Chapter 3Chapter 3The Public Health and The Public Health and Primary Health Care Primary Health Care

SystemsSystemsSusan B. HassmillerSusan B. Hassmiller

Modified by Monica DonaldModified by Monica DonaldJanuary 2009January 2009

Organization of the Health Care Organization of the Health Care SystemSystem

• A variety of facilities and providers make up A variety of facilities and providers make up the health care systemthe health care system

• Two main components of the American Two main components of the American health care systemhealth care system

• Primary Health CarePrimary Health Care – DefinitionDefinition– Strategy Strategy – Types of ServicesTypes of Services– Healthy People 2010: Objectives relative to Healthy People 2010: Objectives relative to

healthhealth

Primary CarePrimary Care • Definition

• Managed care HMO PPO

• Difference between Primary Care and Primary Health Care

Public Health SystemPublic Health System

• GoalGoal

• Mandated through laws that are Mandated through laws that are developed at the national, state, or developed at the national, state, or local levellocal level

• Three levels of organizationThree levels of organization

Federal, State, and Local Systems

• FederalFederal

• StateState

• LocalLocal

Forces Stimulating Change Forces Stimulating Change in U.S. Health Care Systemin U.S. Health Care System

• Demographic trendsDemographic trends

• Social and economic trendsSocial and economic trends

• Health workforce trendsHealth workforce trends

• Technological trendsTechnological trends

Current U.S. Health Care Current U.S. Health Care System: Identifying the System: Identifying the

ProblemsProblems

• CostCost

• AccessAccess

• QualityQuality

Future of the Health Care Future of the Health Care SystemSystem

• Four major competing forces that Four major competing forces that will influence future design of the will influence future design of the health care systemhealth care system

Community-Oriented Primary Community-Oriented Primary Care (COPC) ModelCare (COPC) Model

• DefinitionDefinition

• Main focus of the modelMain focus of the model

Chapter 12Chapter 12Community Assessment Community Assessment

and Evaluationand Evaluation

George F. ShusterGeorge F. Shuster

Jean GoeppingerJean GoeppingerModified by Monica DonaldModified by Monica Donald

January 2009January 2009

What Is a Community?What Is a Community?

• Definitions of CommunityDefinitions of Community

Three Dimensions of the Three Dimensions of the Concept of CommunityConcept of Community

1.1. People – community residentsPeople – community residents

2.2. Place – refers to both geographical and Place – refers to both geographical and time dimensionstime dimensions

3.3. Function – refers to the aims and Function – refers to the aims and activities of the communityactivities of the community

Community as ClientCommunity as Client

• Definition Definition

Community Health

• DefinitionDefinition

• Three Dimensions of Community Three Dimensions of Community HealthHealth

Community-Oriented PracticeCommunity-Oriented Practice

• GoalGoal

• Community PartnershipsCommunity Partnerships

Characteristics of Effective Characteristics of Effective PartnershipsPartnerships

1.1. Equality in decision makingEquality in decision making

2.2. A shared visionA shared vision

3.3. IntegrityIntegrity

4.4. Agreement on specific goalsAgreement on specific goals

5.5. A plan of action to meet the goalsA plan of action to meet the goals

Community AssessmentCommunity Assessment

• Purpose of a community assessmentPurpose of a community assessment

• What does the PHN/CHN learn from a What does the PHN/CHN learn from a community assessment?community assessment?

Assessing Community HealthAssessing Community Health

Steps to assessing a community’sSteps to assessing a community’s

healthhealth

Applying the Nursing Process

• AssessmentAssessment

• PlanningPlanning

• Implementation (Interventions)Implementation (Interventions)

• EvaluationEvaluation

Writing ObjectivesWriting Objectives

• What is an objective?What is an objective?

• Importance of well written objectivesImportance of well written objectives

Writing ObjectivesWriting Objectives

• Four Elements of an ObjectiveFour Elements of an Objective

S.M.A.R.T. ObjectivesS.M.A.R.T. Objectives

• How to write SMART ObjectivesHow to write SMART Objectives

Chapter 21Chapter 21Vulnerability and Vulnerability and

Vulnerable Populations: Vulnerable Populations: An OverviewAn Overview

Juliann G. SebastianJuliann G. SebastianModified by Monica DonaldModified by Monica Donald

January 2009January 2009

Vulnerability and Vulnerable Vulnerability and Vulnerable PopulationsPopulations

• DefinitionsDefinitions

• DisenfranchisementDisenfranchisement

Predisposing FactorsPredisposing Factors

• What are the predisposing factors to What are the predisposing factors to vulnerability?vulnerability?

Outcomes of VulnerabilityOutcomes of Vulnerability

Public Policies Affecting Public Policies Affecting Vulnerable PopulationsVulnerable Populations

• Social Security Act of 1935Social Security Act of 1935

• Social Security Act Amendments of Social Security Act Amendments of 1965, Medicare, and Medicaid1965, Medicare, and Medicaid– Title XXI of the Social Security Act (1997)Title XXI of the Social Security Act (1997)

• Balanced Budget Act of 1997Balanced Budget Act of 1997

Managed Care and Insurance Managed Care and Insurance CompaniesCompanies

• Influences on vulnerable populationsInfluences on vulnerable populations

Nursing InterventionsNursing Interventions

• Wrap-around servicesWrap-around services

• Healthy People 2010Healthy People 2010

Assessment IssuesAssessment Issues

• Information to include in an Information to include in an assessment of a vulnerable clientassessment of a vulnerable client

Planning and Implementing Care Planning and Implementing Care for Vulnerable Populationsfor Vulnerable Populations

• Important factors to consider when Important factors to consider when planning and implementing careplanning and implementing care