Levels of Health Care

Levels of Health Care

There are three levels of healthcare that’s mentioned in the following:
1.      Primary Healthcare:
Primary healthcare denotes the first level of contact between individuals and families with the health system. According to Alma Atta Declaration of 1978, Primary Health care was to serve the community it served; it included care for mother and child which included family planning, immunization, prevention of locally endemic diseases, treatment of common diseases or injuries, provision of essential facilities, health education, provision of food and nutrition and adequate supply of safe drinking water.

Primary care refers to the work of health professionals who act as a first point of consultation for all patients within the health care system. Such a professional would usually be a primary care physician, such as a general practitioner or family physician. Another professional would be a licensed independent practitioner such as a physiotherapist, or a non-physician primary care provider such as a physician assistant or nurse practitioner. Depending on the locality, health system organization the patient may see another health care professional first, such as a pharmacist or nurse. Depending on the nature of the health condition, patients may be referred for secondary or tertiary care.

Primary health care mainly focuses on health equity producing social policy beyond the traditional healthcare system. Its main aim is to provide local care to a patient because professionals related to primary care are normal generalists, deals with a broad range of psychological, physical and social problems etc. rather than specialists in any particular disease area. Primary care services rapidly increasing in both the developed and developing countries depending upon the increasing number of adults at greater risk of chronic noncommunicable disease like diabetes, asthma, back pain, hypertension, anxiety, depression etc.
To achieve the ultimate goals of primary health care., WHO has described five elements to achieve this goal. Following are:
§     Stakeholder participation increased.
§     Integrate health into all sectors.
§     According to people need & expectation organizing healthy services.
§     Pursuing collaborative models of policy dialogue.

2.      Secondary Healthcare:
Secondary care includes acute care: necessary treatment for a short period of time for a brief but serious illness, injury, or other health condition. This care is often found in a hospital emergency department. Secondary care also includes skilled attendance during childbirthintensive care, and medical imaging services.

The term "secondary care" is sometimes used synonymously with "hospital care." However, many secondary care providers, such as psychiatristsclinical psychologistsoccupational therapists, most dental specialties or physiotherapists do not necessarily work in hospitals. Some primary care services are delivered within hospitals. Depending on the organization and policies of the national health system, patients may be required to see a primary care provider for a referral before they can access secondary care. Physiotherapists are both primary and secondary care providers that do not require a referral.
This healthcare is provided by the medical specialists and other health problems who do not have direct contact with a patient like urologists, dermatologists, cardiologists etc. According to National health system policy, the patient required primary care professional’s referral to proceed further for secondary care. Depends on countries to countries, the patient cannot directly take secondary care because sometimes health system imposed a restriction of referral on a patient in terms of payment.

The systems come under this category is known as District Health system and County Health system.
Þ    District Health system: This system mainly focusses on child health and maternity care. People population of this system is about 25000 to 50000 and includes various healthcare centers and district hospitals. Healthcare centers receive referrals from various primary health care and is remain open for 24 hours every day. District hospitals include emergency services, neonatal care, comprehensive emergency obstetric etc.  and is remain open for 24 hours every day.
Þ    County Health system:   Into this system, hospitals receive referrals from the District & community health systems. County hospital provides gynecologic services, general medicine, obstetrics, general surgery etc. and is remain open for 24 hours every day.

3. Tertiary Healthcare:
Tertiary care is specialized consultative health care, usually for inpatients and on referral from a primary or secondary health professional, in a facility that has personnel and facilities for advanced medical investigation and treatment, such as a tertiary referral hospital.
Examples of tertiary care services are cancer management, neurosurgerycardiac surgeryplastic surgery, treatment for severe burns, advanced neonatology services, palliative, and other complex medical and surgical interventions.
This type of healthcare is known as specialized consultative healthcare usually for inpatients and on referral from primary and secondary healthcare for advanced medical investigation and treatment. following examples of tertiary care services are plastic surgery, burn treatment, cardiac surgery, cancer management, neurosurgery, complex medical and surgical interventions etc.
The main provider of tertiary care is national Health system consist of Regional hospitals and National Hospital. Regional hospitals receive a reference from various county hospitals and serves as training sites complementary to the National referral hospital. It also provides additional care services and remains open for 24 hours every day.

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