What is the foundation of the HC system?
Hospitals
Inpatient services
overnight stay of a patient
Manhattan Island
claimed the first U.S hospital in 1663 for ill soldiers
Hospitals were:
the precursor of almshouses or poor houses
Philadelphia General Hospital
- the first almshouse
Pennsylvania Hospital
1st incorporated hospital in America
Greek Temples
- 5,000 years ago
- were the 1st type of hospitals with similar institutions in Egyptian, Hindu, and Roman cultures.
During the 1930s/40s: ownership of hospitals changed from?
Physician owned--> church related and government operated.
Public Hospital of Baltimore
John Hopkins Hospital- one of the best hospitals in the U.S
Certificate of Need (CON)
- encouraged state planning to ensure their medical systems are based on NEED.
3 Major Types of Hospitals by Ownership:
1. Public- oldest; owned by fed, state, and local governments.
2. Voluntary/Community- privately owned and for NON-profit.
- financial support is result of community organizational efforts.
3. Proprietary- investor owned hospitals
- for PROFIT institution
Acute Care Hospitals
Less than 30 days in the hospital
Long Term
More than 30 days in hospital
- usually rehab and chronic disease hospitals
Urban Hospitals offer:
higher salary and more complex care.
Rural Hospitals are for:
seeing more poor + elderly patients
- they have financial issues
Critical Access Hospitals
- if no more than 25 acute care beds - enables them to receive additional Medicare reimbursement= Cost Plus.
Hospitals are governed by:
- Chief executive officer (CEO)
- board of trustees or board of directors
- chief of medical staff
CEO
provides leadership to achieve their mission and vision.
Trustees
responsible for hospital operations
- often form different committees.
ex: finance, quality
Operational Staff:
manages non medical staff
State Licensure
focuses on building codes, sanitation, equipment, and personnel.
Certification
is mandated by HHS.
Accreditation
private standard developed by accepted organizations as a way to meet certain standards.
- process of evaluation
Patient Self-Determination Act
-1990
- to inform patients of their rights
6 Domains of Quality in Health Care:
1. Safety
2. Patient Centeredness
3. Efficiency
4. Effectiveness
5. Equity
6. Timeliness
(Lean Six Sigma)
Outpatient Services
- "ambulatory care"
- physician offices, hospital emergency services, care centers
- ASC (Ambulatory Surgery Centers)- for surgeries that do not require an overnight stay.
Health Centers:
-1960s
- for the uninsured, minorities, infants, homeless, etc.