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Health care or healthcare is the maintenance or improvement of via the prevention, , and of , , , and other in human beings. Healthcare is delivered by health professionals (providers or practitioners) in allied health professions, , physician associates, , , , , , , , , and other health professions. It includes the work done in providing , , and , as well as in .

Access to health care may vary across countries, groups, and individuals, largely influenced by social and economic conditions as well as the 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 ; and well maintained health facilities and logistics to deliver quality medicines and technologies.

Healthcare can contribute to a significant part of a country's . In 2011, the healthcare industry consumed an average of 9.3 percent of the GDP or 3,322 (PPP-adjusted) per capita across the 34 members of OECD countries. The US (17.7%, or US$ PPP 8,508), the (11.9%, 5,099), (11.6%, 4,118), (11.3%, 4,495), (11.2%, 5669), and (11%, 5,634) were the top spenders, however was highest in Switzerland (82.8 years), and (82.7), and (82.4), France (82.2) and (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 . (see also international comparisons.)

Health care is conventionally regarded as an important determinant in promoting the general physical and mental and of people around the world. An example of this was the worldwide eradication of 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.


Delivery
The delivery of modern health care depends on groups of trained and coming together as interdisciplinary teams.United States Department of Labor. Employment and Training Administration: Health care. Retrieved June 24, 2011. This includes professionals in , , , , , and , plus many others such as , community health workers and assistive personnel, who systematically provide personal and population-based preventive, curative and rehabilitative care services.

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

Primary care refers to the work of health professionals who act as a first point of consultation for all 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 , a licensed independent practitioner such as a , 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 or . 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 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 and geographic origins, patients seeking to maintain optimal , and patients with all manner of acute and chronic physical, and social health issues, including . 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, , 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: , diabetes, , COPD, depression and , , or . Primary care also includes many basic and child health care services, such as 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 in Washington.

In context of global , 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.


Secondary care
Secondary care includes : necessary treatment for a short period of time for a brief but serious illness, injury or other health condition, such as in a emergency department. It also includes skilled attendance during , intensive care, and services.

The term "secondary care" is sometimes used synonymously with "hospital care". However, many secondary care providers do not necessarily work in hospitals, such as , 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 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 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 or national health insurance.

Allied health professionals, such as , respiratory therapists, occupational therapists, speech therapists, and , also generally work in secondary care, accessed through either patient self-referral or through physician referral.


Tertiary care

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 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 management, , , , treatment for severe , advanced services, palliative, and other complex medical and surgical interventions.Emory University. School of Medicine. Accessed 27 June 2011.


Quaternary care
The term quaternary care is sometimes used as an extension of tertiary care in reference to advanced levels of medicine which are highly specialised and not widely accessed. Experimental medicine and some types of uncommon or procedures are considered quaternary care. These services are usually only offered in a limited number of regional or national health care centres.Alberta Physician Link. Levels of Care. Retrieved 26 August 2014. This term is more prevalent in the United Kingdom, but just as applicable in the United States. A quaternary care hospital may have virtually any procedure available, whereas a tertiary care facility may not offer a sub-specialist with that training.


Home and community care
Many types of health care interventions are delivered outside of health facilities. They include many interventions of interest, such as surveillance, distribution of and needle-exchange programmes for the prevention of transmissible diseases.

They also include the services of professionals in residential and community settings in support of , , , , treatment for substance use disorders and other types of health and social care services.

Community services can assist with mobility and independence after loss of limbs or loss of function. This can include , or .

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.

(2017). 9780857299123, Springer.

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.


Ratings
Health care ratings are ratings or of health care used to evaluate the process of care, healthcare structures and/or outcomes of health care services. This information is translated into report cards that are generated by quality organizations, nonprofit, consumer groups and media. This evaluation of quality can be based on:
  • Measures of Hospital quality
  • Measures of Health Plan Quality
  • Measures of Physician Quality
  • Measures of Quality for Other Health Professionals
  • Measures of Patient Experience


Related sectors
Health care extends beyond the delivery of services to patients, encompassing many related sectors, and set within a bigger picture of financing and governance structures.


Health system
A health system, also sometimes referred to as health care system or healthcare system is the organization of people, institutions, and resources to deliver health care services to meet the needs of target populations.


Health care industry
The health care industry incorporates several sectors that are dedicated to providing health care services and products. As a basic framework for defining the sector, the United Nations' International Standard Industrial Classification categorises health care as generally consisting of hospital activities, medical and dental practice activities, and "other human health activities". The last class involves activities of, or under the supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratories, pathology clinics, residential health facilities, patient advocates, or other allied health professions.

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 , 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.


Health care research
The quantity and quality of many health care interventions are improved through the results of science, such as advanced through the of health which focuses on the eradication of through diagnosis and effective treatment. Many important advances have been made through health research, including biomedical research and pharmaceutical research, which form the basis for evidence-based medicine and evidence-based practice in health care delivery.

For example, in terms of pharmaceutical research and development spending, 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.

(1994). 9780443040597, Churchill Livingstone.
Results from health services research often form the basis of evidence-based policy in health care systems. Health services research is also aided by initiatives in the field of AI for the development of systems of health assessment that are clinically useful, timely, sensitive to change, culturally sensitive, low burden, low cost, involving for the patient and built into standard procedures.


Health care financing
There are generally five primary methods of funding health care systems:World Health Organization. "Regional Overview of Social Health Insurance in South-East Asia.' Retrieved December 02, 2014.

  1. general to the state, county or municipality
  2. voluntary or private
  3. out-of-pocket payments
  4. to health

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 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 , 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 care administration and regulation
The management and administration of health care is another sector vital to the delivery of health care services. In particular, the practice of health professionals and operation of health care institutions is typically by national or state/provincial authorities through appropriate regulatory bodies for purposes of quality assurance.World Health Organization, 2003. Quality and accreditation in health care services. Geneva http://www.who.int/hrh/documents/en/quality_accreditation.pdf Most countries have credentialing staff in regulatory boards or health departments who document the certification or licensing of health workers and their work history.Tulenko et al., "Framework and measurement issues for monitoring entry into the health workforce." Handbook on monitoring and evaluation of human resources for health. Geneva, World Health Organization, 2012.


Health information technology
Health information technology (HIT) is "the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication and decision making." Technology is a broad concept that deals with a species' usage and knowledge of tools and crafts, and how it affects a species' ability to control and adapt to its environment. However, a strict definition is elusive; "technology" can refer to material objects of use to humanity, such as machines, hardware or utensils, but can also encompass broader themes, including systems, methods of organization, and techniques. For HIT, technology represents computers and communications attributes that can be networked to build systems for moving health information. Informatics is yet another integral aspect of HIT.

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.


Countries and regions

Taiwan
Healthcare in Taiwan is administered and monitored by the Ministry of Health and Welfare and for management of the National Health Insurance.


Canada

United Kingdom
Each of the four countries of the UK has a publicly funded health care system referred to as the National Health Service (NHS). All of the services were founded in 1948, based on legislation passed by the Labour Government that had been elected in 1945 with a manifesto commitment to implement the recommendation to create "comprehensive health and rehabilitation services for prevention and cure of disease".

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, , 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.


United States

India
Main article: Healthcare in India


See also
  • Acronyms in healthcare
  • Catholic Church and health care
  • Clinical documentation improvement
  • Doctor–patient relationship
  • Electronic health record
  • Healthcare system / Health professionals
  • / / /
  • List of OECD countries by health care outcome
  • Medical classification
    • (Anatomical Therapeutic Chemical classification system)
    • Classification of Pharmaco-Therapeutic Referrals (CPR)
    • Diagnostic and Statistical Manual of Mental Disorders (DSM) / List of DSM-IV codes
    • ICD-10 (International Classification of Diseases)
    • International Classification of Primary Care (ICPC-2) / ICPC-2 PLUS
  • / Doctor's visit /
  • Philosophy of healthcare
  • Universal health care


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