Health -Care Providers Structure / Operation

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Health-Care Providers Structure/Operation

description

Health -Care Providers Structure / Operation. Health -Care Facilities. Primary Care General Practice General paediatrics Dental Care Visiting Nurses Secondary Care Ambulatory Specialists Tertiary Care Hospitals / Long Term Care P roviders. General Practice. - PowerPoint PPT Presentation

Transcript of Health -Care Providers Structure / Operation

Page 1: Health -Care  Providers Structure / Operation

Health-Care ProvidersStructure/Operation

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Health-Care Facilities

• Primary Care– General Practice– General paediatrics– Dental Care– Visiting Nurses

• Secondary Care– Ambulatory Specialists

• Tertiary Care– Hospitals/Long Term Care Providers

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General Practice

• Population wide care• Registration• Prevention/Treatment• Social Role of Physician• Density per 1000 population– CZ 0,7; Germany 0,65; Greece 0,28; – Norway 0,81; Sweden 0,62; UK 0,79; USA 0.3

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Challenges

• Aging population• Changing competencies– Nursing care– Physiotherapy

• GP + Technology

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Reimbursement

• Salaried GP• Fee for service• Capitation payment

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Ambulatory Specialists

• Position– Hospitalits– Independent

• Reimbursement– Salaried– Fee for service– Payment per case

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HospitalsBeds/1000 popul Employee/bed Nurse/bed

CZ 7,11 1,87 0,76

Germany 8,25 1,81 0,81

Netherlands 4,69 3,61 1,01

Norway 3,35 6,39 2,55

UK 3,34 6,45 NA

USA 3,08 6,25 2,27

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Hospital structure

• Local ( Internal medicine +)• Regional ( average 10 specialties) • University Hospitals• Special Hospitals• Ownership– State/Municipality– Church– Private non for profit– Private for profit

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Hospital department

• Outpatient– Acute – Clinics

• Inpatient– ICU – centralised/decentralised– Standard wards

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Director

CMO

Head of Dept.

Ward Physician

Physicians

CNO

Head Nurse – Dept.

Ward Sister

Nurses/Porters

Head Therapists

Unit therapists

COO/CFO

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Outpatient Care

• No formal limitation to patients• Low level of centralisation of Acute Care• Time management

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Hospital reimbursement

• Budgeting• FFS• Case mix - DRG

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Long Term CareBeds/1000 population

Beds/1000 seniors

Employees/1000 population

Employees/1000 seniors

CZ 6,5 43,3 3,6 2,4Germany 10,3 50,3 7,8 3,8Netherlands 10,4 68,5 11,7 7,7Norway 9,3 62,9 19,2 13UK 8,8 55,4 NA NAUSA 5,4 41,9 15,4 11,9

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Medical Records vs. Medical Students

• Legal protection of contents – confidentiality• Only with the patient´s consent• Electronic/paper• Entries to be signed and confirmed by a

hospital employee• High level of protection– Patients ID (personal number)– Dg + treatment

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Infection Prevention

• Vaccination• Clothing• Hand Hygiene– Hospital obliged to arrange– Hand + stethoscopes

• Special situations– Face masks– Pregnant students

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Hospital Security and Patient Safety

• Individual badges• Doors• Awareness – strangers• Special precautions– Psychiatry– Paediatrics, neonatology– Infectious diseases

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