INTRODUTION TO HEALTH

PRESENTED BY :MRS. VRUTI PATEL,

LECTURER,SUMANDEEP NURSING COLLEGE

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CONCEPT OF HEALTH• Health is evolved over the centuries as a

concept from individual concern to world wide social goal and encompasses the whole quality of life. Changing concept of health till now are: – Biomedical concept– Ecological concept– Psychosocial concept– Holistic concept

CONCEPT OF HEALTH

BIO MEDICAL CONCEPT

ECOLOGICAL CONCEPT

PSYCHOSOCIAL CONCEPT

HOLISTIC CONCEPT

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BIOMEDICAL CONCEPT

• Traditionally, health has been viewed as an “absence of disease”, and if one was free from disease, then the person was considered healthy.

• This concept has the basis in the “germ theory of disease”.

• The medical profession viewed the human body as a machine, disease as a consequence of the breakdown of the machine and one of the doctor’s task as repair of the machine.

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ECOLOGICAL CONCEPT• Form ecological point of view; health is viewed

as a dynamic equilibrium between human being and environment, and disease a maladjustment of the human organism to environment.

• According to Dubos “Health implies the relative absence of pain and discomfort and a continuous adaptation and adjustment to the environment to ensure optimal function.”

• The ecological concept raises two issues, viz. imperfect man and imperfect environment.

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PSYCHOSOCIAL CONCEPT

• According to psychosocial concept “health is not only biomedical phenomenon, but is influenced by social, psychological, cultural, economic and political factors of the people concerned.”

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HOLISTIC CONCEPT• This concept is the synthesis of all the

above concepts. • It recognizes the strength of social,

economic, political and environmental influences on health.

• It described health as a unified or multi dimensional process involving the wellbeing of whole person in context of his environment .

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DIMENSIONS OF HEALTH • Health is multidimensional.• World Health Organization explained

health in three dimensional perspectives: physical, mental, social and spiritual.

• Besides these many more may be cited, e.g. emotional, vocational, political, philosophical, cultural, socioeconomic, environmental, educational, nutritional, curative and preventive..

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PHYSICAL DIMENSION

• Physical dimension views health form physiological perspective.

• It conceptualizes health that as biologically a state in which each and every organ even a cell is functioning at their optimum capacity and in perfect harmony with the rest of body.

• Physical health can be assessed at community level by the measurement of morbidity and mortality rates.

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MENTAL DIMENSION

• Ability to think clearly and coherently. This deals with sound socialization in communities.

• Mental health is a state of balance between the individual and the surrounding world, a state of harmony between oneself and others, coexistence between the relatives of the self and that of other people and that of the environment.

• Mental health is not merely an absence of mental illness.

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Features of mentally healthy person

• Free from internal conflicts.• Well – adjusted in the external environment.• Searches for one’s identity.• Strong sense of self-esteem.• Knows himself: his mind, problems and goal.• Have good self-controls-balances.• Faces problems and tries to solve them

intellectually.

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SOCIAL DIMENSION

• It refers the ability to make and maintain relationships with other people or communities.

• It states that harmony and integration within and between each individuals and other members of the society.

• Social dimension of health includes the level of social skills one possesses, social functioning and the ability to see oneself as a member of a larger society.

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SPIRITUAL DIMENSION• Spiritual health is connected with religious beliefs

and practices. It also deals with personal creeds, principles of behavior and ways of achieving peace of mind and being at peace with oneself.

• It is intangible “something” that transcends physiology and psychology.

• It includes integrity, principle and ethics, the purpose of life, commitment to some higher being, belief in the concepts that are not subject to “state of art” explanation.

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INDICATORS OF HEALTH • A variable which helps to measure

changes , directly or indirectly (WHO,1981).• The health indicators are defined as

those variables which measures the health status of an individual and community.

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INDICATORS OF HEALTH • Mortality Indicators: Crude Death rate, Life

Expectancy, Infant mortality rate, Child mortality rate, Under five mortality rate, Maternal mortality ratio, Disease specific mortality, proportional mortality rate etc.

• Morbidity Indicators: Incidence and prevalence rate, disease notification rate, OPD attendance rate, Admission, readmission and discharge rate, duration of stay in hospital and spells of sickness or absence from work or school.

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INDICATORS OF HEALTH

• Nutritional Status Indicators: Anthropometric measurement of preschool children, Prevalence of low birth weight etc.

• Health Care Delivery Indicators: Doctor-population ratio, Bed-nurse ratio, Population-bed ration, Population per health facility etc.

• Utilization Rates: immunization coverage, ANC coverage, % of Hospital Delivery, Contraceptives prevalence rate, Bed occupancy rate, average length of stay in hospital and bed turnover rate etc.

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INDICATORS OF HEALTH • Indicators of social and mental health: Rates of

suicides, homicides, violence, crimes, RTAs, drug abuse, smoking and alcohol consumption etc.

• Environmental indicators: proportion of population having access to safe drinking water and improved sanitation facility, level of air pollution, water pollution, noise pollution etc.

• Socio Economic Indicators: rate of population increase, Per capita GNP, Dependency ratio, Level of unemployment, literacy rate, family size etc.

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INDICATORS OF HEALTH • Health policy Indicators: proportion of GNP

spent on health services, proportion of GNP spent on health related activities including safe water supply, sanitation, housing, nutrition etc. and proportion of total health resources devoted to primary health care.

• Indicators of Quality of Life: PQLI, IMR, Literacy rate, Life Expectancy at age one etc.

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CONCEPT OF WELLBEING • Wellbeing of an individual or group of

individuals have several components and has been expressed in various ways, such as ‘standard of living’ or ‘level of living’ and ‘quality of live’.

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STANDARD OF LIVING

• Income and occupation, standards of housing, sanitation and nutrition, the level of provision of health, educational, recreational and other services all be used individually as measures of socioeconomic status, and collectively as an index of the standard of living.

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LEVEL OF LIVING• It consists of nine components : health, food

consumption, education, occupation and working conditions, housing, social security, clothing, recreation and leisure human rights.

• These objective characteristics are believed to influence human wellbeing. It is considered that health is the most important component of the level of living because its impairment always means impairment of the level of living.

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CONCEPT OF DISEASE • Ecological point of view disease is defined as

“a maladjustment of the human organism to the environment.”

• The simplest definition is that disease is just the opposite of health: i.e. any deviation from normal functioning or state of complete physical or mental well-being.

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Distinction between Disease, Illness and Sickness

• The term disease literally means “without ease” (uneasiness), when something is wrong with bodily function.

• Illness refers to the presence of a specific disease, and also to the individual’s perceptions and behavior in response to the disease, as well as the impact of that disease on the psychosocial environment.

• Sickness refers to a state of social dysfunction.

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Distinction between Disease, Illness and Sickness

• Disease is a physiological/psychological dysfunction.

• Illness is a subjective state of the person who feels aware of not being well.

• Sickness is a state of social dysfunction i.e. a role that the individual assumes when ill (sickness role).

HEALTH ILLNESS CONTINUUM

• According to Newman (1990) "Health on a continuum is the degree of client wellness that exists at any point in time, ranging from an optimal wellness condition with available energy at its maximum to death, which represents total energy depletion.“

• According to Health-illness continuum model, 'Health is a dynamic state that continuously alters as a person adapts to changes in the internal and external environments to maintain a state of physical, emotional, intellectual, social, developmental and spiritual well-being. Illness is a process in which the functioning of a person is diminished or impaired in one or more dimensions when compared with the person's previous condition'.

MODEL OF HEALTH AND ILLNESS

Spectrum of Health:• -Positive Health, Better Health• -Unrecognized sickness,• -Mild sickness,• -Severe sickness,• -Death. • The spectrum indicates that health of a person is not

a static condition, there arc always continuous changes that come in the health status and it is not possible to attain health once and for all.

• The literature supports the view that health and its attainment is a central concept and a goal of nursing practice.

1. A nurse can determine a client's level of health at any point on health illness continuum. A client's risk factors (variables) are important in identifying level of health. Risk factors include genetic and physiological variables.2 As a person progresses through the developmental stages, certain risk factors are common than others, e.g. Body image changes and self-concept.3. To help clients set goals to reach an optimal level of health, the nurse helps them identify their positions on the health-illness continuum

1. How many concepts of health?a. 1b. 2 c.3 d. 4 2. What is bio-medical concept?a. germ theory b. environment c. all of above d. none of above 3. What are ecological concepts?a. environment b. air c. water d. all 4. What is psychological concept?a. germ theoryb. environment c. psychology d. all 5. What is holistic concept?a. all of concept b. environment c. diseases d. none of above

Answer keys:-1. (D)2. (a)3. (a)4. (c)5. (a)

1. Howmany dimension are there?a. 1 b. 4 c. 5 d. 3 2. What is physical dimension?a. physical well-being b. environment c. air d. none of above 3. What is mental dimension?a. healthy b. mental condition c. air d. all of above 4. What is vocational dimension?a. related to air b. related to jobc. related to water d. none of above 5. Other dimension include?a. cultural dimension b. educational dimensionc. socio-economic dimension d. all of above

• Answer keys:-1. (d) 2. (a)3. (b)4. (a)5. (d)

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LEVELS OF PREVENTIONPrimordial Prevention : • Prevention from Risk Factors.• Prevention of emergence or development of

Risk Factors.• Discouraging harmful life styles.• Encouraging or promoting healthy eating

habits.

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LEVELS OF PREVENTION

Primary Prevention: • Pre-pathogenesis Phase of a disease.• Action taken prior to the onset of the disease: • Immunization & Chemo-prophylaxis

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LEVELS OF PREVENTIONSecondary Prevention:• Halt the progress of a disease at its incipient

phase.• Early diagnosis & Adequate medical

treatment.Tertiary Prevention:• Intervention in the late Pathogenesis Phase.• Reduce impairments, minimize disabilities &

suffering.

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MODES OF INTERVENTION• Intervention is any attempt to intervene or interrupt

the usual sequence in the development of disease. Five modes of intervention corresponding to the natural history of any disease are: –Health Promotion–Specific Protection–Early Diagnosis and Adquate Treatment–Disability Limitation–Rehabilitation

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HEALTH PROMOTION• It is the process of enabling people to increase

control over diseases, and to improve their health. It is not directed against any particular disease but is intended to strengthen the host through a variety of approaches(interventions):–Health Education– Environmental Modifications–Nutritional Interventions– Lifestyle and Behavioral Change

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SPECIFIC PROTECTION• Some of the currently available interventions

aimed at specific protection are:– Immunization– Use of specific Nutrients– Chemoprophylaxis– Protection against Occupational Hazards– Avoidance of Allergens– Control of specific hazards in general

environment– Control of Consumer Product Quality & Safety

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EARLY DIAGNOSIS & TREATMENT• Though not as effective and economical as ‘Primary

Prevention’, early detection and treatment are the main interventions of disease control, besides being critically important in reducing the high morbidity and mortality in certain diseases like hypertension, cancer cervix, and breast cancer.

• The earlier the disease is diagnosed and treated the better it is from the point of view of prognosis and preventing the occurrence of further cases (secondary cases) or any long term disability.

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DISABILITY LIMITATIONS

• The Objective is to prevent or halt the transition of the disease process from impairment to handicap.

Sequence of events leading to disability & handicap:

• Disease → Impairment → Disability→ Handicap

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DISABILITY LIMITATIONS• Impairment: Loss or abnormality of

psychological, physiological/anatomical structure or function.

• Disability: Any restriction or lack of ability to perform an activity in a manner considered normal for one’s age, sex, etc.

• Handicap: Any disadvantage that prevents one from fulfilling his role considered normal.

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REHABILITATION• Rehabilitation has been defined as the

‘combined and coordinated use of medical, social, educational and vocational measures for training and retraining the individual to the highest possible level of functional ability”

• Areas of concern in rehabilitation:–Medical Rehabilitation– Vocational Rehabilitation– Social Rehabilitation– Psychological Rehabilitation

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CONCEPT OF CONTROL

• DISEASE CONTROL: The term disease control refers ongoing operation aimed at reducing:– The incidence of disease.– The duration of disease and the consequently

the risk of transmission.– The effect of infection including physical and

psychological complication. – The financial burden to the community.

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CONCEPT OF CONTROL• In disease control, the disease agent is

permitted to persist in the community at a level where it ceases to be a public health problem according to the tolerance of local community. For example Malaria control programme. Disease control activities focus on primary prevention

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CONCEPT OF CONTROLELIMINATION: Reduction of case transmission to a predetermined very low level or interruption in transmission. E.g. measles, polio, leprosy from the large geographic region or area.

ERADICATION: Termination of all transmission of infection by extermination of the infectious agent through surveillance and containment. “All or none phenomenon”. E.g. Small pox

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CONCEPT OF CONTROL• MONITORING: Defined as “the performance

and analysis of routine measurement aimed at detecting changes in the environment or health status of population.” e.g. growth monitoring of child, Monitoring of air pollution, monitoring of water quality etc.

• SURVEILLANCE: Defined as “the continuous scrutiny of the factors that determine the occurrence and distribution of disease and other conditions of ill health.” E.g. Poliomyelitis surveillance programme of WHO.

BODY DEFENCE: IMMUNITY

The Body Defence Against Infection

The first line of defense against infection to the body is the normal flora/non specific defense, which helps to keep harmful bacteria from invading the body.

Eg. Mechanical and Chemical Barriers:- It involves the skin and mucous membrane. In these membranes, there are densely packed cells that protect the internal environment from the invasion by foreign cells. Substances such as sebum, mucus, HCI in gastric mucosa act as non-specific defences.

BODY DEFENCE: IMMUNITY

The Immune Response

Involves nonspecific reactions in the body as it responds to an invading foreign protein such as bacteria, and in some cases, the body’s own bacteria.

A complex mechanism that swing into action as the body attempts to protect and defend its self.

Antigen – the foreign body and the body responds to the antigen by producing an antibody.

BODY DEFENCE: IMMUNITY

The inflammatory responseThe inflammatory response is a

protective mechanism that eliminates the invading pathogen and allow tissue to repair by neutralising, controlling or eliminating the harmful agent and prepares the site for repair.

BODY DEFENCE: IMMUNITY

Types of Immunity

1. Innate immunity : the natural defence against infectious agent.

2. Active immunity : Acquired naturally after exposure to infection or it could be artificially acquired immunity resulting from administration of vaccine.

3. Passive immunity : naturally transferred from mother to fetus or could be by the artificial transfer of antibodies by parenteral administration.

BODY DEFENCE: IMMUNIZATION• Immunization is the process by which an

individual immune system becomes fortified against an agent.

• When the system is exposed to molecules that are foreign to the body, an immune response is set off, and the body develops the ability to quickly respond to a subsequent encounter because of immunological immunity that has been acquired.

• T cells, B cells and antibodies are improved by immunisation.

• Vaccination• Introduction of Foreign

molecules in to the body

• Body generate imm.

Active

• Presynthesised elements of immune system

• Antibodies Passive

IMMUNIZATION

• BCG (TB) – At Birth• OPV - At Birth, 6 wks, 10 wks, 14 wks till 5 years• HBV – At birth, 6 wks, 10 wks, 14 wks• Pentovalent - 6 wks, 10 wks, 14 wks• Measles – 9 months• MMR – 15 months• Typhoid vaccine – 2 yrs.• TT – 10+ 15 Yrs.

HEALTH CARE TEAM :-

• Definition:- The health team consists of a group of people who coordinate their particular skills in order to assist a patient or his family. The personnel, who comprise a particular team, will depend upon the needs of the patient.

• The personnel commonly included In the health team are:

• 1. The Physician: - In hospital setting, the physician is responsible for the medical diagnosis and for determining the therapy required by a person who is ill or injured. A physician is a person who is legally authorized to practice medicine in particular jurisdiction.

• 2. The Nurse: - A number of nursing personnel may be involved in health team and may have their own nursing team. A 'nursing team' composed of personnel who provide nursing services to a patient or his family. The team leader 'head nurse' is responsible for delegation of duties to members of her team and care given to the patients.

• 3. The Dietitian or Nutritionist: - When dietary and nutritional services are required, dietitian or' nutritionist may also be a member of health team. Dietitians design special duties and they supervise the preparation of meals according to doctor's prescription. The nutritionist in a community setting recommends healthy diets for people and is frequently involved in broad advisory services in regard to purchase and preparation of food.

• 4. The Physiotherapist:-The physiotherapist provides assistance to a patient who has problem related to his musculoskeletal system.

Functions of Physiotherapist are:

5. The Social Worker:-• The patient and his/her family are assisted by social

worker with such problems as finances, rest home accommodation, counseling or marital problems, adoption of children.

6. The Occupational therapist:- • The occupational therapist assists patients with some

impairment of function to gain skills as they are related to Activities of Daily Living (ADL) and help with a skill that is therapeutic.

• It provides some satisfaction ego Teaching a man who has severe arroyos, in his arms and hands how to adjust kitchen utensils so that he can continue to cook.

7. The Paramedical Technologist;-It includes laboratory technologists, radiologic technologists.• • Laboratory technologists:-Examine and study specimens

such as urine, faeces, blood and discharges from wound.

• • Radiologic technologist:-Assists with wide variety of x-ray procedures, from simple chest radiograph to more complex fluoroscopy. Through use of radioactive materials, nuclear medicine technologist can provide diagnostic information about functioning of a patient's liver etc.

8. The Pharmacist:-The pharmacist prepares and dispenses pharmaceuticals in hospital and community settings. The role of pharmacist in monitoring and evaluating the actions and effects of medications on patients is becoming increasingly prominent.

• 9. The Inhalation Therapist: - The inhalation therapist or respiratory technologist is skilled in therapeutic measures used in care of patients with respiratory problems. These therapists are knowledgeable about oxygen therapy devices, intermittent positive pressure breathing respirators, artificial mechanical ventilators, accessory devices used for inhalation therapy.

HEALTH CARE DELIVERY SYSTEM IN INDIA

India is a union of 28 states and 7 union territories. States are largely

independent in matters relating to the delivery of health care to the people.

Each state has developed its own system of health care delivery, independent of

the Central Government.

• The Central Government responsibility consists mainly

• of policy making , planning , guiding, assisting, evaluating and

• coordinating the work of the State Health Ministries.

The health system in India has 3 main links

Central

• 1. Ministry of Health and Family Welfare

• 2. The Directorate General of Health Services

• 3. The Central Council of Health and Family Welfare

State Local

• 1.Sub –division• 2.

Tehsils(Talukas )• 3. Community

Development Blocks

• 4. Municipalities and Corporations

• 5. Villages and• 6. Panchayats

DISTRICT COLLECTOR

SUBDIVISION 2-3 ASST./SUBCOLLECTOR

TALUKAS 200-600 VILLAGE TEHSILDAR

COMMUNITY DEVELOPMENT BLOCK BLOCKDEV.OFFICER 800000-120000 population

MUNICIPAL BOARDS MUNICIPAL COMISSIONER

CORPORATION (ABOVE 200000)

Panchayat Raj -The panchayat raj is a 3-tier structure of rural local self-government in India,linking the village to the districtØ Panchayat (at the village level)Ø Panchayat Samiti( at the block level)Ø Zila Parishad(at the district level)

PANCHAYAT (AT THE VILLAGE LEVEL):

The Panchayat Raj at the village level consists ofThe Gram SabhaThe Gram Panchayat

The Gram Sabha considers proposals for taxation,and elects members of The Gram Panchayat.

The Gram Panchayat covers the civicl administration including sanitation and public health and work for the social and economic developmentof the village.

PANCHAYAT SAMITI (AT THE BLOCK LEVEL):

Ø The Panchayat Samiti execute the community development programme in the block. The Block Development Officer and his staff give technical assistance and guidance in development work.

ZILA PARISHAD (AT THE DISTRICT LEVEL:

Ø The Zila Parishad is the agency of rural local self government at the district level . Its functions andpowers vary from state to state.

HEALTH CARE AGENCIES• The health care system is intended to deliver the

health care services. It is represented by five major sectors or agencies which differ from each other by the health technology applied and by the source of funds for operation. These are :

1) PUBLIC HEALTH SECTOR : • (a) Primary Health care Primary Health centers sub-centers

(b) Hospitals/Health centers community health centers Rural hospital District Hospitals Specialist Hospitals Teaching Hospital(c) Health Insurance Schemes Employees state Insurance Central Govt. Health Scheme(d) Other agencies Defense services Railways

2) PRIVATE SECTOR (a)Private hospitals, polyclinics , Nursing

homes , and dispensaries (b) General practitioners and clinics 3) INDIGENOUS SYSTEMS OF MEDICINE Ayurveda and siddha Unani and Tibbi Homoeopathy Unregistered practitioners 4) VOLUNTARY HEALTH AGENCIES 5)NATIONAL HEALTH PROGRAMMES

PRIMARY HEALTH CARE

• Definition:

“Primary health care is essential health care based on practical, scientifically sound and socially acceptance method and technology made universally accessible to individual’s families in the community through their full participation and cost which the community and country can afford to maintain at every stage of their development.” - Alma ata declaration.

ELEMENTS OF PRIMARY HEALTH CARE

1. Education concerning prevailing health problems and the methods of preventing and controlling them.

2. Promotion of food supply and proper nutrition.3. Maternal and child health care, including family

planning.4. Adequate safe water supply and basic sanitation.5. Immunization against major infectious diseases.6. Prevention and control of local endemic diseases.7. Appropriate treatment of common diseases.8. Provision of essential basic household drugs for

the community.

PRINCIPLES OF PRIMARY HEALTH CARE

COMMUNITY PARTICIPATION

EQUITABLE DISTRIBUTION

PHC

MULTI SECTORIAL APPROACH

APPROPRIATE HEALTH

TECHNOLOGY

FOCUS ON PREVENTION

• EQUITBLE DISTRIBUTION:- It means that health service must shared equally by all people irrespective of their ability to pay, and all the people rich or poor, rural or urban must have access to health services because the distribution of health & family welfare services, & also other related services, i.e. educative income.

COMMUNITY PARTICIPATION:-

It is the process by which individual, families & communities assume responsibilities in promoting their own health & welfare.

For the success of primary health care, community involvement & participation will be most vital. Community involvement concerned with the levels of community resident participation in health decision making.

To promote the development of the community & the community’s self reliance, resident themselves need to participate in decision about health of the community. Resident & health providers need to work together in partnership to seek solution to the complex problem facing community today.

APPROPRIATE HEALTH TECHNOLOGY:- • Appropriate technology refers to health care that is

relevant to people’s needs & concerns as well as being acceptable to them.

• It includes issues of costs & affordability of resources as the number & type of health professionals & other worker, equipment & their pattern of distribution throughout the community.

• In other words “ appropriate technology means those which are decentralized, require low capital investment, conserve natural resources, are managed by their users, & are in harmony with the environment.

• Thus appropriate technology is the technology which is scientifically or technically sound, adaptable to local needs, culturally acceptable & financially feasible.

MULTI SECTORIAL APPROACH:-

• Health & family welfare programmes cannot stand on its own in an isolated manner.

• it is recognized that health of a community cannot be improved by intervention within just health sector; other sectors are equally important in promoting the communities health & self reliance.

• These are agriculture, irrigation, animal husbandry, education, housing, public works, rural development, co-operatives, industries, and panchayats.

• Therefore, these sectors need to work together in a multi sectorial approach to co-ordinate their goal, plans & activities to ensure conflicting or duplicating efforts.

COMPONENTS OF PRIMARY HEALTH CARE

PRIMARY HEALTH

CARE

IMMUNIZATION HEALTH EDUCATION MCH CARE

SANITATION ADEQUATE NUTRITION

PRAMOTION OF MENTAL HEALTH

PREVENTION OF ILLNESS

PROVISION OF DRUGS

• Population coverage of health centers

HEALTH CENTERS Coverage of population living in plain area

Coverage of population living in hilly/tribal area

Sub centers 5000 3000

Primary health center 30000 20,000

Community health center

1,20,000 80,000

ROLE OF NURSE IN PHC

Direct care provider

Teacher & Educator

Supervisor & Manager

Researcher Evaluator

HOSPITAL

According to WHO :- A hospital is an integral part of a social and medical organization, the function of which is to provide for the population, the complete health care, both curative and preventive and whose outpatient services reach out to the family and its home environment. The hospital is also a Centre for the training of health worker and for bio-social research.

Classification of Hospitals

The most commonly accepted criteria for classification of modern hospital are according to:-• Length of stay of patient (Long term, Short term)• Clinical basis• Ownership/control basis• Objectives• Size• Management• System of medicine

• Classification according to length of stay of patient :-A patient stays for a short time in hospital for treatment of disease that is acute in nature, such as pneumonia, peptic ulcer etc. A patient may stay for a long term in a hospital for treatment of diseases that are chronic in nature such as TB, Leprosy, cancer etc. The hospitals according to long term and short term are also known as chronic care hospitals and acute care hospitals.

• Classification according to Clinical Basis :- These are

the licensed hospitals and are considered as general hospitals, treat all kinds of diseases, major focus on treating condition such as heart diseases, cancer etc.

Classification according to ownership/ control

• On the basis of ownership/Control, hospitals can be divided into four categories:

• Public hospitals.• Voluntary hospitals. • Private!/charitable hospitals/ nursing

houses, • Corporate hospitals,

CLASSIFICATION ACCORDING TO OBJECTIVES:- • TEACHING CUM REASEARCH HOSPITAL - It is a hospital to which a

college is attached for medical/nursing/ dental/pharmacy education, the main objective of these hospitals is teaching based on research and the provision of health care is secondary. e.g.:- f IMS, PCIMER, Chandigarh.

• GENERAL HOSPITAL ;-Are those which provide treatment for common diseases and conditions. The main objectives of these hospitals are to provide medical care to the people. e.g.:- All distinct and taluses or PHC or rural hospitals belong to this type.

• SPCIALIZED HOSPITAL: are those that provide medical and nursing care primarily for only one discipline on a specific disease or condition of one system such as TB, ENT, Leprosy, STD's etc.

• ISOLATION HOSPITAL:- are those hospitals in which the persons suffering from infectious/ communicable diseases require isolation. e.g.:- Epidemic disease hospital, Bangalore .

CLASSIFICATION ACCORDING TO SIZE 1. Teaching hospital - 500 (bed to be increased

according to !lumber of students). 2. District Hospital 200 (bed to be increased

upto 300 depending upon population). 3. Taluka Hospital - 50 (May be raised depending

upon population to be served). 4. Primary Health centers - 6 (May be increased

upto 10).

CLASSIFICATION ACCORDING TO MANAGEMENT • UNION GOVERNMENT/GOVERNMENT OF INDIA:- All hospitals

administered by the government of India. e.g:- Hospitals run by Railways, military/ defense etc.

• STATE GOVERNMENT: - Hospitals administered by state/ union territory including police, prison, irrigation department etc

• LOCAL BODIES:- Hospitals are administered by local bodies i.e,muncipal corporation, zila prishad, panchayat etc. e.g:- co-operation maternity houses.

• AUTONOMUS BODIES: - All hospitals established under special act of parliament or state legislation and founded by the central/ state government e.g. AIlMS, PCI etc.

• PRIVATE:-All private hospitals are owned by an individual or by private Organization e.g.: MAHC Manipal, Hinduja Hospital.

• Voluntary agency: - All hospitals are operated by a voluntary body/ a trust/charitable society etc. It includes hospitals run by missionary bodies and co-operations. e.g: CMC, Vellore

CLASSIFICATION ACCORDING TO SYSTEM

• Allopathic hospitals, • Ayurveda hospitals• Homeopathic hospitals,• Unani hospitals, • Hospitals of other systems of

medicine.

FUNCTIONS OF HOSPITAL• Care of sick and Injured:- Hospital is an medical institution where

client suffering from some disease/health problem is getting treated and cared. Comprehensive care is provided to the sick/injured client by health care team. Clients are treated according to priority or needs. For example: Emergency care is provided to client with Heart attack than the client came with general weakness.

• prevention of disease:-. Prevention of disease is accomplished by early screening, detection of risk prone cases. Maintaining aseptic technique, following the principles of medical care can prevent the occurrence of certain complications. For example: Immunization schedule for children, tetanus injection during pregnancy.

• promotion of health:- A client who is maintaining his health can accomplish higher level of health. In hospital setting, various aspects of health promotion are taken. For example: Health education, supplementation, regular checkup.

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• Diagnosis and treatment of diseases:- As soon as client approaches the health care team, a complete assessment is done. Afterward medical diagnosis is made And treatment is started.

• Scientific Application Of Mental Hygiene And Mental Therapy:-Mental health is an important aspect of a healthy person. Client suffering from stress, mental health 28 problems are getting treated if'. h0spitals. Counseling is also done in the hospital setting.

• Rehabilitation: Rehabilitation is the process where an individual is reeducated, particularly where an individual has been ill/injured to enable them for becoming capable of useful activity. For example: Rehabilitation care is given to client who underwent for mastectomy, amputation etc.

• Medical Education: Hospital attached with medical colleges/nursing colleges are providing education to the students. They are taught how to care for a client. How to provide individualized medical care, how to tackle emergency cases. With this, they are gaining clinical skill as well as knowledge.

• Research: incidence prevalence rate, mortality rate etc. are calculated from the hospital settings. Prevalence of disease is done by conducting research. Etc. in the hospital.