Primary Hospital
Primary hospital refers to the work of health
professionals who act as the first point of consultation for all patients
within the health care system. Such a professional would usually be a primary
care physician, such as; a general practitioner or family physician. Another professional
would be a licensed independent practitioner such as; a physiotherapist, or a non-physician
primary care provider such as; a physician assistant or nurse
practitioner. Depending on the locality,
and health system organization the patient may see another healthcare
professional first, such as a pharmacist or nurse. Depending on the nature of
the health condition, patients may be referred for secondary or tertiary
care.
The primary hospital is often used as the term for the
health care services that play a role in the local community. It can be
provided in different settings, such as; Urgent care centers which provide same-day
appointments or services on a walk-in basis.
Primary hospital involves the widest scope of health
care, including all ages of patients, patients of all socioeconomic and
geographic origins, patients seeking to maintain optimal health, and patients
with all types of acute and chronic physical, mental and social health issues,
including multiple chronic diseases. Consequently, a primary hospital
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, health
education, and every time they require an initial consultation about a new
health problem. The International Classification of Primary Care (ICPC) is a standardized
tool for understanding and analyzing information on interventions in primary hospitals
based on the reason for the patient's visit.
Common chronic illnesses usually treated in a primary
hospital may include, for example:
hypertension, diabetes, asthma, COPD, depression and anxiety, back pain,
arthritis, or thyroid dysfunction. The primary hospital also includes many
basic maternal and child health care services such as; family planning services
and vaccinations.
In India, Primary hospital is provided through a
network of Sub centers and Primary Health Centers in rural areas, whereas in
urban areas, it is provided through Health posts and Family Welfare Centers.
The Sub center consists of one Auxiliary Nurse Midwife and Multipurpose Health
worker and serves a population of 5000 in plains and 3000 persons in hilly and
tribal areas. The Primary Health Center (PHC), staffed by Medical officers and
other paramedical staff serves every 30000 population in the plains and 20,000
persons in hilly, tribal, and backward areas. Each PHC is to supervise 6 Sub
centers.
In the context of global population aging, with
increasing numbers of older adults at greater risk of chronic non-communicable
diseases, rapidly increasing demand for primary hospital services is expected
in both developed and developing countries. The World Health Organization
attributes the provision of the essential primary hospital as an integral
component of an inclusive primary health care strategy.
Secondary Hospital
Secondary hospital refers to the second tier of the health
system, in which patients from primary health care are referred to specialists
in higher hospitals for treatment. In India, the health centers for secondary
health care include; District hospitals and Community Health centers at the block
level.
The secondary hospital includes; acute care, and necessary
treatment for a short period for a brief but serious illness, injury, or other
health condition. This care is often found in a hospital emergency department. The
secondary hospital also includes skilled attendance during childbirth,
intensive care, and medical imaging services.
The term "secondary care" is sometimes used
synonymously with "hospital care."
However, many secondary care providers, such as; psychiatrists, clinical
psychologists, occupational therapists, most dental specialties, or
physiotherapists do not necessarily work in hospitals. 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.
Physiotherapists are both primary and secondary care providers that do not
require a referral. Allied health professionals, such as; physical therapists,
respiratory therapists, occupational therapists, speech therapists, and
dietitians, also generally work in secondary care, accessed through either
patient self-referral or a physician referral.
Tertiary Hospital
A tertiary hospital refers to the third level of the health
system, in which specialized consultative care is provided usually on referral
from primary and secondary medical care. Specialized Intensive Care Units,
advanced diagnostic support services, and specialized medical personnel on the
key features of tertiary health care. In India, under the public health system,
tertiary care service is provided by medical colleges and advanced medical
research institutes.
Examples of tertiary care services are cancer
management, neurosurgery, cardiac surgery, plastic surgery, treatment for
severe burns, advanced neonatology services, and palliative and other complex
medical and surgical interventions.
Quaternary Hospital
The term quaternary hospital is sometimes used as an
extension of a tertiary hospital about advanced levels of medicine which are
highly specialized and not widely accessed. Experimental medicine and some
types of uncommon diagnostic or surgical procedures are considered a quaternary
hospitals. These services are usually only offered in a limited number of
regional or national healthcare centers. The quaternary hospital is more
prevalent in the United Kingdom.