What Are The Roles Provided By Healthcare Delivery Systems

In the past, health care was given only in acute-care amenities. Today, health care is delivered in hospital, outpatient, transitional care, long-term care, rehabilitative care, home, and private office location. Dealings to reduce health-care costs include decreasing the number of hospitals and the length of patient stays, increasing outpatient and home care, and increasing long-term care for the elderly. The home-care industry and managed care have become major providers of health care. The role of specialists in health-care epidemiology has changed consequently.

Home care is a form of health care service provided where a patient lives. Patients are given home care services whether they live in their own homes, with or without family members, or in an assisted living facility. The purpose of home care is to sponsor, keep up, or refurbish a patient's health and condense the effects of disease or disability.

Over the past two decades, there has been an uprising in health-care delivery systems in the United States. The number of acute-care facilities has reduced, the number of patients requiring intensive care in acute-care facilities has gone up, and the number of surgical procedures performed in outpatient settings or surgical centers has increased. Not only has there been a shift to the outpatient setting, but the long-term care, home-care, and managed-care industries have also grown largely.

In the 1970s and 1980s, the acute-care facility was the center of the hospital infection. Most health care was delivered in the acute-care setting, and outpatient, long-term, and home care were comparatively small, in number of facilities and patients. Reports of nursing shortages and downsizing of infection control departments have been increasing, despite the fact that nearly 2 million hospital-acquired infections occur each year. Thus, the challenge for infection control departments in acute-care settings will be to focus scrutiny activities on populations at high risk, calculate risk-adjusted rates of hospital-acquired infection, and provide feedback to appropriate personnel so that integrated prevention programs can be put into practice and interference estimated to ensure quality health care.

The objective of home care is to take care of the requirements of the patient to allow the patient to remain living at home, regardless of age or disability. After surgery, a patient may want home care services that may vary from such homemaking services as cooking or cleaning to skilled medical care.

The fastest-growing sector of the health-care delivery system has been the home health business. In 1988, the Health Care Financing Administration expended approximately $2 billion for home health. By 1999, approximately $20 billion was expended. Today, almost as many persons receive health care in the home as in acute-care settings.

At least initially, home health care and other infection control personnel should focus their efforts on high-risk infections such as urinary tract, bloodstream, pneumonia, or skin and soft tissue infections. For specific infections, e.g., urinary tract and bloodstream infections, device-specific infection rates should be calculated. Uniform definitions applicable to home care, uniform surveillance protocols, and a national no punitive reporting system should be recognized so that rates can be compared.

• Emma Bullock
• 27/04/2009, 4:59 AM
• 0 Comments