Levels of Health care

Carl Wilson A. Santos

Grace Balajediong

 The delivery of modern health care depends on groups of

trainedprofessionalsandparaprofessionalscoming
together asinterdisciplinary teams.
(medicine,psychology,physiotherapy,nursing,dentistry,m
idwiferyand otherallied health)
systematically provide personal and population-based
preventive, curative and rehabilitative care services
definitions of the various types of health care vary
depending on the different cultural, political, organizational
and disciplinary perspectives
Healthcare can be defined as either public or private.


Primary care

work ofhealth professionalswho act as a first point of

consultation for allpatientswithin the health care
system
often used as the term for the health care services which
play a role in the local community
involves the widest scope of health care
Ex.
including all ages of patients
patients of allsocioeconomic geographic origins
patients seeking to maintain optimalhealth
patients with all manner of acute and chronic physical,mental and social

Continuity

key characteristic of primary care, as patients usually prefer to consult

the same practitioner for routine check-ups andpreventive care,
health education, and every time they require an initial consultation
about a new health problem.

Secondary care

provided bymedical specialists,dental specialistsand other health professionals who

generally do not have first contact withpatients
Ex.
cardiologists,urologists,endodontists, andoral and maxillofacial surgeons.

It includesacute care: necessary treatment for a short period of time for a brief but
serious illness, injury or other health condition, such as in ahospital
emergency department.

It also includes skilled attendance duringchildbirth,intensive care, and

medical imagingservices.


Tertiary care

specialized consultative health care, usually forinpatientsand on

referral from a primary or secondary health professional, in a facility
that has personnel and facilities for advancedmedicalinvestigation and
treatment
Examples :

cancermanagement,neurosurgery,cardiac surgery,plastic surgery,

treatment for severeburns, advancedneonatologyservices, palliative, and
other complex medical and surgical interventions

Principles in the care of the older persons

Halbe: wellness as a concept observed that while goals to extend life

expectancy were coming to fruition, older adults were not typically
valued in our society

Increased life expectancy is a triumph of humanity that has benefited

individuals, communities, and society as a whole .

Risk of chronic illness, functional decline, and geriatric syndromes

threaten the well-being of older adults

Wellness, a concept whose defining characteristics include building upon

individual strengths and optimizing potential, is broadly applied in
geriatric nursing. Its meaning is not clear enough.

Health promotion and illness prevention in the care

of older persons

Proven preventive measures for specific conditions should be offered at primary, secondary
and tertiary levels of care.

Strategies demonstrated to promote well-being, maximize functional independence and

minimize disability and dependency should be emphasized.

Promotion and prevention strategies should also be directed towards family caregivers to
enhance their caregiving capacity and their quality of life.

health promotion involves "the development of behaviors that improve bodily functioning
and enhance an individual's ability to adapt to a changing environment".

Disease prevention involves actions to reduce or eliminate exposure to risks that might
increase the chances that an individual or group will incur disease, disability, or premature
death

3 types of prevention activities can affect

health and well-being of the elderly.

Primary prevention refers to efforts to eliminate health or functional problems at

their source (such as immunizations, improving nutritional status, and increasing
physical fitness and emotional well-being) that reduce the incidence of disease or
render a population at risk not vulnerable to that risk.

Secondary prevention involves efforts to detect adverse health conditions early in

their course and to intervene promptly and effectively, or to curtail the spread of
disease to others.

Tertiary prevention aims to reduce the duration and severity of potentially disabling
sequelae of disease and disability, to reduce complications of disease once
established, to minimize suffering, and to assist the individual in adjusting to
irremediable conditions

Recovery and rehabilitation

Disability" is defined as any restriction of ability to perform an activity in

a manner considered normal for a human being

There is a progressive increase in the prevalence of disability with age;

at age 85 it is 84%.

Rehabilitation

it can be seen as a process that aims to restore the functional capacities

of a disabled person

The major goal of rehabilitation programs for older people is to assist

them to manage personal activities of daily living without the assistance
of another person

If this is not possible, the goal is to minimise the need for external
assistance through the use of adaptive techniques and equipment

Older people who may benefit from rehabilitation

Older people who may benefit from rehabilitation typically have a major
disability of recent onset.

Examples:
stroke, hip fracture or other fracture, a fall-related injury, or a major
illness (such as severe cardiac failure); or they have ongoing severe
osteoarthritis or Parkinson's disease.

The disability will have compromised their ability to live independently,

or semi-independently.

The major consideration is the ability to benefit from rehabilitation.

The prime determinants of this are the severity of the presenting

disability and the extent of pre-existing disability.

Severe cognitive impairment is a risk factor for a poor response to a

rehabilitation program.

. Older people with more minor disability can also benefit from
rehabilitation programs.