporation at the PhilHealth Maternal, Newborn and Child Health Summit
The role and scope of pharmacists in community settings a review of developin...pharmaindexing
This document discusses the role and scope of pharmacists in community settings in developing countries. It outlines that community pharmacists play important roles beyond dispensing medications, such as counseling patients, managing medication records, identifying drug interactions, and providing health promotion services. The document argues that community pharmacists are well-positioned to help improve patient adherence and health outcomes. An expanded role for community pharmacists includes services like counseling, health screenings, and smoking cessation programs that can benefit public health.
Presntation by Zorayda E. Leopando, MD, MPH
Professor of Family and Community Medicine University of the Philippines Manila at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012
Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.
Universal Health Care: The Philippine journey towards accessing quality healt...Albert Domingo
Presentation delivered by WHO Consultant for Health Systems Strengthening Dr Albert Domingo at the University of Santo Tomas, on the occasion of UHC Day 2018.
Lecture a discusses how health care in the US is regulated through accreditation, regulatory bodies, and professional associations. The Joint Commission is a major nonprofit accrediting body that establishes standards and accredits hospitals and other organizations through reviews and core measure reporting. Other accrediting organizations include URAC and the National Committee for Quality Assurance. Regulatory agencies like the Food and Drug Administration enforce standards to protect consumers. Professional associations represent various health professions and promote quality through certification, education, and advocacy.
The document provides an overview of different frameworks for conceptualizing health systems. It describes the World Health Organization's definition of a health system as including all organizations, people, and actions aimed at promoting, restoring, or maintaining health. It also outlines WHO's six building blocks of a health system: service delivery, health workforce, information, medical products/vaccines/technology, financing, and governance. Additionally, it summarizes key components of health systems from the perspectives of the World Bank, including financing, payment, organization of service delivery, regulation, persuasion, politics, ethics, and values.
The document discusses key aspects of regulating health care in the United States as covered in Lecture d. It describes the Health Insurance Portability and Accountability Act (HIPAA) which establishes requirements for protecting patient health information and applies to covered entities like health care providers, health plans, and clearinghouses. It also discusses efforts by organizations like The Joint Commission and Agency for Health Care Research and Quality to improve patient safety and reduce medical errors through initiatives and research.
This document provides an overview of public health and the structure of Pakistan's healthcare system. It begins with definitions of key terms like health, public health, and healthcare systems. It then describes the main functions and objectives of public health, including health promotion, disease prevention, and treatment. The document outlines Pakistan's three-tiered public and private healthcare system consisting of primary, secondary and tertiary levels of care. It also discusses issues like inadequate funding, reliance on out-of-pocket payments, and an understaffed and underequipped public system. In conclusion, it presents statistics on Pakistan's health infrastructure and workforce.
The document discusses health and healthcare systems in Pakistan. It defines health according to the WHO as complete physical, mental and social well-being, not just the absence of disease. It then discusses the components of Pakistan's healthcare system including public health, general dentistry, preventative care, and treatment-focused general medicine. It provides statistics on Pakistan's population, health outcomes, and healthcare infrastructure including the three-tiered public, private, and traditional system and the role of different levels of care.
This document provides an overview of public health, including definitions, objectives, and key concepts. It defines public health as promoting physical and mental health and preventing disease, injury, and disability for populations. A public health system involves various public, private, and voluntary entities working as a network to address health issues. The core components of public health are assessment of community health, assurance of public health, and policy development in the public's interest.
This document discusses transcending health information exchange (HIE) by envisioning Michigan as a "Learning Health State". It introduces the concept of a Learning Health System (LHS) which aims to continuously improve health and healthcare by generating new knowledge from care experiences. The document outlines core components of an LHS including infrastructure, governance, and data sharing/analysis. Building an LHS at national and state levels could enable benefits like rapid drug safety updates and epidemic surveillance. The document advocates for Michigan to endorse LHS values and join the emerging Learning Health Community.
This document outlines priority areas for improving quality in public health as identified by the Public Health Quality Forum. It recommends focusing on population health metrics and information technology, evidence-based practices and research/evaluation, systems thinking, and sustainability/stewardship. The goal is to build better systems to support health for all by maximizing opportunities in the Affordable Care Act and learning from quality improvement efforts in healthcare. Key strategies include coordinating efforts across sectors, focusing on prevention, and strengthening foundations for quality public health.
Pharmacists play several important roles in managed health care organizations including distributing and dispensing drugs, ensuring patient safety, developing clinical programs, communicating with patients and providers, designing drug benefits, managing business operations, and controlling costs. They work to provide appropriate, effective, and affordable drug therapies to patients through various functions like utilization review, prior authorizations, quality assurance programs, and collaborating with physicians on prescribing practices.
The document defines a health care system and describes key aspects of the U.S. health care system, including that it is complex and unique among nations with a mix of private and public financing. It has historically produced high physician incomes and drug company profits but performance is uneven with issues around quality, equity, and efficiency. The system faces ongoing calls for change and reform to address problems with financing, access, and service delivery.
This document provides an overview of health systems and their development and strengthening. It defines a health system and its key goals of good health outcomes, responsiveness, and fairness in financing. The six building blocks of a health system are described as service delivery, health workforce, information, medical products/vaccines/technologies, financing, and leadership/governance. Health system strengthening is defined as initiatives that improve one or more of these functions to enhance access, coverage, quality or efficiency. The document discusses challenges faced by health systems and some opportunities to address them.
Public health aims to promote physical and mental health in communities through organized efforts. It focuses on preventing disease, injury, and disability. Public health professionals come from diverse backgrounds including nursing, medicine, education, and social work. The core functions of public health are assessment, policy development, and assurance. Assessment involves monitoring community health status. Policy development means creating plans and policies to support community health. Assurance refers to enforcing laws and regulations to protect health as well as evaluating health services.
The document outlines the 10 essential public health services which provide a framework for public health initiatives and activities. The 10 services include monitoring health status and problems, investigating health issues, informing the public, mobilizing partnerships, developing health policies and plans, enforcing laws and regulations, linking people to health services, assuring a competent workforce, evaluating services, and researching solutions. The 10 services were established to describe the core functions of public health and provide a standard for agencies to assess their performance.
are increasing the importance of environmental ethics has started to take pre...KhalidMdBahauddin
are increasing the importance of environmental ethics has started to take precedence making its global issue. as this issue do not respect National boundaries
The document outlines the 10 essential public health services which provide a framework for public health initiatives and activities. The 10 services include monitoring health status and problems, investigating health issues, informing the public, mobilizing partnerships, developing health policies and plans, enforcing laws and regulations, linking people to health services, assuring a competent workforce, evaluating services, and researching solutions. The 10 services were established to describe the core functions of public health and provide a standard for agencies to assess their performance.
This document provides an overview of key concepts in public health from Lecture b, including:
- Defining important public health terminology like endemic, epidemic, morbidity, and mortality.
- Illustrating the general organization of public health agencies in the United States at the local, state, and federal levels.
- Explaining several roles of public health like education, policy, monitoring and surveillance, and regulating reportable diseases.
The health care delivery system in India is comprised of five major sectors - public, private, indigenous systems of medicine, voluntary agencies, and national health programmes. At the central level, the Union Ministry of Health and Family Welfare oversees the country's health administration along with the Directorate General of Health Services and Central Council of Health. The health system is organized at three levels - central, state, and district - with the goal of improving population health, care experiences, and reducing economic burden.
The document provides an overview of public health nursing in the Philippines. It discusses the country's health imperatives, including goals to eradicate poverty and diseases. Public health evolved alongside the development of the Department of Health, the government agency responsible for citizens' health. The Health Sector Reform Agenda aims to improve health outcomes through reforms to financing, regulation, service delivery, and governance. Public health nursing combines nursing skills with public health to promote community health. The Philippine health system includes both public and private sectors working towards the goal of equitable and quality health care for all.
This document provides an overview of population health management. It begins by describing the transformation from individual to population health management and identifies available models and best practices. The document then details effective tactics used to manage a population, such as risk stratification, predictive modeling, and targeted interventions. It concludes by listing available methods to measure program and intervention effectiveness.
This document provides an overview of health informatics. It defines key terms like information management, information systems, and informatics. It describes the basic theoretical concept underlying informatics practice and defines biomedical and health informatics as fields of study. It outlines the learning objectives which include describing informatics areas of application, summarizing drivers and trends, and identifying professional roles and skills of health informaticians in processing data into information and knowledge to improve patient care. It then discusses the skills, tools, and domains of health informaticians and their roles in academic, research, and health care delivery environments.
Evolution of and Trends in Health Care - Lecture DCMDLearning
The document describes Lecture d of a course on the evolution of and trends in health care in the U.S. It discusses the patient-centered medical home model of care coordination, including characteristics like having a personal physician, team-based care, and quality/safety measures. It also introduces Accountable Care Organizations as a new model of care coordination promoted by the Affordable Care Act. Finally, it provides references for Lecture d.
Evolution of and Trends in Health Care - Lecture CCMDLearning
This lecture defined healthcare quality and gave examples of quality indicators such as process measures and outcome measures. It described approaches to quality improvement like the "Plan, Do, Study, Act" (PDSA) cycle. Comparative Effectiveness Research (CER) was introduced as a way to compare benefits and harms of alternative healthcare methods using evidence from studies. CER aims to help patients and physicians choose between treatment options.
Evolution of and Trends in Health Care - Lecture BCMDLearning
This lecture defines clinical practice guidelines and describes their purpose in helping clinicians and patients make appropriate healthcare decisions. It discusses the U.S. Preventive Services Task Force (USPSTF), an independent panel that issues evidence-based recommendations on clinical preventive services using a grading system (A to I) based on certainty of net benefit. The lecture also briefly introduces the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework for assessing evidence quality in clinical guidelines.
Evolution of and Trends in Health Care - Lecture ACMDLearning
This document discusses key concepts in evidence-based medicine and trends in the U.S. healthcare system. It defines evidence-based medicine as using the best available evidence from research to inform patient care decisions. Clinical practice guidelines and clinical decision support systems aim to promote evidence-based practices. The hierarchy of evidence ranks study types to determine the strength of evidence. Systematic reviews systematically analyze the literature on a topic.
The document discusses topics covered in Lecture c of Public Health, Part 2. It describes the importance of chronic diseases as leading causes of mortality in the US. Behavior modification is discussed as the main public health focus for prevention through education. The World Health Organization's STEPwise Framework for chronic disease prevention and policy is also presented. Environmental public health topics are reviewed, including overlap with chronic and communicable diseases. Air and water quality, hazardous waste management, and topics like smoking and urban planning are discussed.
This document discusses terrorism and public health in three parts. It begins by introducing four main categories of terrorism: bioterrorism, agricultural terrorism, chemical terrorism, and nuclear/radiation terrorism. It then discusses bioterrorism in more detail, including a history of bioterrorism incidents in the US and the CDC's categorization of bioterrorism agents. It concludes by describing the Laboratory Response Network and providing an overview of the public health response and challenges for the other categories of terrorism.
This document discusses communicable diseases and public health activities related to communicable disease prevention and control. It provides examples of communicable disease categories and historic public health triumphs in eradicating smallpox and bringing polio under control. The document also outlines public health investigations of disease outbreaks and monitoring/surveillance efforts at the federal, state, and local levels to control communicable diseases.
The document provides an overview of key concepts from Lecture c of Public Health, Part 1. It discusses the radical improvements public health has made to population health, including examples of successes in communicable disease control. It also reviews some historical highlights of public health in the US, noting how life expectancy has increased 30 years since 1900 due largely to public health initiatives. Major causes of death in 2014 are listed, with all but one being chronic or injury-related.
The document provides an overview of public health in the United States through a series of lectures. It begins with distinguishing between private health, which focuses on treating individuals, and public health, which aims to maintain population health through education, policy, and other measures. Next, it reviews the history of public health in the US from the 1700s to present, highlighting milestones like the establishment of the CDC and responses to health crises. The document concludes with learning objectives and references for further information.
The document discusses regulating health care in the United States. It covers several topics: the role of clinical documentation in health records to support patient safety, quality of care, and as a legal record; the importance of compliance programs to ensure adherence to laws and regulations regarding issues like fraud, abuse, and privacy; and the functions of organizations that oversee healthcare quality and standards like accreditation bodies. Thorough and complete clinical documentation is necessary to protect healthcare providers from legal risks while also supporting patient care, reimbursement, and organizational operations.
This lecture discusses how health care is regulated in the United States. It covers laws related to the Affordable Care Act, standards of care, informed consent, medical malpractice, and fraud/abuse. Providers must follow numerous complicated laws, obtain informed consent from patients, meet reasonable standards of care, and avoid fraudulent billing practices. The system is changing rapidly due to reforms like the Affordable Care Act and tort law proposals.
This lecture discusses how the US legal system regulates health care. It describes the three branches of government - legislative, executive, and judicial - and how the court system is divided into trial courts that hear evidence and appellate courts that review cases. The lecture outlines the main sources of law and different types of laws, such as civil/private laws that govern relationships between people/organizations and public laws that govern relationships between people and the government. It provides examples of how civil cases involve private parties and criminal cases involve the government and a defendant.
The document discusses factors contributing to rising health care expenditures in the United States. It identifies increased demand from chronic disease and an aging population, new medical technologies, high pharmaceutical costs, and administrative inefficiencies compared to other countries as key drivers. While the uninsured account for some costs, evidence shows their emergency department utilization has not increased and is not a primary cause of overcrowding. Overall rising medical costs are challenging to curb due to demand for new, often expensive treatments and an inability to control utilization.
This document discusses reimbursement methodologies used by insurers to pay healthcare providers. It describes fee-for-service reimbursement, where separate payments are made for each service provided, and episode-of-care reimbursement, where one sum is paid for all services during an illness. Specific fee-for-service methods covered include traditional retrospective reimbursement using fee schedules, self-pay, and prospective payment models like capitation, per diem, case rates, and diagnosis-related groups. The document also reviews the revenue cycle of submitting claims and receiving reimbursement.
This document discusses the revenue cycle and billing process in healthcare. It describes how healthcare organizations capture charges for services provided, code diagnoses and procedures, and submit claims to insurers for reimbursement. Accurate coding using standardized code sets like ICD-10-CM, ICD-10-PCS, CPT and HCPCS is essential for reimbursement. The revenue cycle involves registration of patient information, charge capture, coding, claims submission, and payment receipt.
This document discusses methods for controlling rising health care costs in the United States. It explores how increased use of health information technology, evidence-based medicine, and new models of primary care such as the patient-centered medical home can improve efficiency and reduce expenditures. Alternative delivery methods like urgent care clinics and greater use of nurse practitioners and physician assistants may also lower costs. While concierge medicine provides enhanced services, there is no data showing it contains overall spending. Tort reform aims to curb defensive medicine practices that drive up healthcare costs.
This document is a lecture on financing health care in the United States. It discusses how health insurance works by spreading risk over large pools of people. Insurers pay providers based on diagnosis and procedure codes, using contracted rates. The lecture describes the types of private health insurance like indemnity plans, Blue Cross/Blue Shield, and various managed care plans. It also discusses the roles of government programs like Medicare and Medicaid, as well as laws regulating private insurance such as ERISA, COBRA, HIPAA, and the Affordable Care Act.
The document summarizes health care financing models in the United Kingdom and Canada. It describes how the UK uses a centralized National Health Service funded by taxes, while Canada uses a provincial single-payer system. Both aim for universal coverage but differ in administration - the UK operates facilities while Canada uses private providers. Private insurance plays a larger role in the UK by allowing for additional access and choices.
The United States spends the highest amount on health care per capita compared to other countries. Health care represents almost one-fifth of the U.S. economy and health care jobs are one of the fastest growing sectors. National health care spending can be examined based on categories of service, sources of funding, and types of insurance payers. In 2013, the U.S. spent over $3 trillion on health care, with hospital care, physician/clinical services, and prescription drugs representing the largest categories of spending. Employers and households are the primary contributors to national health expenditures.
Hypertension and it's role of physiotherapy in it.Vishal kr Thakur
This particular slides consist of- what is hypertension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is summary of hypertension -
Hypertension, also known as high blood pressure, is a serious medical condition that occurs when blood pressure in the body's arteries is consistently too high. Blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps it. Hypertension can increase the risk of heart disease, brain disease, kidney disease, and premature death.
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This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
1. Introduction to Health Care
and Public Health in the U.S.
Delivering Health Care, Part 1
Lecture a
This material (Comp 1 Unit 2) was developed by Oregon Health & Science University, funded by the Department
of Health and Human Services, Office of the National Coordinator for Health Information Technology under
Award Number 90WT0001.
This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International
License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/.
2. Delivering Health Care, Part 1
Learning Objectives
• Describe the organization of health care at the
federal, state and local levels
(Lecture a)
• Describe the organization of the VA system and
Military Health System (Lecture b)
• Describe the structure and function of hospital
clinical and administrative units (Lecture c)
• Describe different types of long term care
facilities, with an emphasis on their function
(Lecture d)
2
3. Delivering Health Care, Part 1
Learning Objectives – Lecture a
• Describe the organization of health care at
the federal, state, and local levels
– Overview of the U.S. Department of Health
and Human Services (HHS)
– Role of state governments in health care
– Local health care organizations
3
4. Purpose of the HHS
• Provides essential health care for all
Americans
• Protects the needy or underserved
• State, local, and tribal levels
• Structure
– Office of the Secretary
– 11 operating divisions
4
6. Administration for
Children and Families (ACF)
• Addresses the economic and social well-
being of children, families, individuals,
communities
• Vulnerable populations
• Programs are both national and regional
• Well-known program: Head Start
6
7. Administration on Aging (AoA)
• Adults 65 years of age and older will be
21.7% of the U.S. population by 2040
• Programs are both home-based and
community-based
• Funds non-medical programs to prolong
health and independence
• Multiple needs served: nutritional,
logistical, legal, quality of life
7
8. Agency for Healthcare Research
and Quality (AHRQ) - 1
• Mission:
– produce evidence to make health care safer,
higher quality, more accessible, equitable,
and affordable, and to work within the U.S.
Department of Health and Human Services
and with other partners to make sure that the
evidence is understood and used
• All stakeholders are included
– Health care value
8
9. Agency for Healthcare Research
and Quality (AHRQ) - 2
• Helps organizations adopt new technology
• Areas of research:
– Effectiveness of treatments
– Quality improvement and patient safety
– Illness prevention and care management
– Health care value
9
10. Agency for Toxic Substances
and Disease Registry (ATSDR) - 1
• Works to prevent illness and disease due
to toxic or hazardous substances
• Common toxins: arsenic, asbestos, lead,
mercury
• Locations: environmental pollution, waste
sites, disasters
• Methods of exposure: breathing, drinking,
food, soil exposure, cut
10
11. Agency for Toxic Substances
and Disease Registry (ATSDR) - 2
• Identifies exposures, evaluates risk,
recommends action
• Prepares for emergencies/disasters
• Educates about toxicology, environmental
medicine, chemical exposures
• Issues public health advisories
• Example: 9/11/2001
11
12. Centers for Disease Control
and Prevention (CDC) - 1
• Responsible for public health
– Protect America from health, safety and
security threats, both foreign and domestic
• Activities:
– Health promotion
– Disease prevention
– Reduction of injury and disability
– Public Preparedness
• Numerous centers, institutes and offices
12
13. Centers for Disease Control
and Prevention (CDC) - 2
• Works with partners to monitor and
investigate threats to health
• Enacts prevention strategies, develops
public health policies, advocates for
healthy behaviors.
• Educates health care providers,
consumers
13
14. Centers for Medicare
and Medicaid Services (CMS)
• Provides insurance for 1 in 4 Americans
• Medicare
– Largest health insurer in the U.S.
– For people 65+ or disabled people
– Insured person pays premiums
• Medicaid
– For low-income patients and families
– Specific guidelines are determined by each state
– Insured person generally does not pay
• Children’s Health Insurance Program
14
15. Food and Drug Administration
(FDA)
• Ensures safety and effectiveness:
– Food and drugs
– Medical devices
– Animal drugs
– Cosmetics
• Evaluates and approves new drugs
• Regulates tobacco manufacture and
marketing
• 8 centers with oversight by Commissioner
15
16. Health Resources and
Services Administration
(HRSA) - 1
• Improve access to health care for
individuals with:
– Low incomes, no insurance
– Certain medical issues
– Isolated
• Six bureaus and thirteen offices
• Provides leadership and funding to health
care providers
16
17. Health Resources and
Services Administration
(HRSA) - 2
• Monitors organ, blood, bone marrow
donations
• Supports programs that combat
bioterrorism
• Compensates people for severe
vaccination reactions
• Maintains medical malpractice and fraud
database
17
18. Indian Health Service (IHS)
• Improve physical, mental, social, and spiritual
health of American Indians and Alaska
Natives
– Accessible public health services
– Culturally sensitive; recognizes sovereign rights
– 567 federally recognized tribes in 35 states
• Medical and social issues
– Disparities in health and life expectancy
– Higher mortality from diseases, social problems
18
19. National Institutes of Health (NIH)
• World’s largest source of funding for
medical research
• Funds universities, research institutions,
its own laboratories
• 27 institutes and centers:
– Diseases
– Specific patient groups
– Research issues
19
20. Office of the Inspector General
(OIG)
• Protects the integrity of HHS programs
– Performs nationwide audits, investigations
– Reports abuses, fraud, or waste
– Recommends corrections
• “Most-Wanted Health Care Fugitives”
– Names and photos
– Providers and public encouraged to help
20
21. Substance Abuse and Mental
Health Services Administration
(SAMHSA)
• Improves the health of people with mental illness
and abuse alcohol, tobacco, or drugs
• 6 strategic initiatives:
– Prevent substance abuse and mental illness
– Integrate health systems
– Establish a trauma-informed approach in health
– Provide recovery support
– Promote health information technology and electronic
medical records
– Promote cultural sensitivity
21
22. State Health Care
• All states have a Department of Health
– Organizational structures vary
– Responsible for disease treatment, health promotion,
care of special groups
– State governments partner with HHS
• National Academy for State Health Policy
– Works with states to improve health care access and
quality
– Encourages collaboration with federal government,
private companies, other states
– Example: national health care reform
22
23. Local Health Care:
Private Health Care Agencies
• Independent health care providers
– Single-provider practices
– Group practices
• Corporate health care
– Employees, families, retirees
• Some agencies operate community health
centers
• Can have for-profit or nonprofit status
23
24. Local Health Care: Hospitals
• Profit or nonprofit
• Government-supported or not
• General or specialty
– University-affiliated or community-based
– Single or chain
– Critical-access hospitals get Medicare
reimbursement
24
25. Delivering Health Care, Part 1
Summary - Lecture a
• HHS
– Described organization of health care at federal,
state and local levels
– Provides oversight through eleven operating
divisions
• States run their own departments
– Accessed locally through private practices, clinics
and hospitals
• Overall goal – ensure the health of all
Americans
25
26. Delivering Health Care, Part 1
References – 1 – Lecture a
References
Administration for Children and Families. http://www.acf.hhs.gov. Accessed January 19,
2017.
Administration on Aging. http://www.aoa.acl.gov/aging_statistics/index.aspx. Accessed
January 19, 2017.
Agency for Health Care Research and Quality. http://www.ahrq.gov. Accessed January
19, 2017.
Agency for Toxic Substances and Disease. Agency for Toxic Substances and Disease
Registry. http://www.atsdr.cdc.gov. Updated January 18, 2017. Accessed January 19,
2017.
Alliance for Advancing Nonprofit Health Care. The value of nonprofit health care.
http://www.nonprofithealthcare.org/reports/5_value.pdf. Accessed January 19, 2017.
Centers for Disease Control and Prevention. http://www.cdc.gov. Accessed January 19,
2017.
Centers for Medicare and Medicaid Services. CMS programs and information.
http://www.cms.gov. Accessed January 19, 2017.
Corporate Health Care Coalition. http://www.corporatehealthcare.org. Accessed January
19, 2017.
26
27. Delivering Health Care, Part 1
References – 2 – Lecture a
References
Health Resources and Services Administration. http://www.hrsa.gov/index.html. Accessed
January 19, 2017.
HHS.gov. http://www.hhs.gov. Accessed January 19, 2017.
Indian Health Service. http://www.ihs.gov. Accessed January 19, 2017.
Indian Health Service. IHS fact sheets: Indian health disparities.
https://www.ihs.gov/newsroom/factsheets/disparities/. Updated March 2016.
Accessed January 19, 2017.
Medicare.gov. http://www.medicare.gov. Accessed January 19, 2017.
Census Bureau. Medicare & Medicaid. http://blogs.census.gov/2013/09/17/medicare-and-
medicaid-age-and-income-2/. Accessed January 19, 2017.
Medline Plus. Medicare. http://www.nlm.nih.gov/medlineplus/medicare.html. Updated
March 16, 2011. Accessed January 19, 2017.
National Academy for State Health Policy. http://www.nashp.org. Updated March 2011.
Accessed January 19, 2017.
27
28. Delivering Health Care, Part 1
References – 3 – Lecture a
References
National Association of Community Health Centers. http://www.nachc.org. Accessed
January 19, 2017.
National Institutes of Health. http://www.nih.gov. Accessed January 19, 2017.
Office of Inspector General. http://oig.hhs.gov. Accessed January 19, 2017.
Office of the Inspector General. 2016 Work Plan. http://oig.hhs.gov/reports-and-
publications/archives/workplan/2016/oig-work-plan-2016.pdf. Accessed January 19,
2017.
Rural Health Information Hub. Frequently asked questions.
https://www.ruralhealthinfo.org/topics/critical-access-hospitals#faqs. Accessed
January 19, 2017.
Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov.
Accessed January 19, 2017.
U.S. Food and Drug Administration. http://www.fda.gov. Accessed January 19, 2017.
Images
Slide 5: US Department of Health and Human Services organizational chart. Available
from http://www.hhs.gov/about/orgchart/. Accessed January 19, 2017.
28
29. Introduction to Health Care
and Public Health in the U.S.
Delivering Health Care, Part 1
Lecture a
This material was developed by Oregon
Health & Science University, funded by the
Department of Health and Human Services,
Office of the National Coordinator for Health
Information Technology under Award
Number 90WT0001.
29
Editor's Notes
Welcome to Introduction to Health Care and Public Health in the U.S.: Delivering Health Care, Part 1. This is lecture a.
The component, Introduction to Health Care and Public Health in the U.S., is a survey of how health care and public health are organized and how services are delivered in the U.S. It covers public policy, relevant organizations and their interrelationships, professional roles, legal and regulatory issues, and payment systems. It also addresses health reform initiatives in the U.S.
The learning objectives for Delivering Health Care, Part 1 are to:
Describe the organization of health care at the federal, state, and local levels
Describe the organization of the VA system and Military Health System
Describe the structure and function of hospital clinical and administrative units
And, describe different types of long-term care facilities, with an emphasis on their function
This first lecture describes the organization of health care at the federal, state, and local levels, including the U.S. Department of Health and Human Services, or HHS, state governments, and local health care organizations.
The HHS is the federal agency that oversees health care for all Americans. It focuses on helping citizens who are needy or underserved. Services are generally provided at the state, local, and Native American tribal levels. The HHS is run by the Office of the Secretary, and includes eleven operating divisions.
As illustrated in this flowchart, the structure of the HHS is complex.
At the top, outlined in purple, is the Office of the Secretary, which oversees all operations. This lecture focuses on the inner boxes outlined in blue, which represent the eleven HHS operating divisions. Three of these divisions are considered human services agencies: the Administration for Children and Families, the Administration on Aging, and the Centers for Medicare and Medicaid Services. The other eight divisions are part of the U.S. Public Health Service.
The Office of the Inspector General will also be discussed.
Overall, the HHS runs more than 300 health care programs.
The Administration for Children and Families, or ACF, operates federal programs that encourage economic independence, social well-being, and quality of life. Although this agency targets children and families, it also addresses individuals and entire communities. Vulnerable populations are a special focus, such as people with disabilities, foreign-born individuals, Native Americans, and victims of human trafficking.
One current initiative, "Let's Move! Child Care”, is an effort to promote child health by encouraging physical activity and healthier nutrition practices in early care and education settings.
Another initiative seeks to build the supply and stability of high quality family child care providers. Head Start, a program of the ACF, promotes school readiness among young children by working to improve health, nutrition, educational attainment, and social development. The Early Head Start program targets pregnant women as well as infants and toddlers.
Next is the Administration on Aging, or AoA. According to government census projections, people aged 65 and older will represent 21.7% of the population by the year 2040. Individuals who are currently age 65 can expect to live, on average, about another 18 years. Many older people live alone and have a low income, creating an increased need for national programs that target this group.
The AoA provides funding for nonmedical home-based and community-based services for the elderly, with the goal of prolonging the health and independence of senior citizens. Examples of these services are home delivery of meals, nutrition information, transportation services, adult day care, and legal assistance.
Decision-making about any issue is difficult when people do not have the information they need. In terms of health care, a good resource for information is the Agency for Healthcare Research and Quality, or AHRQ. AHRQ’s mission is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and to work within the U.S. Department of Health and Human Services and with other partners to make sure that the evidence is understood and used. The efforts of AHRQ target all stakeholders in the health care system, including patients, individual health care providers, hospitals, insurers, policy makers at all government levels, and medical schools.
AHRQ helps organizations adopt new information technology, such as computerized medical records. It researches the effectiveness of treatments, including drugs, devices, diagnostic tests, and surgery, so patients and physicians can make informed decisions. The agency’s other research interests are quality improvement and patient safety, illness prevention and care management, and issues of health care value, such as the affordability of health care.
The Agency for Toxic Substances and Disease Registry, or ATSDR, works to prevent illness and disease due to toxic or hazardous substances. Among the most common toxic substances are arsenic, asbestos, lead, and mercury. Toxic substances may be found in the environment, in specific areas such as waste sites, or due to sudden disasters. People may be at risk from merely breathing, or from contact with water, food, soil or through an open sore like a cut.
The ATSDR identifies potential exposures, quantifies the risk, and makes recommendations for protecting communities. It ensures emergency preparedness for natural or man-made disasters, and it educates health care providers on topics such as toxicology, environmental medicine, and acute chemical exposures. It also issues public health advisories about hazardous materials or physical hazards such as unsafe buildings or abandoned mine shafts.
To give an example, the ATSDR partnered with other government agencies after the terrorist attacks in New York City on September 11, 2001. It provided information about toxin levels and answered questions from residents, first responders, and the media.
The Centers for Disease Control and Prevention, or CDC, is responsible for public health. The CDC’s mission is to protect America from health, safety, and security threats, both foreign and in the U.S. Major activities include health promotion, disease prevention, reduction of injury and disability, and public preparedness for emerging health threats. The CDC accomplishes these goals through numerous centers, institutes, and offices. Just a few examples are the Center for Global Health, the National Institute for Occupational Safety and Health, the Office of Infectious Disease, and the National Center on Birth Defects and Developmental Disabilities.
The CDC works with its partners, both national and international, to monitor current health and to investigate emerging threats to health, for example swine flu. It also enacts prevention strategies and public health policies, and advocates for healthy behaviors. The CDC monitors new threats to the U.S. public, such as infectious diseases that originate in other countries, like the Zika virus. Finally, the CDC offers a wealth of publications on health care topics, some written for health care providers and some written for the public.
The Centers for Medicare and Medicaid Services, or CMS, provides health care insurance for one in every four Americans. In fact, Medicare is the largest health insurer in the U.S., processing more than one billion claims every year.
Medicare is for people aged 65 and older, along with younger people who have certain disabilities.
Medicare insurance is divided into four parts:
Part A, which is hospital insurance;
Part B, which is medical insurance;
Part C, or Medicare Advantage, which allows the use of private companies approved by Medicare, or provider organizations; and
Part D, which is prescription drug coverage. The insured person may pay monthly premiums depending on the plan selected.
Medicaid is a health insurance program targeted at low-income individuals and families who meet specific requirements. The eligibility rules and the services provided vary by state. Medicaid reimburses the medical provider directly, although some states require the patient to contribute a small co-payment.
Another division of CMS is the Children’s Health Insurance Program, or CHIP. It serves uninsured children and pregnant women who do not qualify for Medicaid but cannot afford private health care insurance.
It is well known that the Food and Drug Administration, or FDA, protects the public by ensuring the safety and effectiveness of foods and drugs. The FDA also regulates medical devices, animal drugs, cosmetics, products that emit radiation, and other toxic substances. The FDA evaluates and approves new drugs and regulates the manufacture and marketing of tobacco products. The FDA is organized into eight centers, with oversight by a Commissioner.
The Health Resources and Services Administration, or HRSA, works to improve access to health care for individuals who are disadvantaged because of low income, lack of insurance, medical problems, or social isolation. With its six bureaus and thirteen offices, HRSA provides leadership and funding for health care providers who treat uninsured patients, those with HIV/AIDS, pregnant women, special-needs children, rural residents, and others.
In addition to improving access to health care, HRSA monitors national organ, blood, and bone marrow donations; supports programs to combat bioterrorism; compensates patients who sustain severe vaccination reactions; and maintains databases to prevent medical malpractice and fraud.
As seen in the previous slides, many HHS agencies target needy, underserved, or rural populations. The Indian Health Service, or IHS, is the federal agency that serves American Indians and Alaska Natives. Its mission is to improve the physical, psychological, and spiritual health of these groups by ensuring access to public health services. Health care for these groups must be delivered in a culturally sensitive manner that recognizes the sovereign rights of tribes. In fact, the U.S. has 567 federally-recognized tribes in thirty-five states, totaling about two million individuals, who mainly reside on reservations, or in rural areas.
Unfortunately, Native populations have poorer health than other Americans. Their life expectancy is a full five years shorter. For American Indians and Alaska Natives born today, their life expectancy is 4.4 years less than the U.S. ‘all races’ population. Sometimes these problems are due to poor education, poverty, discrimination, and cultural misunderstandings. The IHS seeks to address these problems, as well as health disparities.
The medical research arm of the HHS is the National Institutes of Health, or NIH. This is the largest source of medical research funding in the world, promoting scientific discoveries in every U.S. state and abroad. Research is conducted at universities or research centers, and at NIH laboratories on its own campus.
The NIH is organized into twenty-seven institutes and centers, many of which focus on diseases or body systems. Some well-known examples are the National Cancer Institute, the National Institute of Mental Health, and the National Institute of Diabetes and Digestive and Kidney Diseases. Other institutes and centers focus on specific patient groups, such as children and the elderly, for example through the National Institute on Aging. Still other departments focus on specific research issues.
Every society needs to be policed. The Office of the Inspector General, or OIG, works to protect the integrity of HHS programs. It performs nationwide audits and investigations, and it reports any abuses, fraud, or waste to the Office of the Secretary and to Congress. They also recommend corrections.
An important part of the OIG’s work is its ongoing efforts to stop Medicare and Medicaid fraud. It even posts an online list of “Most-Wanted Health Care Fugitives.” The list includes the names and photos of individuals who received millions of dollars in false Medicaid and Medicare claims, then escaped prosecution. Both health care providers and the public are encouraged to help the OIG identify fraud and abuse.
The Substance Abuse and Mental Health Services Administration, or SAMHSA, works to improve the health of people with mental illness and those who abuse alcohol, tobacco, or illegal drugs. The agency provides funding for special programs and disseminates information on behavioral health issues. The rationale is that prevention and treatment reduce health care costs and social costs for individuals, families, and communities.
SAMHSA’s projects are spelled out in six strategic initiatives
Prevent substance abuse and mental illness
Integrate health systems to ensure that behavioral health care services are accessible and connected to the broader health care system
Establish a trauma-informed approach in health, behavioral health, human services, and related systems
Provide mental and substance use disorder recovery support
Promote health information technology and electronic medical records
Promote cultural awareness in health care practitioners
With so much going on at the federal level, what is the role of individual states in providing health care? All states have a department of health, although organizational structures vary. State health departments manage disease prevention and treatment, health promotion, and public health services for special groups, such as racial and ethnic minorities, families, and senior citizens. State and local governments also partner with the HHS to provide these services through state or county agencies or private companies.
Recognizing the disparities in the U.S. health care system, the National Academy for State Health Policy works with states to improve health care access and quality. The Academy encourages states to collaborate with the federal government and private companies, and to share information with other states. Currently, the Agency is working with states as they implement payment reform initiatives related to the Affordable Care Act, the most recent federal health care reform law.
Some local governments run clinics and hospitals, but they generally do not provide health care to their residents directly; instead, various types of private organizations fill this need.
Independent health care providers may be single physicians or group practices in the community. Corporate health care refers to self-insured companies that provide health plans and benefits for employees, their families, and retirees.
Community health centers operate in every U.S. state. They provide primary health care services to low-income residents and are supported by public financing.
At all local levels, health care agencies can operate on either a for-profit or nonprofit basis. All community health centers are nonprofit organizations, but so are about 60% of community hospitals, 30% of nursing homes, and 17% of home health care agencies.
Given the complexity of the U.S. health care system, it is not surprising that many types of hospitals exist. Hospitals may be for-profit or nonprofit, and they may or may not be supported by the government. They may provide general or specialty health care. They may be affiliated with large teaching and research institutions at universities, or they may be based in the community. For-profit hospitals may be single centers, or they may be chains with locations in many states, run by corporations. Critical access hospitals are rural acute care hospitals that are certified to receive reimbursement from Medicare.
This concludes lecture a of Delivering Health Care, Part 1.
In summary, this lecture described the organization of health care at the federal, state, and local levels. The HHS provides oversight through its eleven operating divisions. States run their own departments of health, and health care is accessed locally through private practices, clinics, and hospitals. The overall goal is to ensure the health of all Americans.