On completing this chapter, you will be able to do the following: 1. Compare public and private health care agencies according to the following criteria: c. Examples of agencies in your geographic area d. Possible places of employment for practical/vocational nurses 2. Differentiate between official and voluntary agencies. 3. Explain what is meant by private health care agencies as the usual entry into the health care delivery system in the United States. a. Official government public health care agency in your area b. Official government public health care agency in your state c. Official government public health care agency at the federal level 5. Identify the federal health care agency in the United States that is headed by an appointee of the president and advises the president in health matters. 6. List eight agencies that make up the U.S. Public Health Service (USPHS). 7. Describe the responsibility of the World Health Organization (WHO). 8. Provide examples of two voluntary health care agencies in your area that are not listed in this chapter. 9. Explain the difference between proprietary and nonprofit health care agencies. 10. Discuss how primary care relates to family practice physicians. 11. Differentiate between general and specialized hospitals. 12. Explain the purpose of teaching and research hospitals. 13. Discuss the difference between ambulatory and acute care settings. 14. Describe free clinics as a source of primary care. 15. Differentiate among the following types of long-term care: —Continuous care retirement communities —Intermediate care facility (ICF) (ĂM-bū-lă-tŏr-ē kar fă-sil-i-tēs, p. 233) (ĂM-bū-lă-tŏr-ē SŬR-jĕr-ē SĔN-tĕrs, p. 233) continuous care retirement community (CCRC) Department of Health and Human Services (DHHS) (JĚN-ĕr-ăl HŎS-pĭ-tăls, p. 232) official (government) health care agencies (ŎWT-pā-shĕnt KLĬ-nĭc, p. 233) proprietary hospitals (for profit) skilled nursing facility (SNF) skilled nursing facility for the severely disabled (SNFSD) (SPĚ-shŭl-īzd HŎS-pĭ-tăl, p. 232) teaching and research hospital U.S. Public Health Service (USPHS) (VŎL-ŭn-tăr-ē kŏm-U-nĭ-tē HŎS-pĭ-tăl, p. 229) voluntary health care agencies World Health Organization (WHO) All health care agencies are not the same. They differ in size, focus, quality of service, and how they are financed. Do some research before making an application for a job so you can make an informed choice about employment after you graduate. Compose questions to ask during an employment interview. Refer to Chapter 22 for ideas. Personal Vision of Working as a Nurse What is your vision for working as a nurse after you complete nursing school? The various health care services in the United States can be grouped into two general categories: services delivered by the public sector and services delivered by the private sector. Table 18-1 outlines the major differences between public and private health care agencies. As you read about public and private health care agencies, think of them as potential sources of employment for the LPN/LVN. Table 18-1 Comparison of Health Care Agencies in the Public and Private Sectors • Government agencies supported by tax money • Are accountable to the taxpayers and the government • Government agencies put primary emphasis on the delivery of disease prevention and wellness promotion programs Voluntary health care agencies have these characteristics: • Are supported by voluntary contributions • Sometimes charge a fee for services • Are tuned in to public opinion but are accountable to their supporters • Activities determined by supporter interest, not legal mandate • Primary emphasis is on research and education • It is funded by federal taxes. • A person appointed by the president of the United States is head of the agency. This person advises the president in health matters. • Food and Drug Administration (FDA). Administers Federal Food, Drug, and Cosmetics Act and several related public health laws. • Centers for Disease Control and Prevention (CDC). Lead agency related to surveillance and identification of disease through epidemiologic and laboratory investigations. It is also the primary agency for administering grants to support public health programs such as HIV/AIDS, sexually transmitted diseases, injury protection, immunization, and cancer screening. • National Institutes of Health (NIH). Funds biomedical research in its own laboratories and in universities, hospitals, private research institutions, and private industry. New knowledge can potentially improve health, quality of medical care, and understanding of disease process. • Health Resources and Services Administration (HRA). Improves access to medical care for indigent, uninsured, rural residents, and special-needs populations. • Substance Abuse, and Mental Health Services Administration (SAMHSA). Improves the quality and availability of prevention, treatment, and rehabilitation services for persons suffering from alcoholism, substance abuse, and mental illness. • Agency for Healthcare Research and Quality (AHRQ). Focuses on quality of care and medical care outcomes. • Agency for Toxic Substance and Disease Registry (ATSDR). Works to prevent exposure and to minimize adverse health effects associated with waste management emergencies and pollution by hazardous substances. • Indian Health Services (IHS). Constitution is the legal basis for the federal government’s responsibility to provide health services to American Indians and Alaskan Natives. Goal is to provide comprehensive, culturally acceptable personal and public services. The preceding definitions are based on the Gale Encyclopedia of Public Health. • WHO is located in Geneva, Switzerland. • The major objective of WHO is the highest possible level of health for people all over the world. • WHO defines health as a state of complete physical, mental, and social well-being and not merely as the absence of disease or infirmity. • WHO is funded through fees paid by member nations of the UN. • Coordinates international efforts to control outbreaks of infections, such as SARS, malaria, tuberculosis, influenza, and HIV/AIDS. Also sponsors programs to prevent and treat such diseases. Voluntary or nonofficial health care agencies (Table 18-2) are so named because they are nonprofit. The health services they provide are complementary to official (government) health care agencies. They often meet the needs of persons with specific diseases (e.g., heart disease) and certain segments of the population (e.g., those with disabilities). Although paid personnel work in voluntary health agencies, volunteers form a major part of their support system. Voluntary organizations are sites for volunteer service for practical/vocational nursing students and LPN/LVNs. Some examples follow. Refer to your local telephone directory for additional names and numbers of voluntary health care agencies. Table 18-2 Examples of Voluntary Agencies • Provides home nursing care for persons with acute and chronic diseases. Care includes health supervision, education, counseling, bedside care, and carrying out physicians’ orders. • Visits mothers with newborn infants. • Frequently involves the family in the care of its own members. • Assists with referrals for patients to other community services. • Staffed primarily by BSN nurses and home health aides trained for specific tasks of personal bedside care.
Health Care Settings
Potential Job Sites
Public versus private health care agencies
Public
Official (government)
Nonofficial (voluntary)
Private
Support
Tax money
Voluntary contributions and fees for service
Fees for service
Primary service
Programs of disease prevention and wellness promotion
Research and education
Curing disease and illness
Additional services
Sometimes direct service of health care
Offer direct health services
Disease prevention and wellness promotion
Accountability
Taxpayers and government
Supporters, boards, and so forth
Owners
How programs determined
Mandated and nonmandated
Supporter interest
Defined goals of the organization
Public health care agencies
Examples of public health care agencies
Official Government Agencies
Federal (National)
International
Voluntary health care agencies
Agency
Purpose
Contact
American Cancer Society (ACS)
Cancer research, public information resource to patients, families, professionals
(800) ACS-2345, www.cancer.org
American Lung Association (ALA)
Research, professional education, resource for professionals and public
(800) LUNGUSA, www.lungusa.org
American Heart Association (AHA)
Research and education on heart disease and stroke
(800) 242-8721, www.americanheart.org
American Stroke Association
Research and education on stroke
(888) 4STROKE, www.strokeassociation.org
Alcoholics Anonymous
Rehabilitation help and support to patients and families
Check telephone book’s local listing. Also (800) 511-9225, www.alcoholics-anonymous.org
ALS Society of America
Collects data on persons with amyotrophic lateral sclerosis (Lou Gehrig’s disease) for research purposes; resource for public and professionals
(800) 782-4747, www.alsa.org
Easter Seals National Headquarters
Research and rehabilitative services for disabled children and adults
(800) 221-6827, www.easterseals.org
La Leche League
Information and support for breastfeeding mothers; breast milk for infants because of health reasons but lack a source
(800) LALECHE, www.lalecheleague.org
United Ostomy Association of America (UOA)
Education, information, and advocacy for patients undergoing intestinal or urinary diversion procedures
(800) 826-0826, www.ostomy.org
American Diabetes Association (ADA)
Resource for type 1 and type 2 diabetes, nutrition information, referrals to doctors, and educational programs
(800) 342-2383, www.diabetes.org
Visiting Nurse Association
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Health Care Settings: Potential Job Sites
