Hospital Organization
BACKGROUND
Hospitals continue to be the largest segment of the health care industry, measured by economic volume and delivery of a wide range of professional services.
HEALTH CARE SERVICES
The different segments of the health care delivery system provide various combinations of services. The specific combination offered depends on a variety factors that prevail in a location, including state and local licensing laws, reimbursement structures, availability of medical personnel and facilities, and the demographic details (such as age and industrial distribution) of the potential patient population. The unique aspect of the health care industry from an audit perspective is the health care delivery system – the revenue cycle. The other cycles are essentially similar to those in manufacturing or selling enterprises.
Services are generally described by a six-level classification. Those levels indicate, but do not strictly define, the type of organization, the level of medical treatment involved, or the severity of, or prognosis for, the medical situation. The levels are:
• Preventive – Health education and prevention programs provided by business and other organizations, such as schools and family planning clinics.
• Primary – Early detection and routine treatment of health problems, such as are often provided by physicians’ offices, industrial and school health units, and hospital outpatient and emergency departments.
• Secondary – Acute care services, typically provided by medical personnel, through hospitals, using elaborate diagnostic and treatment procedures.
• Tertiary – Highly technical services, such as for psychiatric and chronic diseases, provided through specialty facilities and teaching hospitals.
• Restorative – Rehabilitative and follow-up acre, typically provided by home health agencies, nursing homes, and halfway houses.
• Continuing – Long-term, chronic care, typically provided by geriatric day care centers and
Hospitals continue to be the largest segment of the health care industry, measured by economic volume and delivery of a wide range of professional services.
HEALTH CARE SERVICES
The different segments of the health care delivery system provide various combinations of services. The specific combination offered depends on a variety factors that prevail in a location, including state and local licensing laws, reimbursement structures, availability of medical personnel and facilities, and the demographic details (such as age and industrial distribution) of the potential patient population. The unique aspect of the health care industry from an audit perspective is the health care delivery system – the revenue cycle. The other cycles are essentially similar to those in manufacturing or selling enterprises.
Services are generally described by a six-level classification. Those levels indicate, but do not strictly define, the type of organization, the level of medical treatment involved, or the severity of, or prognosis for, the medical situation. The levels are:
• Preventive – Health education and prevention programs provided by business and other organizations, such as schools and family planning clinics.
• Primary – Early detection and routine treatment of health problems, such as are often provided by physicians’ offices, industrial and school health units, and hospital outpatient and emergency departments.
• Secondary – Acute care services, typically provided by medical personnel, through hospitals, using elaborate diagnostic and treatment procedures.
• Tertiary – Highly technical services, such as for psychiatric and chronic diseases, provided through specialty facilities and teaching hospitals.
• Restorative – Rehabilitative and follow-up acre, typically provided by home health agencies, nursing homes, and halfway houses.
• Continuing – Long-term, chronic care, typically provided by geriatric day care centers and