Health care or treatment can be divided into various levels, such as acute and long-term care; primary, specialized, and inpatient care; or primary, secondary, and tertiary care.
Acute care refers to treatment given to the person whose illness has a rapid onset and is of brief duration. Treatment may be managed in the doctor`s office, emergency room, clinic, or hospital, depending on the seriousness of the illness and availability of services.
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Chronic or long-term care refers to treatment given over time for an illness that may not be curable but that may improve somewhat, become regulated, or go into remission. Such care may be managed in the doctor`s office, clinic, patient`s home, dispensary of an industry or school, a rehabilitation center, or a nursing home. At times, the patient may be admitted to a hospital for diagnostic procedures or to achieve better control over the illness.
Primary care has been classified as ambulatory care, prevention and treatment of acute diseases and disability, management of common chronic disorders, guidance and counseling of persons / families, as well as personal preventive measures. Primary care refers to the place where the person enters the health care system. Assistance may initially come from the physician or nurse, pharmacist, social worker, nutritionist, or home health aid. Wherever the entry point or with whomever initial contact is made, the following should be provided :
a. Consideration of the whole person-his physical, emotional, social, economic, cultural, family, religious, and environmental status and background.
b. Access to the health care system and any needed services.
c. Care by an individual provider or team of providers who, along with the client, is responsible for continuing coordination and management of all aspects of basic health services necessary for individual and family care.
The overwhelming majority of health complaints seen at the primary or ambulatory care level are uncomplicated and do not require specialists. Common problems include respiratory or gastrointestinal infections; skin lesions; minor emotional problems involving life-style disorders and problems of youth and old age; and chronic problems with bones, joints, and muscles. Yet, today`s medical doctors are being trained in an atmosphere of increased technology and specialization. The Amarican Medical Association recognizes at least 63 medical specialties. One author blames this scientific technologic medicine for the near collapse of primary health care, which emphasizes compassion and the relationship between emotional factors and illness. The news service of one large American city said that while fine specialized and inpatient services were available, the city might quality as a disaster from a primary health standpoint.
Specialized care is given by a specially practitioner, usually to those people who need secondary care or who are too ill or have distinct problems that cannot be handled in a primary care setting. A few medical specialties are urology, pediatric allergy, ophthalmology, neurosurgery, and aerospace medicine. Nursing is increasingly specialized also, usually following the specialization areas created by the medical profession. However, some nurses become specialized in caring for age groups, such as neonates, infants, adolescents, or the aged. These nurses may encounter a wide variety of medical, surgical, or psychiatric problems within any one age group.
Inpatient care is provided in institutional beds, such as a hospital, extended care facility, or nursing home, and is usually supervised by a primary or specialized practitioner. Either the acute or chronic illness may be given inpatient care. This is also called secondary care because the person has an illness that needs care so that complications may be prevented. Initial prevention of the health problem is no longer possible if it was not accomplished in the primary care setting. Tertiary care, treating the sequelae or complications of an illness, is also given in the inpatient setting and is often considered chronic care. Rehabilitative measures may be implemented and may or may not be successful.
References :
Murray, RB and Zentner JP., Nursing Concepts for Health Promotion, Second Edtion, Prentice-Hall, Inc, Englewood Cliffs, N.J, 1979.
Drosness, Daniel O., Steven Jonas, and Victor Sidel, “The Delivery of Health Care,” Practice of Medicine. Hagerstown, Md.: Harper & Row, Publishers, 1977.
White, K.L.,”Organization and Delivery of Personal Health services : Public Policy Issues,” read before a Seminar on Health Policy, Institute for Policy Studies, Washington, D.C., 1966.
Battistella, Roger,” The Right to Adequate Health Care,” Nursing Digest, 1976.
Amberg, Richard,” Health Statistics Rank St. Louis Among the Worst in Primary Care,” St. Louis Globe-Democrat, 1975.
