changing hospital role.pdf

HOSPITAL FUNCTION By Dr. Reham Elkalla Objectives By the end of this lecture the student will be able to Discover the changing role of hospital in the last decades list the function of hospital Identify the essential components of a hospital. Understand the factors influencing hospital utilisation...

HOSPITAL FUNCTION By Dr. Reham Elkalla Objectives By the end of this lecture the student will be able to Discover the changing role of hospital in the last decades list the function of hospital Identify the essential components of a hospital. Understand the factors influencing hospital utilisation Recognize the factors determining the health needs of community In the past, the hospital has been a place for care of the sick. Today, the hospital has become a center of technical services for the sick and well, in patients as well-as outpatients With greater emphasis on achieving the highest standard of patient care and community health. changing hospital role The important factors that have led to the changing role and functions of the hospital are • Expansion of clientele from dying at all classes of people. • Improved socio-economic status. • Increased health awareness. • Government’s duty to provide comprehensive health care. • Improved transportation and communication services. • Rapid advances in medical science and technology. • Increase in population leading to increase in demand for hospital beds. • Reorientation of health care delivery system with an emphasis on primary health care THE CHANGING ROLE OF HOSPITAL The role of hospitals has changed, with emphasis shifting from: • Curative preventive. • In-patient care • Acute out-patient and home care. chronic illness. • Tertiary and secondary primary health care Modern HOSPITAL A modern hospital has become highly scientific and complex institution over the years particularly in last three decades 1. The role of the hospital has been broadened crossing the limits of ‘curative Health’ to health care. Further the health care has crossed the barrier of the hospital to the community care. 2.The modern hospitals have broadened their role from health care to health education, training, research and disease surveillance Hospital function Intramural Function within the wall of the hospital Extramural function Outside the wall of the hospital 1- Intramural function Services within the wall of hospital i. Therapeutic ❖ Diagnostic ❖ Curative ❖ Rehabilitative ❖ Care of emergencies. Curative II. Preventive ❖ Antenatal and postnatal services. ❖ Well baby clinics and immunisation schedule. ❖ Family welfare services. ❖ Control of communicable diseases. ❖ Health education. Antenatal care Rehabilitation Diagnostic Care of emergencies. CONT. intra-mural function III. Education ❖Medical : Undergraduate, post-graduate and post- doctoral. ❖Nursing education :Undergraduate, post-graduate. ❖Specialty ❖Paramedical ❖Community health. iiii. Research ❖Clinical medicine ❖Hospital administration 2-Extra-mural function Services outside the wall of hospital. eg, • Outreach services. • Medical Camps. Outreach services • Immunization Program. • Outpatient services. • Home care. Immunization program Medical Camps. 1- CURATIVE CARE Shifting of focus from Indoor Care to Outpatient care because of • Rising cost of hospital care. • Shortage of hospital beds. • Economic importance. Outpatient department care (OPD) care – Ambulatory care centre such as • Day hospital-, Cataract operation, Dialysis etc. are provided as day care facilities • Polyclinic. • Walk-in clinic (walk-in clinics refer to any healthcare provider that provides care without an appointment) • Dispensary is the room or area in a hospital where medicine is prepared and given out to patients 2- Preventive care Preventive care helps detect or prevent serious diseases and medical problems before they can become major. The Importance of Preventive Health Care • Improves population health in the Long-Term. • Avoid High Medical Expenses & Pay Less Over Time • Increases Lifespan. The Levels of prevention Definition PRIMARY prevention SECONDARY prevention An intervention implemented before there is evidence of a disease or injury An intervention implemented An intervention after a disease has begun, implemented after a but before it is symptomatic. disease or injury is established Intent Reduce or eliminate causative risk factors (risk reduction) example - Prevent addiction from NAS* occurring - Prevent pregnancy TERTIARY prevention Early identification (through screening) & treatment Prevent sequelae (stop bad things from getting worse) Screen pregnant women for - Treat addicted women substance use during Treat babies with NAS prenatal visits and refer for treatment Neonatal abstinence syndrome ( NAS) is a group of conditions caused when a baby withdraws from certain drugs he's exposed to in the womb before birth. LEVELS OF DISABILITY PREVENTION * N.B: Sentinel surveillance is the "monitoring of rate of occurrence of specific diseases/conditions Communicable disease Non-communicable disease (i) The diseases which spread from one person to another. (i) The diseases which do not spread from one person to another. They are transmitted when the infectious agents are transmitted through contact with contaminated surfaces, bodily fluids, blood products, insect bites, or through the air. Infectious agents like bacteria and viruses do not cause these diseases, and thus these diseases do not spread from an infected person to a healthy individual. (ii) They are caused by pathogens. (ii) usually occur due to genetics (hereditary) or developed by lifestyle choice (e.g smoking) or environmental exposure (e.g air pollution) (iii) They are also known as infectious disease (iii) They are known as chronic disease OR OR contagious diseases non-contagious (iv) Examples: Common cold, pneumonia , HIV, AIDS, and tuberculosis. (iv) Examples: Diabetes, High blood pressure, Cancer, heart diseases and Arthritis. Maternal Health Absolute Neutrophil Count (ANC)* Human Immunodeficiency Virus (HIV ) Sexually Transmitted Disease ( HIV) Respiratory tract infections (RTIs) * Trained and competent professionals in adequate numbers ESSENTIAL COMPONENTS OF A HOSPITAL The necessary infrastructure to facilitate smooth functioning of the hospital. An efficient organisation so that each member of the hospital is able to extend the best services to the client A holistic approach*: Treating the whole patient, not just the disease An atmosphere conducive to staff, self and professional growth by arranging regular in-service education programmes. A holistic approach focusses on a person's wellness and not just their illness or condition (physical, emotional, social and spiritual wellbeing). Availability of hospital beds Service coverage and bed distribution Age of the population Factors influencing Hospital Utilisation Means of communication Morbidity and mortality rate Availability of extra-mural medical services. Supply of Physicians & Existence of proprietary hospitals. Hospital’s physical layout and internal organization. Research and Training Methods of payment for hospital services 1. Demographic Factors determining the health needs of community 2. Enabling factors 3. Internal or Health System Factors 4. External Factors 1. Demographic Factors • Age • Sex • Marital status • Family composition • Education 2. Enabling Factors • Family financial resources • Family relationships in the household • Availability and accessibility of services • Health insurance (compensation for illness changes health behaviour) • Attitude to health and disease. Cont. 3. Internal or Health System Factors • Manpower availability • Physical facilities • Organisation and structure • Interface with users 4. External Factors • Political • Social • Administrative ❖ ❖ Health services should be designed to meet the health needs of the community through the use of available resources and knowledge. Health care is provided through health system comprising of • A. Organization • B. Management