health care system

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health

 [helth]
a relative state in which one is able to function well physically, mentally, socially, and spiritually in order to express the full range of one's unique potentialities within the environment in which one is living. In the words of René Dubos, “health is primarily a measure of each person's ability to do and become what he wants to become.” 

Current views of health and illness recognize health as more than the absence of disease. Realizing that humans are dynamic beings whose state of health can change from day to day or even from hour to hour, leaders in the health field suggest that it is better to think of each person as being located on a graduated scale or continuous spectrum (continuum) ranging from obvious dire illness through the absence of discernible disease to a state of optimal functioning in every aspect of one's life. High-level wellness is described as a dynamic process in which the individual is actively engaged in moving toward fulfillment of his or her potential.
A common concept of health as a continuum ranging from optimal wellness at one end to illness culminating in death at the other end.
allied health see allied health.
health education.
1. in the nursing interventions classification, a nursing intervention defined as developing and providing instruction and learning experiences to facilitate voluntary adaptation of behavior conducive to health in individuals, families, groups, or communities.
2. See Window on Health Education.
health as expanding consciousness a conceptual model of nursing formulated by Margaret A. newman which offers a paradigm based on the view of health as the undivided wholeness of the person in interaction with the environment. The four key concepts of her model are consciousness, movement, space, and time. Consciousness is defined as the informational capacity of the human system, or the capacity of the system to interact with the environment. Movement is the manifestation of consciousness, viewed as waves of energy and energy transformation in the space and time of a person's life.

Person and environment are defined as co-extensive, open energy fields. The two evolve together and move toward increasing complexity and diversity, manifested in patterns of interaction that occur along continua of time and space. Person is also defined as a specific pattern of consciousness.

Health is a process of expanding consciousness that synthesizes disease and non-disease and is recognized by patterns of person-environment interaction. An understanding of pattern is basic to an understanding of health, and involves the movement from looking at parts to looking at the whole. Pattern is defined as information that depicts the whole, and gives an understanding of the meaning of relationships.

Nursing is an integrative force within the new paradigm of health seen as the undivided wholeness of the person in interaction and as a process of evolving consciousness. The nursing process is modified by Newman and encompasses nursing diagnosis/intervention based on the unique configuration of each person-environment interaction. Intervention is broadly intepreted as the recognition and augmentation of person-environment patterns, where the nurse and the client evolve together toward expanding consciousness.
health care system an organized plan of health services. The term usually is used to refer to the system or program by which health care is made available to the population and financed by government, private enterprise, or both. In a larger sense, the elements of a health care system embrace the following: (1) personal health care services for individuals and families, available at hospitals, clinics, neighborhood centers, and similar agencies, in physicians' offices, and in the clients' own homes; (2) the public health services needed to maintain a healthy environment, such as control of water and food supplies, regulation of drugs, and safety regulations intended to protect a given population; (3) teaching and research activities related to the prevention, detection, and treatment of disease; and (4) third party (health insurance) coverage of system services.

In the United States, the spectrum of health care has been defined by the Department of Health and Human Services as encompassing six levels of health care. The first level of care is preventive care, which is primarily provided by school health education courses and community and public health services.

Primary care is the usual point at which an individual enters the health care system. Its major task is the early detection and prevention of disease and the maintenance of health. This level of care also encompasses the routine care of individuals with common health problems and chronic illnesses that can be managed in the home or through periodic visits to an outpatient facility. Providers of care at the primary level include family members as well as the professionals and paraprofessionals who staff community and neighborhood health centers, hospital outpatient departments, physicians' offices, industrial health units, and school and college health units.

Secondary or acute care is concerned with emergency treatment and critical care involving intense and elaborate measures for the diagnosis and treatment of a specified range of illness or pathology. Entry into the system at this level is either by direct admission to a health care facility or by referral. Provider groups for secondary care include both acute- and long-term care hospitals and their staffs.

Tertiary care includes highly technical services for the treatment of individuals and families with complex or complicated health needs. Providers of tertiary care are health professionals who are specialists in a particular clinical area and are competent to work in such specialty agencies as psychiatric hospitals and clinics, chronic disease centers, and the highly specialized units of general hospitals; for example, a coronary care unit. Entry into the health care system at this level is gained by referral from either the primary or secondary level.

Respite care is that provided by an agency or institution for long-term care patients on a short-term basis to give the primary caretaker(s) at home a period of relief.

Restorative care comprises routine follow-up care and rehabilitation in such facilities as nursing homes, halfway houses, inpatient facilities for alcohol and drug abusers, and in the homes of patients served by home health care units of hospitals or community-based agencies.

Continuing care is provided on an ongoing basis to support those persons who are physically or mentally handicapped, elderly and suffering from a chronic and incapacitating illness, mentally retarded, or otherwise unable to cope unassisted with daily living. Such care is available in personal care homes, domiciliary homes, inpatient health facilities, nursing homes, geriatric day care centers, and various other types of facilities. See also home health care.
holistic health a system of preventive care that takes into account the whole individual, one's own responsibility for one's well-being, and the total influences—social, psychological, environmental—that affect health, including nutrition, exercise, and mental relaxation.
health Insurance Portability and Accountability Act an act of Congress, passed in 1996, that affords certain protections to persons covered by health care plans, including continuity of coverage when changing jobs, standards for electronic health care transactions, and privacy safeguards for individually identifiable patient information.
health maintenance organization (HMO) any of a variety of health care delivery systems with structures ranging from group practice through independent practice models or independent practice associations (IPAs). They provide alternatives to the fee-for-service private practice of medicine and other allied health professions. Although the type of organizational pattern, membership, and ownership of the organization may vary among HMOs, all have the major goal of allowing for investment in and incentives to use a prepaid, organized, comprehensive health care system that serves a defined population. The enrolled population enters into a contract with the organization, agreeing to pay, or have paid on their behalf, a fixed sum, in return for which the HMO makes available the health care personnel, facilities, and services that the population may require. The services are available on a 24-hour-a-day, 7-day-a- week basis. Some HMOs may provide directly the entire range of health services, including rehabilitation, dental, and mental health care. Others may agree to provide directly or arrange to pay only for physicians' services, in-hospital care, and outpatient emergency and preventive medical services. The kinds of services available are stipulated in the contract between the organization and its enrolled population. The emphasis of a health maintenance organization is on preventive rather than crisis-oriented medical care.
public health see public health.
health seeking behaviors a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as a state in which a person in stable health is actively seeking ways to alter his or her personal habits or environment in order to move toward a higher level of health. “Stable health” is defined as the achieving of age-appropriate illness prevention measures, with reporting of good or excellent health, and signs or symptoms of disease, when present, being controlled.
sexual health see sexual health.

system

 [sis´tem]
1. a set or series of interconnected or interdependent parts or entities (objects, organs, or organisms) that act together in a common purpose or produce results impossible by action of one alone.
2. an organized set of principles or ideas. adj., adj systemat´ic, system´ic.

The parts of a system can be referred to as its elements or components; the environment of the system is defined as all of the factors that affect the system and are affected by it. A living system is capable of taking in matter, energy, and information from its environment (input), processing them in some way, and returning matter, energy, and information to its environment as output.

An open system is one in which there is an exchange of matter, energy, and information with the environment; in a closed system there is no such exchange. A living system cannot survive without this exchange, but in order to survive it must maintain pattern and organization in the midst of constant change. Control of self-regulation of an open system is achieved by dynamic interactions among its elements or components. The result of self-regulation is referred to as the steady state; that is, a state of equilibrium. homeostasis is an assemblage of organic regulations that act to maintain steady states of a living organism.

A system can be divided hierarchically into subsystems, which can be further subdivided into sub-subsystems and components. A system and its environment could be considered as a unified whole for purposes of study, or a subsystem could be studied as a system. For example, the collection of glands in the endocrine system can be thought of as a system, each endocrine gland could be viewed as a system, or even specific cells of a single gland could be studied as a system. It is also possible to think of the human body as a living system and the endocrine system as a subsystem. The division of a system into a subsystem and its environment is dependent on the perspective chosen by the person studying a particular phenomenon.
Systems, subsystems, and suprasystems. Within the environment there are suprasystems, such as human society, and systems within the suprasystem, such as the educational and industrial systems and the health care delivery system. Within the health care delivery system are subsystems, such as the patient, family members, the nurse, the physician, and allied health care professionals and paraprofessionals.
alimentary system digestive system.
apothecaries' system see apothecaries' system.
autonomic nervous system see autonomic nervous system.
avoirdupois system see avoirdupois system.
behavioral system in the behavioral system model of nursing, the patterned, repetitive, and purposeful behaviors of an individual.
cardiovascular system the heart and blood vessels, by which blood is pumped and circulated through the body; see also circulatory system.
CD system (cluster designation) a system for classifying cell-surface markers expressed by lymphocytes based on a computer analysis of monoclonal antibodies against hla antigens, with antibodies having similar specificity characteristics being grouped together and assigned a number (CD1, CD2, CD3, etc.); these CD numbers are also applied to the specific antigens recognized by the various groups of monoclonal antibodies. See also CD antigen.
centimeter-gram-second system (CGS) (cgs) a system of measurements in which the units are based on the centimeter as the unit of length, the gram as the unit of mass, and the second as the unit of time.
central nervous system see central nervous system.
centrencephalic system the neurons in the central core of the brainstem from the thalamus to the medulla oblongata, connecting the cerebral hemispheres.
circulatory system see circulatory system.
client system in the general systems framework and theory of goal attainment, the composite of physiological, psychological, sociocultural, and developmental variables that make up the total person.
colloid system (colloidal system) colloid (def. 3).
conduction system (conductive system (of heart)) the system of atypical cardiac muscle fibers, comprising the sinoatrial and atrioventricular nodes, internodal tracts, atrioventricular bundle, bundle branch, and terminal ramifications into the Purkinje network.
digestive system see digestive system.
Emergency Medical Services (EMS) system a comprehensive program designed to provide services to the patient in the prehospital setting. The system is activated when a call is made to the EMS operator, who then dispatches an ambulance to the patient. The patient receives critical interventions and is stabilized at the scene. A communication system allows the health care workers at the scene to contact a trauma center for information regarding further treatment and disposition of the patient, followed by transportation of the patient to the most appropriate facility for treatment.
endocrine system the system of ductless glands and other structures that produce internal secretions (hormones) that are released directly into the circulatory system, influencing metabolism and other body processes; see endocrine glands.
environmental control system environmental control unit.
expert system a set of computer programs designed to serve as an aid in decision making.
extrapyramidal system see extrapyramidal system.
gateway system a software interface between an online searcher and one or more search systems, facilitating the use of the system by searchers who are unfamiliar with it, or with online retrieval in general.
genitourinary system the organs concerned with production and excretion of urine, together with the reproductive organs. (See Plates.) Called also urogenital system.
haversian system a haversian canal and its concentrically arranged lamellae, constituting the basic unit of structure in compact bone (osteon).
Haversian system: Structures of compact and spongy bone with the central haversian canal surrounded by the lamellae. From Applegate, 2000.
health care system see health care system.
heterogeneous system a system or structure made up of mechanically separable parts, as an emulsion or suspension.
His-Purkinje system the intraventricular conduction system from the bundle of His to the distal Purkinje fibers, which carries the impulse to the ventricles.
Home Health Care Classification system see home health care classification system.
homogeneous system a system or structure made up of parts that cannot be mechanically separated, as a solution.
hypophyseoportal system (hypophysioportal system) (hypothalamo-hypophysial portal system) the venules connecting the hypothalamus with the sinusoidal capillaries of the anterior lobe of the pituitary gland; they carry releasing substances to the pituitary.
immune system see immune system.
interpersonal system in the general systems framework and theory of goal attainment, two or more individuals interacting in a given situation.
lay health system a system comprising an informal referral network and sources of treatment outside the formal biomedical sources of health care; it includes individual consultation and information-seeking through significant others and peers concerning health behaviors, symptoms, and evaluation of treatment before, during, and after consultation with health care professionals.
legal system in the omaha system, anything connected with law or its administration; it includes legal aid, attorney, courts, or Child Protective Services (CPS), and many other agencies and officials.
limbic system a system of brain structures common to the brains of all mammals, comprising the phylogenetically old cortex (archipallium and paleopallium) and its primarily related nuclei. It is associated with olfaction, autonomic functions, and certain aspects of emotion and behavior.
lymphatic system see lymphatic system.
lymphoid system the lymphoid tissue of the body, collectively; it consists of primary (or central) lymphoid tissues, the bone marrow, and thymus, and secondary (or peripheral) tissues, the lymph nodes, spleen, and gut-associated lymphoid tissue (tonsils, Peyer's patches).
lymphoreticular system the lymphoid and reticuloendothelial systems considered together; see also lymphoreticular disorders.
metric system see metric system.
mononuclear phagocyte system the group of highly phagocytic cells that have a common origin from stem cells of the bone marrow and develop circulating monocytes and tissue macrophages, which develop from monocytes that have migrated to connective tissue of the liver (kupffer's cells), lung, spleen, and lymph nodes. The term has been proposed to replace reticuloendothelial system, which includes some cells of different origin and does not include all macrophages.
nervous system see nervous system.
nursing system in the self-care model of nursing, all the actions and interactions of nurses and patients in nursing practice situations; nursing systems fall into three categories: wholly compensatory, partly compensatory, and supportive-educative.
Omaha system see omaha system.
oxygen delivery system a device that delivers oxygen through the upper airways to the lungs at concentrations above that of ambient air. There are two general types: the fixed performance or high flow type, which can supply all of the needs of a patient for inspired gas at a given fractional inspired oxygen; and the variable performance or low flow type, which cannot supply all of the patient's needs for oxygen and delivers fractional inspired oxygen that varies with ventilatory demand.
parasympathetic nervous system see parasympathetic nervous system.
peripheral nervous system the portion of the nervous system consisting of the nerves and ganglia outside the brain and spinal cord.
personal system in the general systems framework and theory of goal attainment, the unified self, a complex whole that is rational, conscious, and feeling and that sets goals and decides on the means of achieving them.
pituitary portal system hypothalamo-hypophysial portal system.
portal system an arrangement by which blood collected from one set of capillaries passes through a large vessel or vessels and another set of capillaries before returning to the systemic circulation, as in the pituitary gland (the hypothalamo-hypophysial portal system) or the liver (the hepatic portal circulation).
renin-angiotensin-aldosterone system see renin-angiotensin-aldosterone system.
respiratory system the group of specialized organs whose specific function is to provide for the transfer of oxygen from the air to the blood and of waste carbon dioxide from the blood to the air. The organs of the system include the nose, the pharynx, the larynx, the trachea, the bronchi, and the lungs. See also respiration and Plates 7 and 8.
reticular activating system see reticular activating system.
reticuloendothelial system see reticuloendothelial system.
safety system see safety system.
SI system see SI units.
skeletal system see skeletal system.
social system in the general systems framework and theory of goal attainment, an organized boundary system of social roles, behaviors, and practices developed to maintain balance for growth, development, and performance, which involves an exchange of energy and information between the person and the environment for regulation and control of stressors.
support system in the omaha system, the circle of friends, family, and associates that provide love, care, and need gratification; it may include church, school, workplace, or other groupings.
sympathetic nervous system see sympathetic nervous system.
Unified Medical Language system see unified medical language system.
Unified Nursing Language system see unified nursing language system.
unit dose system a method of delivery of patient medications directly to the patient care unit. Following review by a nurse, a copy of the physician's original order is sent to the pharmacy, where the pharmacist reviews it again. The pharmacist then fills the order and delivers the medication to the patient care unit, usually in a 24-hour supply. Each patient has an individual supply of medications prepared and labeled by the pharmacist.
urinary system the system formed in the body by the kidneys, ureters, urinary bladder, and urethra, the organs concerned in the production and excretion of urine.
urogenital system genitourinary system.
vascular system circulatory system.
vasomotor system the part of the nervous system that controls the caliber of the blood vessels.

health care system

the complete network of agencies, facilities, and all providers of health care in a specified geographic area. Nursing services are integral to all levels and patterns of care, and nurses form the largest number of providers in a health care system.

health care sys·tem

(helth kār sis'tĕm)
Organized system of providers and services for health care; may include hospitals, clinics, home care, long-term care facilities, assisted living, physicians, health plans, and other services.

health care system

an organized plan of health services by which health care is made available to the animal population and financed by government or private enterprise or both. A health care system embraces the following: (1) health care services available to individual animals and to groups through private practices and government veterinary officer services in veterinary clinics, laboratories and hospitals and the clients' own homes and on farms, in stables and other group animal facilities; (2) the veterinary preventive medical services needed to maintain a healthy environment; for example, control of medicine and food supplies, regulation of drugs, and control of the movement of animals intended to protect a given population; and (3) teaching and research activities related to the prevention and treatment of disease.
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NEW YORK -- Nonprofit hospitals and health care systems demonstrated a stronger financial profile overall in fiscal 2003, according to a new report issued yesterday by Fitch Ratings.

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