Continuum of Care

The United States health care system can be somewhat complicated and often have some barriers or limitations to care. The continuum of care is one of the concepts that is applied to prevent the limitations within the system. Continuum of care is defined as: A range of services developed and organized to address the variety of needs individuals have as they age. This concept recognizes and considers the availability and extent of short-term and long-term care systems and services in the community and in institutional settings.

Included in the continuum of care are residential alternatives, in-home care, community programs and institutional services. (Buckeye Hills-Hocking Valley Regional Development District, 2010) The continuum of care also refers to the use of health care services from birth through death. The continuum of care is comprehensive as it includes patients who uses the services over time. According to Clapp (1993), the continuum of care model includes acute, transitional, long-term and preventive care.

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Clapp (1993) continues to validate that “An integrated continuum requires active collaboration among local providers in two general groups. The first includes hospitals, nursing homes, retirement communities, physicians and home health services. The second group is social or community-based service. ” Health care services are delivered in a myriad of settings and providers. The focus of this essay is on one of the components of health care delivery means of access; that is the Hackensack University Medical Center and the continuum of care.

Hackensack University Medical Center Hackensack University Medical Center (HUMC) is in the heart of Hackensack, NJ. HUMC a “not-for-profit, tertiary-care, teaching and research hospital” (Hackensack University Medical Center, 2010). Established in 1888 with only 12 beds, it is the largest provider of out-patient and in-patient services in the state of New Jersey. HUMC in essence, provides most of the services in the health services spectrum.

Functions and Responsibilities of HUMC HUMC principally provides comprehensive medical, surgical, and psychiatric services without regardless of the patient’s ability to pay and other discriminating factors that involves race, nationality, etc. As a teaching hospital, it also supports the dynamics of the community health care system.

Additionally, tertiary care hospitals offer the most intricate and scientifically advanced services. Given that the arrays of services are numerous, the chart below describes the main functions of the hospital. Patient Care Providing patient care is the central and most significant responsibility of a hospital such as HUMC.

Within that basis, HUMC is also responsible for in-patient, ambulatory (out-patient), emergency, and rehabilitative care. Since the inception of the first hospital to the present, in-patient care remains an indispensable role of a hospital. In-patient care typically necessitates an overnight stay in the hospital. However, with the shifting of delivery, out-patient care uses fewer beds by using the facility for minimally invasive surgery such oral surgery, chemotherapy, and dialysis.

HUMC has an emergency/trauma department that treats “all ages from neonates to geriatrics” (Hackensack University Medical Center, 2010). Teaching and Research According to Healy and McKee (2001), “Teaching, research and patient care are highly interdependent. The health care system cannot exist without a supply of trained staff or the knowledge generated by appropriate research.

” Additionally, Healy and McKee (2001) continue to express about the teaching aspect of hospitals such as HUMC that: Teaching hospitals are a key component in any health system.

They directly affect the quality of new graduates but also indirectly affect the wider health care system. As training locations, their dominant beliefs and values influence medical and nursing students, many of whom, in their subsequent careers, will work in other parts of the health sector. (Healy & McKee, 2001) Community Health System Provision Another function of the hospital is to support the community’s health care services; this stipulates that HUMC not monopolize all the health services within the locality.

HUMC share resources with the health care system surrounding it as well as play a part in community initiatives. Administration Finally, the services of the hospital are organized by the administration. The administration is responsible for managing and coordinating activities in addition to creating policies for the hospital. With a complex health system such as HUMC and other hospitals that offers services that are based on the continuum of care concept, there are critical issues among stakeholders.

A stakeholder is “a person or group that has an investment, share, or interest in something, as a business or industry” (Dictionary. com, 2010). Three stakeholders that are affected by the continuum of care concept, not specifically HUMC, health care services in general are patients, providers, employers, and payers, such as a health insurance company.

As stated in the Duke University Quality Improvement Module, providers tend to view quality in a technical sense – accuracy of diagnosis, appropriateness of therapy, resulting outcome. Second, payers focus on cost-effectiveness.

Third, employers want to keep costs down and get employees back to work immediately. Last but not least, patients want compassion as well as skill with clear communication (Department of Community and Family Medicine, Duke University Medical Center, 2005).

As a result of the continuum of care model, which is to provide comprehensive care from the hospital to the home, conflicts emerge between patients and employers; and between providers and payers. Providers want to provide preventative care with the most modern and possible the most expensive treatment.

The conflict between the provider and payer surfaces when the payer does approve the providers’ treatment for the patient. The payers’ interest is accurate diagnosis and treatment with less visits and tests (Department of Community and Family Medicine, Duke University Medical Center, 2005).

The other stakeholders, the patient and employer are affected by the continuum of care concept as the patient assumes that the employer is to provide superior health benefits that is to be funded by the employer, with minimal out-of-pocket expenses to the employee.

On the contrary, the employer seeks to lower the cost of the employer contributed health plan. Some functions of HUMC are diagnosing and treating wounded and sick patients. Out-patients activities treat patients who can return home after a visit, such as in an emergency, doctors’ office, or the clinic. In-patient activities provide accommodations for patients who require extended medical attention after a medical procedure. As a teaching and research hospital HUMC has the advantage to perform research in advances in medicine.

The dynamics of the relationships between the stakeholders will continual present areas of concern within the continuum of care concept. References Buckeye Hills-Hocking Valley Regional Development District. (2010). Glossary: Continuum of Care. Retrieved March 1, 2010, from Area Agency on Aging District 8: http://www. areaagency8. org/glossary Clapp, R. (1993). Health care continuum: Nursing Homes: Long Term Care Management . Retrieved March 1, 2010, from MasterFILE Premier database. Department of Community and Family Medicine, Duke University Medical Center.

(2005). Patient Safety – Quality Improvement. Retrieved March 2, 2010, from Duke University Medical Center: http://patientsafetyed. duhs. duke. edu/module_a/introduction/stakeholders. html Dictionary. com. (2010). Define: Stakeholder. Retrieved March 2, 2010 , from http://dictionary. reference. com/browse/stakeholder Hackensack University Medical Center. (2010).

Retrieved March 1, 2010, from http://www. humc. com/ Healy, J. , & McKee, M. (2001). The Role and Function of Hospitals. Retrieved March 2, 2010, from http://www. euro. who. int/document/OBS/HIAC04. pdf.

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