Health care
Encyclopedia
Health care is the diagnosis, treatment, and prevention of disease
, illness
, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine
, chiropractic
, dentistry
, nursing
, pharmacy
, allied health, and other care providers
. It refers to the work done in providing primary care, secondary care and tertiary care, as well as in public health
.
Access to health care varies across countries, groups and individuals, largely influenced by social and economic conditions as well as the health policies in place. Countries and jurisdictions have different policies and plans in relation to the personal and population-based health care goals within their societies. Health care system
s are organizations established to meet the health
needs of target populations. Their exact configuration varies from country to country. In some countries and jurisdictions, health care planning is distributed among market participants, whereas in others planning is made more centrally among governments or other coordinating bodies. In all cases, according to the World Health Organization
(WHO), a well-functioning health care system requires a robust financing mechanism; a well-trained and adequately-paid workforce
; reliable information on which to base decisions and policies; and well maintained facilities
and logistics to deliver quality medicines and technologies.
Health care can form a significant part of a country's economy
. In 2008, the health care industry consumed an average of 9.0 percent of the gross domestic product
(GDP) across the most developed OECD countries. The United States (16.0%), France (11.2%), and Switzerland (10.7%) were the top three spenders.
Health care is conventionally regarded as an important determinant in promoting the general health
and wellbeing of peoples around the world. An example of this is the worldwide eradication of smallpox
in 1980—declared by the WHO as the first disease in human history to be completely eliminated by deliberate health care interventions.
The delivery of modern health care depends on groups of trained professional
s and paraprofessional
s coming together as interdisciplinary teams. This includes professionals in medicine
, nursing
, dentistry
and allied health, plus many others such as public health practitioners
, community health worker
s and assistive personnel
, who systematically provide personal and population-based preventive, curative and rehabilitative care services.
While the definitions of the various types of health care vary depending on the different cultural, political, organizational and disciplinary perspectives, there appears to be some consensus that primary care constitutes the first element of a continuing health care process, that may also include the provision of secondary and tertiary levels of care.
who act as a first point of consultation for all patients within the health care system. Such a professional would usually be a primary care physician
, such as a general practitioner
or family physician
. Depending on the locality, health system organization, and sometimes at the patient's discretion, they may see another health care professional first, such as a pharmacist
, a nurse (such as in the United Kingdom), a clinical officer
(such as in parts of Africa), or an Ayurvedic
or other traditional medicine professional (such as in parts of Asia). Depending on the nature of the health condition, patients may then be referred
for secondary or tertiary care.
Primary care involves the widest scope of health care, including all ages of patients, patients of all socioeconomic and geographic origins, patients seeking to maintain optimal health
, and patients with all manner of acute and chronic physical, mental
and social health issues, including multiple chronic diseases
. Consequently, a primary care practitioner must possess a wide breadth of knowledge in many areas. Continuity is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine check-ups and preventive care
, health education
, and every time they require an initial consultation about a new health problem. The International Classification of Primary Care
(ICPC) is a standardized tool for understanding and analyzing information on interventions in primary care by the reason for the patient visit.
Common chronic illnesses usually treated in primary care may include, for example: hypertension
, diabetes
, asthma
, COPD
, depression and anxiety
, back pain
, arthritis
or thyroid dysfunction
. Primary care also includes many basic maternal
and child health care services, such as family planning
services and vaccination
s.
In context of global population ageing
, with increasing numbers of older adults at greater risk of chonic non-communicable disease
s, rapidly increasing demand for primary care services is expected around the world, in both developed and developing countries. The World Health Organization
attributes the provision of essential primary care as an integral component of an inclusive primary health care
strategy.
and other health professionals who generally do not have first contact with patients, for example, cardiologists, urologists and dermatologists
.
It includes acute care
: necessary treatment for a short period of time for a brief but serious illness, injury or other health condition, such as in a hospital emergency department
. It also includes skilled attendance during childbirth
, intensive care
, and medical imaging
services.
The "secondary care" is sometimes used synonymously with "hospital
care". However many secondary care providers do not necessarily work in hospitals, such as psychiatrists or physiotherapists, and some primary care services are delivered within hospitals. Depending on the organization and policies of the national health system, patients may be required to see a primary care provider for a referral
before they can access secondary care.
For example in the United States, which operates under a mixed market health care system, some physician
s might voluntarily limit their practice to secondary care by requiring patients to see a primary care provider first, or this restriction may be imposed under the terms of the payment agreements in private/group health insurance
plans. In other cases medical specialists may see patients without a referral, and patients may decide whether self-referral is preferred.
In the United Kingdom and Canada, patient self-referral to a medical specialist for secondary care is rare as prior referral from another physician (either a primary care physician or another specialist) is considered necessary, regardless of whether the funding is from private insurance schemes
or national health insurance
.
Allied health professionals
, such as occupational therapists, speech therapists
, and dietitians, also generally work in secondary care, accessed through either patient self-referral or through physician referral.
investigation and treatment, such as a tertiary referral hospital
.
Examples of tertiary care services are cancer
management, neurosurgery
, cardiac surgery
, plastic surgery
, treatment for severe burn
s, advanced neonatology
services, palliative, and other complex medical and surgical interventions.
and some types of uncommon diagnostic
or surgical
procedures are considered quaternary care. These services are usually only offered in a limited number of regional or national health care centres.
interest, such as food safety
surveillance, distribution of condom
s and needle-exchange programme
s for the prevention of transmissible diseases.
They also include the services of professionals in residential and community settings in support of self care, home care
, long-term care
, assisted living
, treatment for substance use disorder
s, and other types of health and social care services.
Health care extends beyond the delivery of services to patients, encompassing many related sectors, and set within a bigger picture of financing and governance structures.
categorizes health care as generally consisting of hospital activities, medical and dental practice activities, and "other human health activities". The last class involves activities of, or under the supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratories, pathology clinics, residential health facilites, or other allied health professions
, e.g. in the field of optometry, hydrotherapy, medical massage, yoga therapy, music therapy, occupational therapy, speech therapy, chiropody, homeopathy, chiropractics, acupuncture, etc.
In addition, according to industry and market classifications, such as the Global Industry Classification Standard
and the Industry Classification Benchmark
, health care includes many categories of medical equipment, instruments and services as well as biotechnology
, diagnostic laboratories and substances, and drug manufacturing and delivery.
For example, pharmaceuticals and other medical devices are the leading high technology exports of Europe and the United States. The United States dominates the biopharmaceutical
field, accounting for three-quarters of the world’s biotechnology revenues.
of health which focuses on the eradication of illness
through diagnosis
and effective treatment. Many important advances have been made through health research, including biomedical research
and pharmaceutical research. They form the basis of evidence-based medicine
and evidence-based practice in health care delivery.
For example, in terms of pharmaceutical research and development spending, Europe
spends a little less than the United States (€22.50bn compared to €27.05bn in 2006). The United States accounts for 80% of the world's research and development spending in biotechnology.
In addition, the results of health services research
can lead to greater efficiency and equitable delivery of health care interventions, as advanced through the social model of health and disability
, which emphasizes the societal changes that can be made to make population healthiers. Results from health services research often form the basis of evidence-based policy
in health care systems.
There are generally five primary methods of funding health care systems:
In most countries, the financing of health care services features a mix of all five models, but the exact distribution varies across countries and over time within countries. In all countries and jurisdictions, there are many topics in the politics and evidence that can influence the decision of a government, private sector business or other group to adopt a specific health policy regarding the financing structure.
For example, social health insurance is where a nation's entire population is eligible for health care coverage, and this coverage and the services provided are regulated. In almost every jurisdiction with a government-funded health care system, a parallel private, and usually for-profit, system is allowed to operate. This is sometimes referred to as two-tier health care
or universal health care
.
is another sector vital to the delivery of health care services. In particular, the practice of health professionals and operation of health care institutions is typically regulated
by national or state/provincial authorities through appropriate regulatory bodies for purposes of quality assurance
. Most countries have credentialing staff in regulatory boards or health department
s who document the certification or licensing of health workers
and their work history.
Some of this data is easy to extract and readily available to healthcare administrators, however the patient or clinical data is not as easy to Extract, Transform and Load. The reason that this data is more difficult to extract is that the data itself is more subjective than calculated. The data comes from notes and observations and to extract it properly the data needs to be considered within its context.
The process of analyzing health care data is a monumental task and one that must be done properly and continually. For these reason it becomes very costly and consumes a large number of IT resource hours.
was passed, which guarantees access to primary and other health care services for all citizens, and prohibits extra billing by doctors on patients while at the same time billing the public insurance system. In 1999, the prime minister and most premiers reaffirmed in the Social Union Framework Agreement
that they are committed to health care that has "comprehensiveness, universality, portability, public administration and accessibility." The system is for the most part publicly funded, with most services provided through publicly administered hospitals or privately operating practitioners or the government.
Guinea
has been reorganizing its health system since the Bamako Initiative
of 1987 formally promoted community-based methods of increasing accessibility of primary health care
to the population, including community ownership and local budgeting, resulting in more efficient and equitable provision of drugs and other essential health care resources.
In June 2011, the Guinean government announced the establishment of an air solidarity levy on all flights taking off from national soil, with funds going to UNITAID
to support expanded access to treatment for HIV/AIDS, tuberculosis and malaria. Guinea is among the growing number of countries and development partners using market-based transactions taxes and other innovative financing
mechanisms to expand financing options for health care in resource-limited settings.
has a National Health Service
that provides public healthcare to all UK permanent residents that is free at the point of need and paid for from general taxation. However private healthcare companies are free to operate alongside the public one. Since health is a devolved matter
, considerable differences are developing between the systems in each of the countries.
The United States currently operates under a mixed market health care system. Government sources (federal, state, and local) account for 45% of U.S. health care expenditures. Private sources account for the remainder of costs, with 38% of people receiving health coverage through their employers and 17% arising from other private payment such as private insurance and out-of-pocket co-pays.
A few states have taken serious steps toward universal health care coverage, most notably Minnesota
, Massachusetts
and Connecticut
, with recent examples being the Massachusetts 2006 Health Reform Statute and Connecticut's SustiNet
plan to provide quality, affordable health care to state residents.
The Patient Protection and Affordable Care Act
(Public Law 111-148) was signed into law by President Barack Obama
on March 23, 2010. Along with the Health Care and Education Reconciliation Act of 2010
(signed March 30), the Act is a product of the health care reform
efforts of the Democratic
111th Congress and the Obama administration. The law includes health-related provisions to take effect over the next four years, including expanding Medicaid
eligibility for people making up to 133% of the federal poverty level (FPL), subsidizing insurance premiums for people making up to 400% of the FPL ($88,000 for family of 4 in 2010) so their maximum "out-of-pocket" payment for annual premiums will be on sliding scale from 2% to 9.8% of income, providing incentives for businesses to provide health care benefits, prohibiting denial of coverage and denial of claims based on pre-existing conditions, establishing health insurance exchange
s, prohibiting insurers from establishing annual coverage caps, and support for medical research.
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
, illness
Illness
Illness is a state of poor health. Illness is sometimes considered another word for disease. Others maintain that fine distinctions exist...
, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine
Doctor of Medicine
Doctor of Medicine is a doctoral degree for physicians. The degree is granted by medical schools...
, chiropractic
Chiropractic
Chiropractic is a health care profession concerned with the diagnosis, treatment and prevention of disorders of the neuromusculoskeletal system and the effects of these disorders on general health. It is generally categorized as complementary and alternative medicine...
, dentistry
Dentistry
Dentistry is the branch of medicine that is involved in the study, diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Dentistry is widely considered...
, nursing
Nursing
Nursing is a healthcare profession focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life from conception to death....
, pharmacy
Pharmacy
Pharmacy is the health profession that links the health sciences with the chemical sciences and it is charged with ensuring the safe and effective use of pharmaceutical drugs...
, allied health, and other care providers
Health care provider
A health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities....
. It refers to the work done in providing primary care, secondary care and tertiary care, as well as in public health
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
.
Access to health care varies across countries, groups and individuals, largely influenced by social and economic conditions as well as the health policies in place. Countries and jurisdictions have different policies and plans in relation to the personal and population-based health care goals within their societies. Health care system
Health care system
A health care system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations....
s are organizations established to meet the health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...
needs of target populations. Their exact configuration varies from country to country. In some countries and jurisdictions, health care planning is distributed among market participants, whereas in others planning is made more centrally among governments or other coordinating bodies. In all cases, according to the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
(WHO), a well-functioning health care system requires a robust financing mechanism; a well-trained and adequately-paid workforce
Health Human Resources
Health human resources — also known as “human resources for health” or “health workforce” — is defined as “all people engaged in actions whose primary intent is to enhance health”, according to the World Health Organization's World Health Report 2006. Human resources for health are identified as...
; reliable information on which to base decisions and policies; and well maintained facilities
Health care provider
A health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities....
and logistics to deliver quality medicines and technologies.
Health care can form a significant part of a country's economy
Economic system
An economic system is the combination of the various agencies, entities that provide the economic structure that defines the social community. These agencies are joined by lines of trade and exchange along which goods, money etc. are continuously flowing. An example of such a system for a closed...
. In 2008, the health care industry consumed an average of 9.0 percent of the gross domestic product
Gross domestic product
Gross domestic product refers to the market value of all final goods and services produced within a country in a given period. GDP per capita is often considered an indicator of a country's standard of living....
(GDP) across the most developed OECD countries. The United States (16.0%), France (11.2%), and Switzerland (10.7%) were the top three spenders.
Health care is conventionally regarded as an important determinant in promoting the general health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...
and wellbeing of peoples around the world. An example of this is the worldwide eradication of smallpox
Smallpox
Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...
in 1980—declared by the WHO as the first disease in human history to be completely eliminated by deliberate health care interventions.
Health care delivery
Professional
A professional is a person who is paid to undertake a specialised set of tasks and to complete them for a fee. The traditional professions were doctors, lawyers, clergymen, and commissioned military officers. Today, the term is applied to estate agents, surveyors , environmental scientists,...
s and paraprofessional
Paraprofessional
Paraprofessional is a job title given to persons in various occupational fields, such as education, healthcare, engineering and law, who are trained to assist professionals but are not themselves licensed at a professional level...
s coming together as interdisciplinary teams. This includes professionals in medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
, nursing
Nursing
Nursing is a healthcare profession focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life from conception to death....
, dentistry
Dentistry
Dentistry is the branch of medicine that is involved in the study, diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Dentistry is widely considered...
and allied health, plus many others such as public health practitioners
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
, community health worker
Community health worker
Community health workers are members of a community who are chosen by community members or organizations to provide basic health and medical care to their community...
s and assistive personnel
Unlicensed assistive personnel
Unlicensed assistive personnel is an umbrella term to describe a job class of paraprofessionals who assist individuals with physical disabilities, mental impairments, and other health care needs with their activities of daily living and provide bedside care — including basic nursing...
, who systematically provide personal and population-based preventive, curative and rehabilitative care services.
While the definitions of the various types of health care vary depending on the different cultural, political, organizational and disciplinary perspectives, there appears to be some consensus that primary care constitutes the first element of a continuing health care process, that may also include the provision of secondary and tertiary levels of care.
Primary care
Primary care is the term for the health care services which play a role in the local community. It refers to the work of health care professionalsHealth care provider
A health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities....
who act as a first point of consultation for all patients within the health care system. Such a professional would usually be a primary care physician
Primary care physician
A primary care physician, or PCP, is a physician/medical doctor who provides both the first contact for a person with an undiagnosed health concern as well as continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis....
, such as a general practitioner
General practitioner
A general practitioner is a medical practitioner who treats acute and chronic illnesses and provides preventive care and health education for all ages and both sexes. They have particular skills in treating people with multiple health issues and comorbidities...
or family physician
Family medicine
Family medicine is a medical specialty devoted to comprehensive health care for people of all ages. It is a division of primary care that provides continuing and comprehensive health care for the individual and family across all ages, sexes, diseases, and parts of the body...
. Depending on the locality, health system organization, and sometimes at the patient's discretion, they may see another health care professional first, such as a pharmacist
Pharmacist
Pharmacists are allied health professionals who practice in pharmacy, the field of health sciences focusing on safe and effective medication use...
, a nurse (such as in the United Kingdom), a clinical officer
Clinical officer
Clinical officers are health care providers who practice modern medicine. They practice independently but may be supervised by a physician in some settings....
(such as in parts of Africa), or an Ayurvedic
Ayurveda
Ayurveda or ayurvedic medicine is a system of traditional medicine native to India and a form of alternative medicine. In Sanskrit, words , meaning "longevity", and , meaning "knowledge" or "science". The earliest literature on Indian medical practice appeared during the Vedic period in India,...
or other traditional medicine professional (such as in parts of Asia). Depending on the nature of the health condition, patients may then be referred
Referral (medicine)
In medicine, referral is the transfer of care for a patient from one clinician to another.Tertiary care is usually done by referral from primary or secondary medical care personnel....
for secondary or tertiary care.
Primary care involves the widest scope of health care, including all ages of patients, patients of all socioeconomic and geographic origins, patients seeking to maintain optimal health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...
, and patients with all manner of acute and chronic physical, mental
Mental health
Mental health describes either a level of cognitive or emotional well-being or an absence of a mental disorder. From perspectives of the discipline of positive psychology or holism mental health may include an individual's ability to enjoy life and procure a balance between life activities and...
and social health issues, including multiple chronic diseases
Polypharmacy
Polypharmacy is the use of multiple medications by a patient, especially when too many forms of medication are used by a patient, when more drugs are prescribed than is clinically warranted, or even when all prescribed medications are clinically indicated but there are too many pills to take ....
. Consequently, a primary care practitioner must possess a wide breadth of knowledge in many areas. Continuity is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine check-ups and preventive care
Preventive medicine
Preventive medicine or preventive care refers to measures taken to prevent diseases, rather than curing them or treating their symptoms...
, health education
Health education
Health education is the profession of educating people about health. Areas within this profession encompass environmental health, physical health, social health, emotional health, intellectual health, and spiritual health...
, and every time they require an initial consultation about a new health problem. The International Classification of Primary Care
International Classification of Primary Care
The International Classification of Primary Care is a classification method for primary care encounters. It allows for the classification of the patient’s reason for encounter , the problems/diagnosis managed, primary or general health care interventions, and the ordering of the data of the...
(ICPC) is a standardized tool for understanding and analyzing information on interventions in primary care by the reason for the patient visit.
Common chronic illnesses usually treated in primary care may include, for example: hypertension
Hypertension
Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...
, diabetes
Diabetes mellitus
Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced...
, asthma
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
, COPD
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease , also known as chronic obstructive lung disease , chronic obstructive airway disease , chronic airflow limitation and chronic obstructive respiratory disease , is the co-occurrence of chronic bronchitis and emphysema, a pair of commonly co-existing diseases...
, depression and anxiety
Anxiety disorder
Anxiety disorder is a blanket term covering several different forms of abnormal and pathological fear and anxiety. Conditions now considered anxiety disorders only came under the aegis of psychiatry at the end of the 19th century. Gelder, Mayou & Geddes explains that anxiety disorders are...
, back pain
Back pain
Back pain is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine.The pain can often be divided into neck pain, upper back pain, lower back pain or tailbone pain...
, arthritis
Osteoarthritis
Osteoarthritis also known as degenerative arthritis or degenerative joint disease, is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion...
or thyroid dysfunction
Thyroid disease
-Hyper- and hypofunction:Imbalance in production of thyroid hormones arises from dysfunction of the thyroid gland itself, the pituitary gland, which produces thyroid-stimulating hormone , or the hypothalamus, which regulates the pituitary gland via thyrotropin-releasing hormone . Concentrations of...
. Primary care also includes many basic maternal
Maternal health
Maternal health refers to the health of women during pregnancy, childbirth, and the postpartum period. It encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to reduce maternal morbidity and mortality.Preconception care can include...
and child health care services, such as family planning
Family planning
Family planning is the planning of when to have children, and the use of birth control and other techniques to implement such plans. Other techniques commonly used include sexuality education, prevention and management of sexually transmitted infections, pre-conception counseling and...
services and vaccination
Vaccination
Vaccination is the administration of antigenic material to stimulate the immune system of an individual to develop adaptive immunity to a disease. Vaccines can prevent or ameliorate the effects of infection by many pathogens...
s.
In context of global population ageing
Population ageing
Population ageing or population aging occurs when the median age of a country or region rises. This happens because of rising life expectancy or declining birth rates. Excepting 18 countries termed 'demographic outliers' by the UN) this process is taking place in every country and region across...
, with increasing numbers of older adults at greater risk of chonic non-communicable disease
Non-communicable disease
A non-communicable disease, or NCD, is a medical condition or disease which is non-infectious. NCDs are diseases of long duration and generally slow progression. They include heart disease, stroke, cancer, asthma, diabetes, chronic kidney disease, osteoporosis, Alzheimer's disease, cataracts, and...
s, rapidly increasing demand for primary care services is expected around the world, in both developed and developing countries. The World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
attributes the provision of essential primary care as an integral component of an inclusive primary health care
Primary health care
Primary health care, often abbreviated as “PHC”, has been defined as "essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost...
strategy.
Secondary care
Secondary care is the health care services provided by medical specialistsSpecialty (medicine)
A specialty in medicine is a branch of medical science. After completing medical school, physicians or surgeons usually further their medical education in a specific specialty of medicine by completing a multiple year residency to become a medical specialist.-History of medical specialization:To...
and other health professionals who generally do not have first contact with patients, for example, cardiologists, urologists and dermatologists
Dermatology
Dermatology is the branch of medicine dealing with the skin and its diseases, a unique specialty with both medical and surgical aspects. A dermatologist takes care of diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails....
.
It includes acute care
Acute care
Acute care is a branch of secondary health care where a patient receives active but short-term treatment for a severe injury or episode of illness, an urgent medical condition, or during recovery from surgery...
: necessary treatment for a short period of time for a brief but serious illness, injury or other health condition, such as in a hospital emergency department
Emergency department
An emergency department , also known as accident & emergency , emergency room , emergency ward , or casualty department is a medical treatment facility specialising in acute care of patients who present without prior appointment, either by their own means or by ambulance...
. It also includes skilled attendance during childbirth
Childbirth
Childbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...
, intensive care
Intensive care medicine
Intensive-care medicine or critical-care medicine is a branch of medicine concerned with the diagnosis and management of life threatening conditions requiring sophisticated organ support and invasive monitoring.- Overview :...
, and medical imaging
Medical imaging
Medical imaging is the technique and process used to create images of the human body for clinical purposes or medical science...
services.
The "secondary care" is sometimes used synonymously with "hospital
Hospital
A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....
care". However many secondary care providers do not necessarily work in hospitals, such as psychiatrists or physiotherapists, and some primary care services are delivered within hospitals. Depending on the organization and policies of the national health system, patients may be required to see a primary care provider for a referral
Referral (medicine)
In medicine, referral is the transfer of care for a patient from one clinician to another.Tertiary care is usually done by referral from primary or secondary medical care personnel....
before they can access secondary care.
For example in the United States, which operates under a mixed market health care system, some physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
s might voluntarily limit their practice to secondary care by requiring patients to see a primary care provider first, or this restriction may be imposed under the terms of the payment agreements in private/group health insurance
Health insurance
Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is...
plans. In other cases medical specialists may see patients without a referral, and patients may decide whether self-referral is preferred.
In the United Kingdom and Canada, patient self-referral to a medical specialist for secondary care is rare as prior referral from another physician (either a primary care physician or another specialist) is considered necessary, regardless of whether the funding is from private insurance schemes
Health insurance
Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is...
or national health insurance
National health insurance
National health insurance is health insurance that insures a national population for the costs of health care and usually is instituted as a program of healthcare reform. It is enforced by law. It may be administered by the public sector, the private sector, or a combination of both...
.
Allied health professionals
Allied health professions
Allied health professions are clinical health care professions distinct from dentistry, nursing and medicine. One estimate reported allied health professionals make up 60 percent of the total health workforce...
, such as occupational therapists, speech therapists
Speech and language pathology
Speech-Language Pathology specializes in communication disorders.The main components of speech production include: phonation, the process of sound production; resonance, opening and closing of the vocal folds; intonation, the variation of pitch; and voice, including aeromechanical components of...
, and dietitians, also generally work in secondary care, accessed through either patient self-referral or through physician referral.
Tertiary care
Tertiary care is specialized consultative health care, usually for inpatients and on referral from a primary or secondary health professional, in a facility that has personnel and facilities for advanced medicalMedicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
investigation and treatment, such as a tertiary referral hospital
Tertiary referral hospital
A tertiary hospital, tertiary referral center or tertiary care center is a term without a formal definition which in the United States generally refers to:...
.
Examples of tertiary care services are cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
management, neurosurgery
Neurosurgery
Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...
, cardiac surgery
Cardiac surgery
Cardiovascular surgery is surgery on the heart or great vessels performed by cardiac surgeons. Frequently, it is done to treat complications of ischemic heart disease , correct congenital heart disease, or treat valvular heart disease from various causes including endocarditis, rheumatic heart...
, plastic surgery
Plastic surgery
Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic: plastic surgery includes many types of reconstructive surgery, hand...
, treatment for severe burn
Burn
A burn is an injury to flesh caused by heat, electricity, chemicals, light, radiation, or friction.Burn may also refer to:*Combustion*Burn , type of watercourses so named in Scotland and north-eastern England...
s, advanced neonatology
Neonatology
Neonatology is a subspecialty of pediatrics that consists of the medical care of newborn infants, especially the ill or premature newborn infant. It is a hospital-based specialty, and is usually practiced in neonatal intensive care units...
services, palliative, and other complex medical and surgical interventions.
Quaternary care
The term quaternary care is also used sometimes as an extension of tertiary care in reference to medicine of advanced levels which are highly specialized and not widely accessed. Experimental medicineMedical laboratory
A medical laboratory or clinical laboratory is a laboratory where tests are done on clinical specimens in order to get information about the health of a patient as pertaining to the diagnosis, treatment, and prevention of disease.-Departments:...
and some types of uncommon diagnostic
Diagnosis
Diagnosis is the identification of the nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships...
or surgical
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
procedures are considered quaternary care. These services are usually only offered in a limited number of regional or national health care centres.
Home and community care
Many types of health care interventions are delivered outside of health facilities. They include many interventions of public healthPublic health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
interest, such as food safety
Food safety
Food safety is a scientific discipline describing handling, preparation, and storage of food in ways that prevent foodborne illness. This includes a number of routines that should be followed to avoid potentially severe health hazards....
surveillance, distribution of condom
Condom
A condom is a barrier device most commonly used during sexual intercourse to reduce the probability of pregnancy and spreading sexually transmitted diseases . It is put on a man's erect penis and physically blocks ejaculated semen from entering the body of a sexual partner...
s and needle-exchange programme
Needle-exchange programme
A Needle & syringe programme or syringe-exchange programme is a social policy based on the philosophy of harm reduction where injecting drug users can obtain hypodermic needles and associated injection equipment at little or no cost. Many programmes are called "exchanges" because some require...
s for the prevention of transmissible diseases.
They also include the services of professionals in residential and community settings in support of self care, home care
Home care
Home Care, , is health care or supportive care provided in the patient's home by healthcare professionals Home Care, (also referred to as domiciliary care or social care), is health care or supportive care provided in the patient's home by healthcare professionals Home Care, (also referred to as...
, long-term care
Long-term care
Long-term care is a variety of services which help meet both the medical and non-medical need of people with a chronic illness or disability who cannot care for themselves for long periods of time....
, assisted living
Assisted living
Assisted living residences or assisted living facilities provide supervision or assistance with activities of daily living ; coordination of services by outside health care providers; and monitoring of resident activities to help to ensure their health, safety, and well-being.Assistance may...
, treatment for substance use disorder
Substance use disorder
Substance use disorders include substance abuse and substance dependence. In DSM-IV, the conditions are formally diagnosed as one or the other, but it has been proposed that DSM-5 combine the two into a single condition called "Substance-use disorder"....
s, and other types of health and social care services.
Related sectors
-
- For general descriptions of health care financing and delivery systems by country, please see Health care systemHealth care systemA health care system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations....
- For general descriptions of health care financing and delivery systems by country, please see Health care system
Health care extends beyond the delivery of services to patients, encompassing many related sectors, and set within a bigger picture of financing and governance structures.
Health care industry
The health care industry incorporates several sectors that are dedicated to providing health care services and products. As a basic framework for defining the sector, the United Nations' International Standard Industrial ClassificationInternational Standard Industrial Classification
The International Standard Industrial Classification of All Economic Activities is a United Nations system for classifying economic data. The United Nations Statistics Division describes it in the following terms:...
categorizes health care as generally consisting of hospital activities, medical and dental practice activities, and "other human health activities". The last class involves activities of, or under the supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratories, pathology clinics, residential health facilites, or other allied health professions
Allied health professions
Allied health professions are clinical health care professions distinct from dentistry, nursing and medicine. One estimate reported allied health professionals make up 60 percent of the total health workforce...
, e.g. in the field of optometry, hydrotherapy, medical massage, yoga therapy, music therapy, occupational therapy, speech therapy, chiropody, homeopathy, chiropractics, acupuncture, etc.
In addition, according to industry and market classifications, such as the Global Industry Classification Standard
Global Industry Classification Standard
The Global Industry Classification Standard is an industry taxonomy developed by MSCI and Standard & Poor's for use by the global financial community. The GICS structure consists of 10 sectors, 24 industry groups, 68 industries and 154 sub-industries into which S&P has categorized all major...
and the Industry Classification Benchmark
Industry Classification Benchmark
The Industry Classification Benchmark is an industry classification taxonomy developed by Dow Jones and FTSE. It is used to segregate markets into sectors within the macroeconomy...
, health care includes many categories of medical equipment, instruments and services as well as biotechnology
Biotechnology
Biotechnology is a field of applied biology that involves the use of living organisms and bioprocesses in engineering, technology, medicine and other fields requiring bioproducts. Biotechnology also utilizes these products for manufacturing purpose...
, diagnostic laboratories and substances, and drug manufacturing and delivery.
For example, pharmaceuticals and other medical devices are the leading high technology exports of Europe and the United States. The United States dominates the biopharmaceutical
Biopharmaceutical
Biopharmaceuticals are medical drugs produced using biotechnology. They include proteins , nucleic acids and living microorganisms like virus and bacteria where the virulence of viruses and bacteria is reduced by the process of attenuation, they can be used for therapeutic or in vivo diagnostic...
field, accounting for three-quarters of the world’s biotechnology revenues.
Health care research
The quantity and quality of many health care interventions are improved through the results of science, such as advanced through the medical modelMedical model
Medical model is the term cited by psychiatrist Ronald D. Laing in his The Politics of the Family and Other Essays , for the "set of procedures in which all doctors are trained." This set includes complaint, history, physical examination, ancillary tests if needed, diagnosis, treatment, and...
of health which focuses on the eradication of illness
Illness
Illness is a state of poor health. Illness is sometimes considered another word for disease. Others maintain that fine distinctions exist...
through diagnosis
Medical diagnosis
Medical diagnosis refers both to the process of attempting to determine or identify a possible disease or disorder , and to the opinion reached by this process...
and effective treatment. Many important advances have been made through health research, including biomedical research
Biomedical research
Biomedical research , in general simply known as medical research, is the basic research, applied research, or translational research conducted to aid and support the body of knowledge in the field of medicine...
and pharmaceutical research. They form the basis of evidence-based medicine
Evidence-based medicine
Evidence-based medicine or evidence-based practice aims to apply the best available evidence gained from the scientific method to clinical decision making. It seeks to assess the strength of evidence of the risks and benefits of treatments and diagnostic tests...
and evidence-based practice in health care delivery.
For example, in terms of pharmaceutical research and development spending, Europe
Europe
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...
spends a little less than the United States (€22.50bn compared to €27.05bn in 2006). The United States accounts for 80% of the world's research and development spending in biotechnology.
In addition, the results of health services research
Health services research
Health services research is a multidisciplinary scientific field that examines how people get access to health care practitioners and health care services, how much care costs, and what happens to patients as a result of this care...
can lead to greater efficiency and equitable delivery of health care interventions, as advanced through the social model of health and disability
Social model of disability
The social model of disability is a reaction to the dominant medical model of disability which in itself is a Cartesian functional analysis of the body as machine to be fixed in order to conform with normative values...
, which emphasizes the societal changes that can be made to make population healthiers. Results from health services research often form the basis of evidence-based policy
Evidence-based policy
Evidence-based policy is public policy informed by rigorously established objective evidence. It is an extension of the idea of evidence-based medicine to all areas of public policy...
in health care systems.
Health care financing
-
- For descriptions of health care financing by country, please see Health care systemHealth care systemA health care system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations....
and Universal health careUniversal health careUniversal health care is a term referring to organized health care systems built around the principle of universal coverage for all members of society, combining mechanisms for health financing and service provision.-History:...
- For descriptions of health care financing by country, please see Health care system
There are generally five primary methods of funding health care systems:
- general taxation to the state, county or municipality
- social health insuranceSocial insuranceSocial insurance is any government-sponsored program with the following four characteristics:* the benefits, eligibility requirements and other aspects of the program are defined by statute;...
- voluntary or private health insuranceHealth insuranceHealth insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is...
- out-of-pocket paymentsOut-of-pocket expensesOut-of-pocket expenses are direct outlays of cash which may or may not be later reimbursed.In operating a vehicle, gasoline, parking fees and tolls are considered out-of-pocket expenses for the trip...
- donationDonationA donation is a gift given by physical or legal persons, typically for charitable purposes and/or to benefit a cause. A donation may take various forms, including cash, services, new or used goods including clothing, toys, food, and vehicles...
s to health charities
In most countries, the financing of health care services features a mix of all five models, but the exact distribution varies across countries and over time within countries. In all countries and jurisdictions, there are many topics in the politics and evidence that can influence the decision of a government, private sector business or other group to adopt a specific health policy regarding the financing structure.
For example, social health insurance is where a nation's entire population is eligible for health care coverage, and this coverage and the services provided are regulated. In almost every jurisdiction with a government-funded health care system, a parallel private, and usually for-profit, system is allowed to operate. This is sometimes referred to as two-tier health care
Two-tier health care
Two-tier health care is a term used to describe a situation that arises when there is a basic health care system financed by government providing medically necessary but perhaps quite basic health care services, and a secondary tier of care for those with access to more funds who can purchase...
or universal health care
Universal health care
Universal health care is a term referring to organized health care systems built around the principle of universal coverage for all members of society, combining mechanisms for health financing and service provision.-History:...
.
Health care administration and regulation
The management and administration of health careHealth administration
Health administration or healthcare administration is the field relating to leadership, management, and administration of hospitals, hospital networks, health care systems, and public health systems...
is another sector vital to the delivery of health care services. In particular, the practice of health professionals and operation of health care institutions is typically regulated
Regulation
Regulation is administrative legislation that constitutes or constrains rights and allocates responsibilities. It can be distinguished from primary legislation on the one hand and judge-made law on the other...
by national or state/provincial authorities through appropriate regulatory bodies for purposes of quality assurance
Quality Assurance
Quality assurance, or QA for short, is the systematic monitoring and evaluation of the various aspects of a project, service or facility to maximize the probability that minimum standards of quality are being attained by the production process...
. Most countries have credentialing staff in regulatory boards or health department
Health department
A health department or health ministry is a part of government which focuses on issues related to the general health of the citizenry. Subnational entities, such as states, counties and cities, often also operate a health department of their own...
s who document the certification or licensing of health workers
Healthcare provider requisites
Healthcare provider requisites refer to the regulations used by countries to control the quality of individual healthcare workers practicing in their jurisdictions and to control the size of the health labour market...
and their work history.
Health care Information Technology
Health care is growing rapidly in terms of the quantity and quality of data that is collected on a daily basis. Problem is that this data is growing faster than the provider can analyze it. As the world’s population increases so will this problem. The health care providers are facing the challenge of not only providing the best care for their patients, but doing it in a cost effective method to insure that they can provide services that are affordable. This is where Business Intelligence comes in. Business intelligence is the extraction of pertinent data from the massive data collected so for in health care. There are three categories of data that are mined, they are:- Patient data (clinical)
- Patient Information
- Patient History
- Diagnosis
- Treatments or Procedures
- Financial Data
- Eligibility
- Billing
- Insurance Claims
- Institutional Data (operations)
- Resources available
- Resources used
- Inventory & Supply details
Some of this data is easy to extract and readily available to healthcare administrators, however the patient or clinical data is not as easy to Extract, Transform and Load. The reason that this data is more difficult to extract is that the data itself is more subjective than calculated. The data comes from notes and observations and to extract it properly the data needs to be considered within its context.
The process of analyzing health care data is a monumental task and one that must be done properly and continually. For these reason it becomes very costly and consumes a large number of IT resource hours.
Canada
In 1984 the Canada Health ActCanada Health Act
The Canada Health Act is a piece of Canadian federal legislation, adopted in 1984, which specifies the conditions and criteria with which the provincial and territorial health insurance programs must conform in order to receive federal transfer payments under the Canada Health Transfer...
was passed, which guarantees access to primary and other health care services for all citizens, and prohibits extra billing by doctors on patients while at the same time billing the public insurance system. In 1999, the prime minister and most premiers reaffirmed in the Social Union Framework Agreement
Social Union Framework Agreement
The Social Union Framework Agreement, or SUFA, was an agreement made in Canada in 1999 between Prime Minister Jean Chrétien and the premiers of the provinces and territories of Canada, save Quebec Premier Lucien Bouchard...
that they are committed to health care that has "comprehensiveness, universality, portability, public administration and accessibility." The system is for the most part publicly funded, with most services provided through publicly administered hospitals or privately operating practitioners or the government.
Guinea
- See also: Health care in Guinea
Guinea
Guinea
Guinea , officially the Republic of Guinea , is a country in West Africa. Formerly known as French Guinea , it is today sometimes called Guinea-Conakry to distinguish it from its neighbour Guinea-Bissau. Guinea is divided into eight administrative regions and subdivided into thirty-three prefectures...
has been reorganizing its health system since the Bamako Initiative
Bamako Initiative
The Bamako Initiative was a formal statement adopted by African health ministers in 1987 in Bamako, Mali, to implement strategies designed to increase the availability of essential drugs and other healthcare services for Sub-Saharan Africans....
of 1987 formally promoted community-based methods of increasing accessibility of primary health care
Primary health care
Primary health care, often abbreviated as “PHC”, has been defined as "essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost...
to the population, including community ownership and local budgeting, resulting in more efficient and equitable provision of drugs and other essential health care resources.
In June 2011, the Guinean government announced the establishment of an air solidarity levy on all flights taking off from national soil, with funds going to UNITAID
Unitaid
UNITAID is an international facility for the purchase of drugs against HIV/AIDS, Malaria and Tuberculosis. It was founded in September 2006 on the initiative of Brazil and France, and is to a great part financed by so called innovative development financing mechanisms, namely a solidarity levy on...
to support expanded access to treatment for HIV/AIDS, tuberculosis and malaria. Guinea is among the growing number of countries and development partners using market-based transactions taxes and other innovative financing
Innovative financing
Innovative financing refers to a range of non-traditional mechanisms to raise additional funds for development aid through "innovative" projects such as micro-contributions, taxes, public-private partnerships and market-based financial transactions....
mechanisms to expand financing options for health care in resource-limited settings.
United Kingdom
Each of the Countries of the United KingdomCountries of the United Kingdom
Countries of the United Kingdom is a term used to describe England, Northern Ireland, Scotland and Wales. These four countries together form the sovereign state of the United Kingdom of Great Britain and Northern Ireland, which is also described as a country. The alternative terms, constituent...
has a National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
that provides public healthcare to all UK permanent residents that is free at the point of need and paid for from general taxation. However private healthcare companies are free to operate alongside the public one. Since health is a devolved matter
Devolution
Devolution is the statutory granting of powers from the central government of a sovereign state to government at a subnational level, such as a regional, local, or state level. Devolution can be mainly financial, e.g. giving areas a budget which was formerly administered by central government...
, considerable differences are developing between the systems in each of the countries.
United States
A few states have taken serious steps toward universal health care coverage, most notably Minnesota
Minnesota
Minnesota is a U.S. state located in the Midwestern United States. The twelfth largest state of the U.S., it is the twenty-first most populous, with 5.3 million residents. Minnesota was carved out of the eastern half of the Minnesota Territory and admitted to the Union as the thirty-second state...
, Massachusetts
Massachusetts
The Commonwealth of Massachusetts is a state in the New England region of the northeastern United States of America. It is bordered by Rhode Island and Connecticut to the south, New York to the west, and Vermont and New Hampshire to the north; at its east lies the Atlantic Ocean. As of the 2010...
and Connecticut
Connecticut
Connecticut is a state in the New England region of the northeastern United States. It is bordered by Rhode Island to the east, Massachusetts to the north, and the state of New York to the west and the south .Connecticut is named for the Connecticut River, the major U.S. river that approximately...
, with recent examples being the Massachusetts 2006 Health Reform Statute and Connecticut's SustiNet
SustiNet
SustiNet is a Connecticut health care plan passed into law in July, 2009. Its goal is to provide affordable health care coverage to 98% of Connecticut residents by 2014.-Provisions of the legislation:...
plan to provide quality, affordable health care to state residents.
The Patient Protection and Affordable Care Act
Patient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law is the principal health care reform legislation of the 111th United States Congress...
(Public Law 111-148) was signed into law by President Barack Obama
Barack Obama
Barack Hussein Obama II is the 44th and current President of the United States. He is the first African American to hold the office. Obama previously served as a United States Senator from Illinois, from January 2005 until he resigned following his victory in the 2008 presidential election.Born in...
on March 23, 2010. Along with the Health Care and Education Reconciliation Act of 2010
Health Care and Education Reconciliation Act of 2010
The Health Care and Education Reconciliation Act of 2010 is a law that was enacted by the 111th United States Congress, by means of the reconciliation process, in order to amend the Patient Protection and Affordable Care Act...
(signed March 30), the Act is a product of the health care reform
Health care reform in the United States
Health care reform in the United States has a long history, of which the most recent results were two federal statutes enacted in 2010: the Patient Protection and Affordable Care Act , signed March 23, 2010, and the Health Care and Education Reconciliation Act of 2010 , which amended the PPACA and...
efforts of the Democratic
Democratic Party (United States)
The Democratic Party is one of two major contemporary political parties in the United States, along with the Republican Party. The party's socially liberal and progressive platform is largely considered center-left in the U.S. political spectrum. The party has the lengthiest record of continuous...
111th Congress and the Obama administration. The law includes health-related provisions to take effect over the next four years, including expanding Medicaid
Medicaid
Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent...
eligibility for people making up to 133% of the federal poverty level (FPL), subsidizing insurance premiums for people making up to 400% of the FPL ($88,000 for family of 4 in 2010) so their maximum "out-of-pocket" payment for annual premiums will be on sliding scale from 2% to 9.8% of income, providing incentives for businesses to provide health care benefits, prohibiting denial of coverage and denial of claims based on pre-existing conditions, establishing health insurance exchange
Health insurance exchange
A health insurance exchange is a set of state-regulated and standardized health care plans in the United States, from which individuals may purchase health insurance that is eligible for Federal subsidies...
s, prohibiting insurers from establishing annual coverage caps, and support for medical research.
See also
- Acronyms in healthcareAcronyms in healthcareThe following is a partial list of acronyms commonly used in health care. The terms listed are used within the health care systems of various countries.- A :*A&E Accident and Emergency Department...
- Healthcare system / Health care providerHealth care providerA health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities....
- Health center / ClinicClinicA clinic is a health care facility that is primarily devoted to the care of outpatients...
/ HospitalHospitalA hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays.... - MedicineMedicineMedicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
/ Doctor's visitDoctor's visitA doctor's visit, also known as "doctor's office visit" or "physician office visit", is a meeting between a patient with a physician to get health advice or treatment for a symptom or condition...
/ NursingNursingNursing is a healthcare profession focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life from conception to death.... - Philosophy of healthcarePhilosophy of healthcareThe philosophy of healthcare is the study of the ethics, processes, and people which constitute the maintenance of health for human beings. For the most part, however, the philosophy of healthcare is best approached as an indelible component...
- Social service / Social determinants of healthSocial determinants of healthSocial determinants of health are the economic and social conditions under which people live which determine their health. They are "societal risk conditions", rather than individual risk factors that either increase or decrease the risk for a disease, for example for cardiovascular disease and...
- Family medicineFamily medicineFamily medicine is a medical specialty devoted to comprehensive health care for people of all ages. It is a division of primary care that provides continuing and comprehensive health care for the individual and family across all ages, sexes, diseases, and parts of the body...
/ Preventive medicinePreventive medicinePreventive medicine or preventive care refers to measures taken to prevent diseases, rather than curing them or treating their symptoms...
/ Social medicineSocial medicineThe field of social medicine seeks to:# understand how social and economic conditions impact health, disease and the practice of medicine and# foster conditions in which this understanding can lead to a healthier society.... - Community health service / Community health centers in the United StatesCommunity health centers in the United StatesA Community health center in the United States is a Community health center in the United States.Community Health Centers are unique in that at least 51 percent of all Governing Board Members must be patients at the CHC. Access to care is improved by decreasing the cost of care with a sliding fee...
- Direct primary careDirect primary careIn the USA Direct Primary Care is primary care offered direct to the consumer, without insurance intervention. It is an umbrella term which incorporates various health care delivery systems that involve direct financial relationships between patients and health care providers.One niche variant of...
(United States)
- Social service / Social determinants of health
- Health policy
- Health insuranceHealth insuranceHealth insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is...
/ InsuranceInsuranceIn law and economics, insurance is a form of risk management primarily used to hedge against the risk of a contingent, uncertain loss. Insurance is defined as the equitable transfer of the risk of a loss, from one entity to another, in exchange for payment. An insurer is a company selling the...
/Social health insurance / Subsidies - Health care reformHealth care reformHealth care reform is a general rubric used for discussing major health policy creation or changes—for the most part, governmental policy that affects health care delivery in a given place...
/ Health care reform in the United StatesHealth care reform in the United StatesHealth care reform in the United States has a long history, of which the most recent results were two federal statutes enacted in 2010: the Patient Protection and Affordable Care Act , signed March 23, 2010, and the Health Care and Education Reconciliation Act of 2010 , which amended the PPACA and... - Healthy cityHealthy cityHealthy city is a term used in public health and urban design to stress the impact of policy on human health. Its modern form derives from a World Health Organization initiative on Healthy Cities and Villages in 1986, but has a history dating back to the mid 19th century...
/ Alliance for Healthy CitiesAlliance for Healthy CitiesThe Alliance for Healthy Cities is a cooperative international alliance aimed at protecting and enhancing the health and health care of city dwellers. It is composed of groups of cities, urban districts and other organizations from countries around the world in exchanging information to achieve...
- Health insurance
- Universal health careUniversal health careUniversal health care is a term referring to organized health care systems built around the principle of universal coverage for all members of society, combining mechanisms for health financing and service provision.-History:...
- Health care in the United StatesHealth care in the United StatesHealth care in the United States is provided by many separate legal entities. Health care facilities are largely owned and operated by the private sector...
as a private system - Healthcare in the United Kingdom as a private system under unified insurance
- Healthcare in Cuba as a state owned system
- Health in Germany Health in GermanyAccording to the World Health Organization, Germany's health care system was 77% government-funded and 23% privately funded as of 2004. In 2004 Germany ranked thirtieth in the world in life expectancy . It had a very low infant mortality rate , and it was tied for eighth place in the number of...
as a private system under state controlled insurance - Primary Health OrganisationPrimary Health OrganisationPrimary Health Organisations , in New Zealand, are health care providers that are funded on a capitation basis by the New Zealand Government via District Health Boards...
(New Zealand)
- Health care in the United States
- Medical classificationMedical classificationMedical classification, or medical coding, is the process of transforming descriptions of medical diagnoses and procedures into universal medical code numbers...
- ATC codes (Anatomical Therapeutic Chemical classification system)
- Classification of Pharmaco-Therapeutic ReferralsClassification of Pharmaco-Therapeutic ReferralsThe Classification of Pharmaco-Therapeutic Referrals is a taxonomy focused to define and group together situations requiring a referral from pharmacists to physicians regarding the pharmacotherapy used by the patients. It has been published in 2008...
(CPR) - ICD-10ICD-10The International Statistical Classification of Diseases and Related Health Problems, 10th Revision is a medical classification list for the coding of diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases, as maintained by the...
(International Classification of Diseases) - International Classification of Primary CareInternational Classification of Primary CareThe International Classification of Primary Care is a classification method for primary care encounters. It allows for the classification of the patient’s reason for encounter , the problems/diagnosis managed, primary or general health care interventions, and the ordering of the data of the...
(ICPC-2) / ICPC-2 PLUSICPC-2 PLUSICPC-2 PLUS is an extended terminology classified to ICPC-2 International Classification of Primary Care, which aids data entry, retrieval and analysis. ICPC-2 PLUS takes into account the frequency distribution of problems seen in primary health care...
External links
- HR3200: America's Affordable Health Choices Act of 2009
- Defining Primary Care from Institute of Medicine IOM—Primary Care: America's Health in a New Era (1996)
- Primary Care Definitions from American Academy of Family Physicians AAFP
- Definition of Primary Care from American Medical Association AMA
- Defining primary health care Department of Health United Kingdom UK
- What is primary health care? Aboriginal Medical Services Alliance Northern Territory (AMSANT) Australia
- Primary Care Diabetes Journal