Health Care Settings

Physicians and other health care practitioners provide health care to people in a variety of settings depending on their needs. Common health care settings include hospitals and long-term, subacute, home, and ambulatory care facilities.

Hospitals

Hospitals are acute care settings, in which health care professionals deliver care to patients who are experiencing sudden illness or injury. Patients may be treated in the emergency department or admitted for medical and nursing care on a 24-hour basis. Depending on the size and type of hospital, it may include a number of specialty units, such as orthopedics, medical, oncology, pediatrics, maternity, surgery, and intensive care. Hospitals may be designated as providing Level I, II, or III trauma care, depending on the types of injuries they are equipped to deal with. Some hospitals,
designated as teaching hospitals, are affiliated with medical schools. Teaching hospitals employ medical school residents, who are physicians in the process of obtaining further clinical training after internship, usually as a member of the hospital staff. These residents provide much of the physician related care in these hospitals under the supervision of licensed physicians. A growing number of hospitals have day-surgery units where uncomplicated surgeries are performed. Patients generally are admitted and discharged from such units in the same day. Hospitals are further designated as private or nonprofit. Private hospitals are commonly owned by stockholders and run by companies.

Nonprofit hospitals have a community-service focus and are generally run by a board of directors.While these hospitals may make a profit, all such monies must be reinvested in the
hospital. Physicians must possess hospital privileges in order to see patients in a hospital. Before a hospital grants such privileges, it will consider such factors as the physician’s education, licensure, experience, and prior revocation of privileges or actions against the physician’s license.

Long-Term Care

Long-term care (LTC) facilities, also known as nursing homes, provide skilled nursing care for people who are deemed medically stable yet unable to attend to activities of daily living (ADLs) without assistance. Such people are generally referred to as residents rather than patients because the LTC facility is their home. Sometimes, a person’s stay at an LTC facility may be temporary; however, it is more commonly permanent. While nurses and nurses’ aides provide care for the residents, the aim of care is to create a homelike atmosphere to the greatest extent possible, where residents have opportunities for social, physical, and creative activities.

Subacute Care

Subacute care facilities provide a level of care somewhere between that of the acute care and long-term care facilities. A patient’s stay in such a facility is usually longer than in acute care, but still temporary. The purpose of the patient’s stay is commonly rehabilitation activities with the goal of supporting the patient in regaining enough strength, mobility, and function to return home or to a semi-independent assisted-care setting.

Home Care

Home care is a setting in which individuals are able to remain in their own private homes with the help of private nurses, trained aides, chore services, and other types of assistance. Another setting that falls under the umbrella of home care is the increasingly popular adult family homes that are becoming more common in many communities, also known as assisted living facilities. The owners of such facilities are generally licensed by the state to provide housing, meals, and limited health care services to a specified number of residents. Most adult family homes accept only private-pay patients and do not provide intensive nursing care. However, they are an attractive option for people who are unable to live independently yet are not in need of LTC placement.

Ambulatory Care

The term ambulatory means “to walk or move about freely.” An ambulatory care facility is one that provides medical care to nonresidential patients who do not stay overnight. Most medical assistants work in ambulatory care settings, such as physicians’ offices and medical clinics.