This component is a survey of how health care and public health are organized and services are delivered in the US. This is unit 1, The Introduction to Modern Health Care in the US. Within this unit, this is lecture 1, Introduction and Definitions.
So what are the objectives of this unit? In this unit, we will delineate some of the key definitions that are encountered in the health care domain; distinguish between health care systems and health care practices, outline key paradigm shifts in medicine, describe in overview terms the technology that is used in the delivery and administration of health care, and discuss core values in American health care.
So, let’s start with some definitions, and let’s begin by defining the term “health.” We often think of health as the absence of disease but this is a somewhat narrow description of the term. In 1946, representatives of 61 countries attended the International Health Conference in New York to ratify the Preamble to the Constitution of the World Health Organization, which is the specialized agency of the United Nations that deals with global health. The WHO [hoo] definition of health is that health is the state of complete physical, mental, and social well being and not merely the absence of disease or infirmity. Thus, illness represents a state of poor health.
Let’s look at the term “health care.” Health care is the prevention and treatment of illness. It’s delivered by people who are drawn from different and often disparate disciplines including medicine, dentistry, nursing, laboratory science, pharmacy, and other allied health professions which may include anesthesia technologists, cardiovascular technologists, medical assistants, perfusionists [purr-FYOO-zhuhn-ihsts] or respiratory therapists. As you can see, these people have different backgrounds, and they have disparate training, but often work together as interdisciplinary teams in order to deliver care to patients.
Health care is delivered in different places. In this unit, we are going to define and look at in-patient facilities, nursing and residential care, and out-patient facilities.
When we think of in-patient facilities, we typically think of hospitals. Hospitals are institutions that treat patients who are sick or injured. These are physical structures that house patients during treatment, and allow clinicians to conduct diagnostic tests and perform management interventions and also perform specialized functions such as surgery or managing childbirth.
Historically, hospitals were places for shelter, or alms-houses for the poor. In 1946, the Hospital Survey and Construction Act was passed – this act was known as the Hilburton Act, since it was sponsored by Senator Harold Burton of Ohio and Senator Lister Hill of Alabama. This law provided federal grants to improve hospital physical infrastructure and led to a significant augmentation of the infrastructure of facilities that provided in-patient care in the United States.
And there are different types of hospitals. Hospitals can provide general, medical, and surgical care. But some hospitals may provide specialty services that focus on a particular aspect of care such as orthopedics, pediatrics, or women’s services. Some hospitals focus on mental health, or psychiatric care.
Hospitals may be publicly or privately owned. Public hospitals may be administered by the city, county, state, or at a federal level. Privately owned hospitals may be not-for-profit, or may pursue profits like any other business.
Patients may be admitted to a hospital one of two ways. They may go into an emergency room where they will be evaluated by a team of clinicians. If the clinicians feel that they are sick enough, they may be admitted into the hospital for care. Patients may also be directly admitted to hospitals from physician’s...