Lecture 2: Healthcare Delivery and Pharmacists' Roles Flashcards
What are examples of primary care?
- Outpatient setting (not in a hospital or nursery, basic medical care)
- Annual physical exam
- Immunizations
- If you have a sore throat go to primary care clinic
- Flu shot not in an institution
What are examples of secondary care?
- being in a hospital but short-term stay
- Examples: Routine surgery and Specialist physician visit
Secondary care occurs when your primary care provider refers you to a specialist. Secondary care means your healthcare provider has transferred your care to someone who has more specific expertise in whatever health issue you are experiencing. Example: cardiologist, oncologists
What are examples of tertiary care?
- Institution such as a hospital or nursery
- highly specialized care such as heart surgery, NICU, burn treatment, chemotherapy for cancer, dialysis, head and neck oncology
- Long-term stay
If you are hospitalized and require a higher level of specialty care, your doctor may refer you to a tertiary care center. Tertiary care refers to highly specialized equipment and expertise to treat specific, complex health conditions.
Which type of healthcare is most complex? And which type of healthcare is least complex?
Most complex: tertiary care
Least complex: primary care
In which types of care do we typically see more health care
specialists (as compared to general practice providers)?
Secondary care
What was the purpose of the Hill Burton Act (1946)?
Federal funding to states to build hospitals and public health centers
Why is care provided in a hospital setting so expensive?
- uninsured people use the services and that cost money
- Healthcare workforce: need to pay physicians, PAs,
- 24/7 care: overnight stays
- Administrative fees
- Latest models in technology (good but cost a lot of money)
*insured people come to the hospital, they are more sick, they requires the use of more resources to treat them
What happens if patients use the emergency department of a hospital for their source of
primary care? How does this impact patient care and healthcare costs overall?
- Opportunity for continuity of care is lost because they are not follow up with healthcare providers (no continuum of care)
- Very expensive: they are paying for hospital fees and services
People go to the ER out of convenience because it’s open 24/7
The problem: an inconvenient and perhaps outdated primary care delivery system that’s not always open or accessible when people need immediate treatment.
Describe factors that are shifting patient care from the hospital (inpatient) to outpatient
setting (e.g., outpatient clinics/ambulatory care clinics).
- Reimbursement factors: outpatient is less expensive
- Technological factors: MRI or cat scans don’t have to go to hospital, can go to outpatient center
- Control of healthcare utilization in hospital setting: PA for inpatient admission (not an emergency) or monitoring of costs and utilization during hospital stay; how much good and services are they using? *hospitals want to shift patient care to outpatient care to save money and resources for medical emergencies
- Social factors: patient preferences, patients don’t want to be in hospitals
What are some examples of outpatient settings?
- Private physician practice (80-90% of primary care)
- Urgent care centers, surgical centers
- Mobile medical, diagnostic, and screening services (taking healthcare services outside in community)
- Patient’s home
What are some examples of pharmacists’ roles in hospitals?
- Drug distribution
- Patient discharge counseling
- medication reconcilliation
- Drug Review: monitor drug adverse effects, dosing, choice of drug
- Responding to codes
What is the difference between centralized vs. decentralized pharmacy?
Centralized: single location, one pharmacy, usually by small or rural hospital
Decentralized: satellite pharmacies; ex/ different floors of hospital, right by operating room; increasing pharmacy presence
What are some examples of pharmacists’ roles in outpatient settings?
- Immunizations
- MTM: Medication Therapy Management
- Counseling patients
- Prevention and wellness
just some examples
What are some examples of pharmacists’ roles in LTC setting?
- Drug Distribution
- Consulting (Consultant Pharmacist)
What is the role of a consultant pharmacist in long term care setting?
- MTMs
- medication reconciliation
