types of healthcare agencies, hospitals

1. TYPES OF HEALTHCARE AGENCIES,
HOSPITALS
Nursing Foundations
Unit 1

2. LEVELS OF HEALTH CARE
Primary level (Primary health care)
 First level of contact with the system,
 close to people,
 most of the problems are dealt with
 Has community based interventions that improve outcomes for
entire population
 PHCs and subcentres
 Includes medical services, health education, nutritional
counselling, MCH care, Family planning, and control of diseases
Secondary level
Tertiary level
“Primary health care is essentially health
care made universally accessible to
individuals and families in the community
by means acceptable to them, through
their full participation and at a cost the
community and country can afford”.

3. PRIMARY HEALTH CARE
 In 1946, Bhore Committee- Primary Health Centre as a basic unit with 6 MOs, 6Ns providing
integrated curative and preventive care
 1977 – GoI launched rural health scheme on “placing people’s health in people’s hands”; 3 tier
system for rural area based on Shrivastav Committee in 1975
 1977- World Health Assembly - Declaration of ‘Health for All (HFA)’. Main social goal of
governments and WHO should be ‘attainment by all the people of the world by the year 2000
AD of a level of health that will permit them to lead a socially and economically productive life’
 1978 – Alma-Ata on Primary Health Care
“Primary health care is essentially health care made universally accessible to individuals and
families in the community by means acceptable to them, through their full participation and at
a cost the community and country can afford”.
 GoI is committed to the HFA goal through Primary Health Care
 National Health Policy (2002) was based on primary healthcare approach with plan of action
for modifying the existing rural health infrastructure
 To further strengthen & make rural PHC system functional, the launch of National Rural Health
Mission (NRHM) in April 2005, NUHM in 2013, both under NHM

4. LEVELS OF HEALTH CARE
Secondary level
 When the nature or severity of a condition
makes primary care insufficient
 Care provided by specialist or agency on
referral from primary care
 Needs specialized knowledge, skill or
equipment–
 District hospitals and Community health
centres
HEALTH CARE DELIVERY SYSTEM
An organization of people, institutions, and resources to deliver health
care services to meet the health needs of a target population.
Tertiary level
 More specialized than secondary, on
referral from secondary
 Requires specific facilities, and highly
specialized HCPs
 At regional or central institutes (medical
college hospitals, AIIMS, specialised
hospitals etc.)
 Tertiary care (acute care)can be expensive

5. HEALTH CARE DELIVERY SYSTEM-INDIA

6. PRIMARY HEALTH CENTRES (PHC)
 In 1983 GoI proposed 1 PHC for 30, 000
(plains)/20,000(hilly) population
 Basic Functions of PHCs
 Medical care
 MCH care including FP
 Safe water supply and basic sanitation
 Prevention and control of endemic diseases
 Collection and reporting of vital statistics
 Education about health
 National health programmes
 Referral services
 Training of VHGs, HCWs, Dais and Has
 Basic lab services
 Subcentres under PHCs 1 for 5,000/3000
 Provide Primary health care services
 Immunizations
 MCH care (antenatal, natal and
postnatal care) including FP
 Prevention of malnutrition and
childhood diseases
 Elementary drugs for minor ailments
[ARIs, diarrhoea, fever, worm
infestation etc.]
 Community surveys
 National health programmes

7.  Ayushman Bharat Program (ABP) in
February 2018 with two components
a) Health and Wellness Centres
(HWCs) to strengthen & deliver
comprehensive Primary Health
Care (cPHC) services for entire
population and
b) Pradhan Mantri Jan ArogyaYojana
(PMJAY) for secondary and
tertiary level hospitalization
services for bottom 40% of
families in India
AB HEALTH AND WELFARE CENTRES
An upgraded version of existing Sub-
Centers (HSC); Primary Health
Centers and Urban Primary Health
Centers (UPHCs).

8. HEALTH CARE
DELIVERY SYSTEM
INDIA

9. HOSPITALS/HEALTH CENTRES
 Community health centres
 1 for 80,000-1,20,000 population; 30 beds
 Surgery, medicine, OBGYN, Paediatrics,
Diagnostic (X-ray, lab)
 CHO
 Rural Hospitals
 Hospitals in remote areas
 Care for minor ailments
 District Hospitals
 In the remote districts with less private
facilities
 Services through the Govt. Programmes
and policies
 75-500 beds
 Speciality Hospitals
 For specialist services like Cancer,
spinal injuries, trauma, rehabilitation
 Is well-equipped with machines and
critical care facilities
 Teaching Hospitals
 Has affiliated nursing and medical
colleges
 Provides tertiary level curative services
 Teaching and research activities

10. HOSPITALS
 Derived from Latin word ‘Hospice’“an establishment where a guest is
received and cared”
 Definition:“Hospital is an integral part of the social and medical
organization, the function of which is to provide for the population,
complete health care, both curative and preventive and whose
outpatient services reach out to the families and environment; the
hospital is also a center for the training of health workers and
biosocial research”
 Generally means an institution in which sick or injured persons are
treated and healthy persons are helped to promote and maintain an
optimum level of well-being

11. TYPES OF HOSPITALS
1. Based on clinical specialties
1. General hospitals (general services)
2. Specialized hospitals (e.g., Cardiology, Neuro)
2. Based on ownership
a. Public (Central, state, Municipal bodies)
b. Private (individuals or groups.)
c. Charitable (philanthropic organizations, and charitable trusts)
d. Corporate (Registered companies running for commercial purposes)
3. Based on location
1. Rural
2. District
4. Based on diversity in aims
1. Teaching (medical, Nursing, PG or other healthcare professionals)
2. Non-teaching (Only services)

12. HOSPITALS
 Size and Services
 In patient and Outpatient
Services
 Basic functions
 Organization
 Role of a nurse
BASIC FUNCTIONS OF A HOSPITAL
• Diagnostic
• Therapeutic
• Emergency care
• Critical care
• Rehabilitation
• Preventive services
• Health promotion
• Education and training
• Research

13. HOSPITALS
 Specialized Care Centres
 Day Care
 Mental Health
 Rural health
 School
 Homeless shelters
 Rehab
 Healthcare for seriously ill
 Respite care – for caregivers of homebound
ill, disabled or older patients (patient care
given at the centre or home)
 Hospice care
 Palliative care - interdisciplinary team
focuses on the relief of physical, mental,
and spiritual distress; goal is to prevent and
relieve pain and other problems

14. ORGANIZATION OF THE HOSPITALS