Nursing Chapter 2: Health Care Delivery System

Health Care Delivery System

• The health care delivery system faces four challenges:
  • Aging baby boomer generation
  • Shortage and uneven distribution of physicians
  • Rate of nurses’ retirements
  • Uncertainty of health care reform

Traditional Levels of Health Care

• There are six traditional levels of health care:
  • Preventative
  • Primary
  • Secondary
  • Tertiary
  • Restorative
  • Continuing health care

Integrated Health Care Delivery

• Primary and preventive health care services are focused on:

  • Improved health outcomes for an entire population
  • Collaboration among health professionals, health care leaders, and community members
  • Health promotion programs to reduce disease incidence
  • Preventive care to reduce and control risk factors for disease

• Secondary and tertiary care involves:

  • Hospitals
  • Intensive care
  • Mental health facilities
  • Rural hospitals
  • Discharge planning

• Restorative care includes:

  • Home care
  • Rehabilitation
  • Extended care facilities

• Continuing care encompasses:

  • Nursing centers or facilities
  • Assisted living
  • Respite care
  • Adult day care centers
  • Palliative and hospice care

Healthy People

• Provides evidence-based, 10-year national objectives for promoting health and preventing disease
• Healthy People 2030 aims to promote a society in which all people live long, healthy lives
• Identifies leading health indicators, which are high-priority health issues in the United States

Definition of Health

• A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity (WHO, 1947, 2018)
• A state of being that people define in relation to their own values, personality, and lifestyle

Models of Health and Illness

• Models help explain complex concepts or ideas, such as health and illness
• Health beliefs are a person's ideas, convictions, and attitudes about health and illness
• Health beliefs can influence health positively or negatively
• Maslow's Hierarchy of Needs is used to understand the interrelationships of human needs
• Holistic Health Model considers emotional, spiritual, social, cultural, and physical aspects of wellness

Variables Influencing Health

• Internal variables: developmental stage, intellectual background, perception of functioning, emotional factors, spiritual factors
• External variables: family role and practices, social determinants of health, culture

Health Promotion and Illness Prevention

• Health promotion helps individuals maintain or enhance their present health
• Health education helps people develop a greater understanding of their health and how to better manage their health risks
• Illness prevention protects people from actual or potential threats to health

Levels of Prevention

• Primary prevention reduces the incidence of disease
• Secondary prevention focuses on preventing the spread of disease, illness, or infection once it occurs
• Tertiary prevention occurs when a defect or disability is permanent or irreversible

Risk Factors

• Any attribute, quality, environmental situation, or trait that increases the vulnerability of an individual or group to an illness or accident
• Risk factors include nonmodifiable risk factors, modifiable risk factors, and environment

Risk Factor Identification and Changing Health Behaviors

• Identify risk factors through assessment and health risk appraisal forms
• Implement education and counseling, wellness strategies, and understand the stages of change using the Transtheoretical Model of Change

Illness

• A state in which a person's physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired
• Acute illness has a short duration and is severe
• Chronic illness lasts longer than 6 months and affects functioning
• Illness behavior involves how people monitor their bodies and define and interpret their symptoms
• Variables influencing illness and illness behavior include internal variables and external variables
• Impact of illness on the patient and family includes behavioral and emotional changes, impact on body image, self-concept, family roles, and family dynamics

Caring for Yourself

• Eat a nutritious diet
• Get adequate sleep
• Engage in exercise and relaxation activities
• Establish a good work-family balance
• Engage in regular nonwork activities