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Community-Based HealthCare

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Community-Based HealthCare PPP by Marianne McAuley , BSN, MS, RN Revised KBurger1008 LECTURE # 20 FALL 2010 What is Community-Based Health Care? Part of holistic ... – PowerPoint PPT presentation

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Title: Community-Based HealthCare


1
Community-Based HealthCare
  • PPP by Marianne McAuley , BSN, MS, RN Revised
    KBurger1008 LECTURE 20 FALL 2010

2
What is Community-Based Health Care?
  • Part of holistic nursing practice
  • Focuses on primary health interventions
    preventative health care
  • Considers unique needs of a specific geographic
    region and population of that community.
  • Diverse settings rural, urban, etc.

3
HEALTHY PEOPLE 2010
  • Health care goals for the nation
  • Increase quality years of healthy life for
    Americans
  • Remove disparities in health care

4
PUBLIC HEALTH NURSING Understand needs of a
population
  • PUBLIC HEALTH PROBLEMS
  • Prevalence of overweight
  • Under immunization of children
  • Increase of STD
  • Drug resistant strains of TB
  • Toxic environmental conditions
  • New diseases - AIDS, West Nile Virus

5
Components of a Community Assessment
  • Population
  • Demographic census data
  • Predominant cultural group
  • Structure
  • Location of services
  • Locations where people congregate
  • Housing
  • economy
  • Social System
  • Transportation system
  • Health system gaps in services?
  • Government

6
Types of Preventive Services
  • Primary
  • Decrease risk to a client for disease
  • life-style modifications
  • Secondary
  • Early intervention to alleviate disease
  • Diagnosis prompt intervention to decrease
    severity of a disease
  • screenings
  • Tertiary
  • Minimize effects of chronic conditions
  • rehabilitation activities

7
(No Transcript)
8
National Public Agencies
  • U.S. Dept. of Health Human Services
  • administratively responsible for public health
    care services
  • U.S. Public Health Services
  • oversees delivery of public services
  • Veterans Administration
  • health care for members of armed forces

9
Agencies of USPHS
  • CDC- prevents transmission of communicable
    diseases
  • FDA - Protects public from unsafe drugs, food,
    cosmetics
  • NIH National Institute of Health
  • conducts research education for specific
    diseases
  • AHRQ Agency for Health Care Research Quality
  • identifies standard of care for high-volume
    diseases

10
State and Local Health Departments
  • New York State Department of Health
    NYSDOH
  • Suffolk County Department of Health SCDOH

11
Voluntary Agencies
  • ANA, AMA
  • American Heart Association
  • American Cancer Society
  • Meals on Wheels
  • Support Groups

12
ROLES OF THE NURSE
  • Caregiver
  • Collaborator
  • Advocate
  • Educator
  • Manager
  • Change agent
  • Counselor

13
FINANCIAL ASPECTS OF HEALTH CARE
  • US private insurance model
  • Past Retrospective System fee-for-service
  • Present Prospective System predetermined fixed
    amounts of payments
  • Managed Care
  • Payment System 1983 Prospective
  • Diagnosis Related Groups (DRGs)
  • Length of Stay (LOS)

14
Managed Care
  • access, cost quality are controlled
  • emphasis on prevention primary care
  • not a place, but an organizational structure
  • primary care physician - gatekeeper

15
Types of Managed Care
  • Managed Care Organizations (MCO)
  • - Staff model physicians employed by the MCO
  • - Group, Network, Independent model MCO
    contracts with specific practitioners or groups
  • capitated rates a preset flat fee based on
    membership not services
  • referral needed for specialists

16
TYPES OF MANAGED CARE
  • PPO Preferred Provider Organization
  • - members use network of providers
  • - insurance plans and self-insured employers
  • members pay extra for providers outside of
    network
  • incentive for providers large of patients
  • 42 growth rate in last 10 years

17
MEDICARE
  • A type of MCO
  • Part A inpatient hospital, skilled nursing
    facility, home, hospice care
  • no premium - paid by Federal govt
  • Part B outpatient costs, physician visits
  • paid by monthly premium
  • Part D as of 1/06 prescription coverage Part
    D as of 1/06 prescription coverage

18
MEDICAID
  • For people with low income
  • Jointly administered by Federal government
    states
  • Each state determines eligibility services
  • 90 of long-term care (nursing centers) paid by
    Medicaid

19
ISSUES IN HEALTH CARE
  • Cost
  • oversupply of specialized providers
  • focus on treatment of disease, not prevention
  • surplus of hospital beds
  • consumers are passive
  • aging of population
  • advanced technology
  • lawsuits

20
ISSUES IN HEALTH CARE
  • Access
  • more likely to develop health problems
  • poorer outcomes
  • Vulnerable Populations -Poor -Homeless -Abused -Su
    bstance Dependent -Elderly -Immigrant
  • -Mentally Ill
  • Proper assessment requires non-judgmental and
    culturally competent attitudes. Critical
    thinking!
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