Health care or healthcare is the maintenance or improvement of health via the diagnosis, therapy, and prevention of disease, illness, injury, and other disability in human beings. Healthcare is delivered by health professionals (providers or practitioners) in allied health professions, chiropractic, physicians, physician associates, dentistry, midwifery, nursing, medicine, optometry, pharmacy, psychology, and other health professions. It includes the work done in providing primary care, secondary care, and tertiary care, as well as in public health.
Access to health care may vary across countries, groups, and individuals, largely influenced by social and economic conditions as well as the health policy in place. Countries and jurisdictions have different policies and plans in relation to the personal and population-based health care goals within their societies. Healthcare systems are organisations established to meet the health needs of target populations. Their exact configuration varies between national and subnational entities. In some countries and jurisdictions, health care planning is distributed among market participants, whereas in others, planning occurs more centrally among governments or other coordinating bodies. In all cases, according to the World Health Organization (WHO), a well-functioning healthcare system requires a robust financing mechanism; a well-trained and adequately paid workforce; reliable information on which to base decisions and health policy; and well maintained health facilities and logistics to deliver quality medicines and technologies.
Healthcare can contribute to a significant part of a country's Economic system. In 2011, the healthcare industry consumed an average of 9.3 percent of the GDP or Us dollar 3,322 (PPP-adjusted) per capita across the 34 members of OECD countries. The US (17.7%, or US$ PPP 8,508), the Netherlands (11.9%, 5,099), France (11.6%, 4,118), Germany (11.3%, 4,495), Canada (11.2%, 5669), and Switzerland (11%, 5,634) were the top spenders, however life expectancy was highest in Switzerland (82.8 years), Japan and Italy (82.7), Spain and Iceland (82.4), France (82.2) and Australia (82.0), while OECD's average exceeds 80 years for the first time ever in 2011: 80.1 years, a gain of 10 years since 1970. The US (78.7 years) ranges only on place 26 among the 34 OECD member countries, but has the highest costs by far. All OECD countries have achieved universal (or almost universal) health coverage, except the US and Mexico. (see also international comparisons.)
Health care is conventionally regarded as an important determinant in promoting the general physical and mental health and well-being of people around the world. An example of this was the worldwide eradication of smallpox in 1980, declared by the WHO as the first disease in human history to be completely eliminated by deliberate health care interventions.World Health Organization. Anniversary of smallpox eradication. Geneva, 18 June 2010.
While the definitions of the various types of health care vary depending on the different cultural, political, organizational and disciplinary perspectives, there appears to be some consensus that primary care constitutes the first element of a continuing health care process, that may also include the provision of secondary and tertiary levels of care.Thomas-MacLean R et al. No Cookie-Cutter Response: Conceptualizing Primary Health Care. Retrieved 26 August 2014. Healthcare can be defined as either public or private.
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.World Health Organization. Definition of Terms. Retrieved 26 August 2014. Such a professional would usually be a primary care physician, such as a general practitioner or Family medicine, a licensed independent practitioner such as a physiotherapist, or a non-physician primary care provider (mid-level provider) such as a physician assistant or nurse practitioner. Depending on the locality, health system organization, and sometimes at the patient's discretion, they may see another health care professional first, such as a pharmacist, a nurse (such as in the United Kingdom), a clinical officer (such as in parts of Africa), or an Ayurveda or other traditional medicine professional (such as in parts of Asia). Depending on the nature of the health condition, patients may then be referred for secondary or tertiary care.
Primary care is often used as the term for the health care services which play a role in the local community. It can be provided in different settings, such as Urgent care centres which provide services to patients same day with the appointment or walk-in basis.
Primary care involves the widest scope of health care, including all ages of patients, patients of all socioeconomic and geographic origins, patients seeking to maintain optimal health, and patients with all manner of acute and chronic physical, mental health and social health issues, including Polypharmacy. Consequently, a primary care practitioner must possess a wide breadth of knowledge in many areas. Continuity is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine check-ups and preventive care, health education, and every time they require an initial consultation about a new health problem. The International Classification of Primary Care (ICPC) is a standardised tool for understanding and analysing information on interventions in primary care by the reason for the patient visit.World Health Organization. International Classification of Primary Care, Second edition (ICPC-2). Geneva. Accessed 24 June 2011.
Common chronic illnesses usually treated in primary care may include, for example: hypertension, diabetes, asthma, COPD, depression and Anxiety disorder, back pain, Osteoarthritis or Thyroid disease. Primary care also includes many basic maternal health and child health care services, such as family planning services and . In the United States, the 2013 National Health Interview Survey found that skin disorders (42.7%), osteoarthritis and joint disorders (33.6%), back problems (23.9%), disorders of lipid metabolism (22.4%), and upper respiratory tract disease (22.1%, excluding asthma) were the most common reasons for accessing a physician.
In the United States, primary care physicians have begun to deliver primary care outside of the managed care (insurance-billing) system through direct primary care which is a subset of the more familiar concierge medicine. Physicians in this model bill patients directly for services, either on a pre-paid monthly, quarterly, or annual basis, or bill for each service in the office. Examples of direct primary care practices include Foundation Health in Colorado and Qliance in Washington.
In context of global population aging, with increasing numbers of older adults at greater risk of chronic non-communicable diseases, rapidly increasing demand for primary care services is expected in both developed and developing countries.World Health Organization. Aging and life course: Our aging world. Geneva. Accessed 24 June 2011.Simmons J. Primary Care Needs New Innovations to Meet Growing Demands. HealthLeaders Media, May 27, 2009. The World Health Organization attributes the provision of essential primary care as an integral component of an inclusive primary health care strategy.
The term "secondary care" is sometimes used synonymously with "hospital care". However, many secondary care providers do not necessarily work in hospitals, such as psychiatrists, clinical psychologists, occupational therapists, most dental specialties or (physiotherapists are also primary care providers, and a referral is not required to see a physiotherapist), and 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.
For example, in the United States, which operates under a mixed market health care system, some might voluntarily limit their practice to secondary care by requiring patients to see a primary care provider first, or this restriction may be imposed under the terms of the payment agreements in private or group health insurance plans. In other cases, medical specialists may see patients without a referral, and patients may decide whether self-referral is preferred.
In the United Kingdom and Canada, patient self-referral to a medical specialist for secondary care is rare as prior referral from another physician (either a primary care physician or another specialist) is considered necessary, regardless of whether the funding is from Health insurance or national health insurance.
Allied health professionals, such as physical therapy, respiratory therapists, occupational therapists, speech therapists, and dietitians, also generally work in secondary care, accessed through either patient self-referral or through physician referral.
Tertiary care is specialized consultative health care, usually for and on referral from a primary or secondary health professional, in a facility that has personnel and facilities for advanced medicine investigation and treatment, such as a tertiary referral hospital.Johns Hopkins Medicine. Patient Care: Tertiary Care Definition. Accessed 27 June 2011.
Examples of tertiary care services are cancer management, neurosurgery, cardiac surgery, plastic surgery, treatment for severe , advanced neonatology services, palliative, and other complex medical and surgical interventions.Emory University. School of Medicine. Accessed 27 June 2011.
They also include the services of professionals in residential and community settings in support of self care, home care, long-term care, assisted living, treatment for substance use disorders and other types of health and social care services.
Many countries, especially in the west are dealing with aging populations, and one of the priorities of the health care system is to help seniors live full, independent lives in the comfort of their own homes. There is an entire section of health care geared to providing seniors with help in day-to-day activities at home, transporting them to doctor's appointments, and many other activities that are so essential for their health and well-being. Although they provide home care for older adults in cooperation, family members and care workers may harbour diverging attitudes and values towards their joint efforts. This state of affairs presents a challenge for the design of ICT for home care.
With obesity in children rapidly becoming a major concern, health services often set up programs in schools aimed at educating children in good eating habits; making physical education compulsory in school; and teaching young adolescents to have positive self-image.
In addition, according to industry and market classifications, such as the Global Industry Classification Standard and the Industry Classification Benchmark, health care includes many categories of medical equipment, instruments and services as well as biotechnology, diagnostic laboratories and substances, and drug manufacturing and delivery.
For example, pharmaceuticals and other medical devices are the leading high technology exports of Europe and the United States. The United States dominates the biopharmaceutical field, accounting for three-quarters of the world's biotechnology revenues.
For example, in terms of pharmaceutical research and development spending, Europe spends a little less than the United States (€22.50bn compared to €27.05bn in 2006). The United States accounts for 80% of the world's research and development spending in biotechnology.
In addition, the results of health services research can lead to greater efficiency and equitable delivery of health care interventions, as advanced through the social model of health and disability, which emphasizes the societal changes that can be made to make population healthier.
In most countries, the financing of health care services features a mix of all five models, but the exact distribution varies across countries and over time within countries. In all countries and jurisdictions, there are many topics in the politics and evidence that can influence the decision of a government, private sector business or other group to adopt a specific health policy regarding the financing structure.
For example, social health insurance is where a nation's entire population is eligible for health care coverage, and this coverage and the services provided are regulated. In almost every jurisdiction with a government-funded health care system, a parallel private, and usually for-profit, system is allowed to operate. This is sometimes referred to as two-tier health care or universal health care.
For example, in Poland, the costs of health services borne by the National Health Fund (financed by all citizens that pay health insurance contributions) in 2012 amounted to 60.8 billion PLN (approximately 20 billion USD). The right to health services in Poland is granted to 99.9% of the population (also registered unemployed persons and their spouses). Adamiak, E. Chojnacka, D. Walczak, Social security in Poland – cultural, historical and economical issues, Copernican Journal of Finance & Accounting, Vol 2, No 2, p. 23.
Health information technology can be divided into further components like Electronic Health Record (EHR), Electronic Medical Record (EMR), Personal Health Record (PHR), Practice Management System (PMS), Health Information Exchange (HIE) and many more. There are multiple purposes for the use of HIT within the health care industry. Further, the use of HIT is expected to improve the quality of health care, reduce medical errors, improve the health care service efficiency and reduce health care costs.
The NHS was born out of a long-held British ideal that good healthcare should be available to all, regardless of wealth. At its launch by the UK minister of health, Aneurin Bevan, on 5 July 1948, it had at its heart three core principles: That it meet the needs of everyone, that it be free at the point of delivery, and that it be based on clinical need, not ability to pay.