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Introduction to Healthcare and Public Health in the US

This lecture covers the organization and structure of the Department of Veterans Affairs (VA) and the Military Health System (MHS), including their services, benefits, and strategic goals. It also discusses different healthcare facilities within the VA system.

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Introduction to Healthcare and Public Health in the US

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  1. Introduction to Healthcareand Public Health in the US Delivering Healthcare (Part 1) Lecture b This material (Comp1_Unit2b) was developed by Oregon Health and Science University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number IU24OC000015.

  2. Delivering Healthcare (Part 1)Learning Objectives • Describe the organization of healthcare at the federal, state and local levels (Lecture a) • Describe the organization of the VA system and Military Health System (Lecture b) • Describe the structure and function of hospital clinical and administrative units (Lecture c) • Describe different types of long term care facilities, with an emphasis on their function (Lecture d) Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  3. Department of Veterans Affairs (VA) Overview • Is a department of the federal government • Established in 1930 • Provides medical care, benefits, social support, memorials • Serves veterans and their families • For all branches of military service Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  4. VA Structure 1.2 Chart: (va.gov, ND) Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  5. VA Strategic Goals • Improve quality of life for veterans with disabilities • Ease the transition from military to civilian life • Honor veterans in life and after death • Contribute to public health, emergency readiness, and socioeconomic well-being • Deliver high-quality service to veterans through optimal personnel, technology, business practices, and financial resources Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  6. VA Services and Benefits 1.3 Chart: (va.gov, ND) Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  7. VA Capacity • 153 hospitals • 956 community-based outpatient clinics • 134 community living centers • 90 domiciliary (residential) care programs • 232 community-based Vet Centers • 57 veterans benefits regional offices Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  8. VA Hospitals • Single hospitals –and– • Healthcare systems • Groups of medical centers, clinics • Share resources; improve efficiency • Examples • VA Pittsburgh Healthcare System • VA Puget Sound Healthcare System Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  9. VA Community-Based Outpatient Clinics • Freestanding clinics • Routine care • Every state and territory • Accessible and convenient Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  10. VA Community Living Centers • Similar to nursing homes • Skilled nursing facilities • Veterans with special concerns • Chronic health conditions • Need for rehabilitation • End-of-life care Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  11. VA Domiciliary Care Program • Oldest element in VA healthcare system • Called “soldiers’ homes” in late 1860s • Residential treatment for veterans with: • Severe medical conditions • Mental illness, substance abuse, psychosocial problems • Operate together with the VA’s mental health residential rehabilitation and treatment programs • Goals are healthy behaviors, quality of life, integration into society Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  12. VA Vet Centers • Counseling for combat veterans and their families • Every state and territory • Services include help with: • Readjustment to civilian life • Medical problems • Military sexual trauma • Substance abuse • Bereavement Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  13. Veterans IntegratedServices Networks (http://www2.va.gov/directory/guide/division.asp?dnum=1, 2011) Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  14. Military Health System (MHS): Overview • Operated by the Department of Defense • For U.S. active-duty military personnel and their families • Structure: • Secretary of Defense for Health Affairs • Medical departments of the military branches • Combatant Command surgeons • Providers in the TRICARE healthcare program (including private companies) Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  15. MHS: TRICARE Program Overview • Group of managed care plans • Comprehensive, low-cost options • Network of physicians, hospitals, pharmacies • Active duty, retirees, families; all service branches • Most common coverage plans • TRICARE Prime (health maintenance organization) • TRICARE Standard • TRICARE for Life (retirees) • TRICARE Reserve Select • Also overseas options, family care Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  16. MHS: TRICAREProgram Benefits • 1.4 Chart: (MHS.com, ND) Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  17. MHS: Goals ofDeployable Medicine • Effective healthcare wherever troops go • Specific goals include: • First-responder care • Essential care (life and limb) • Definitive care • Care during transfer to another medical facility • Logistics (supplies, equipment) • Education, training, information technology Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  18. MHS: Disaster Response • Mass-casualty violence • Homeland defense • Flu outbreak preparedness • Humanitarian assistance after natural disaster • International health initiatives • North Atlantic Treaty Organization (NATO) • International Committee of Military Medicine Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  19. MHS: Education and Research • Education • Teaching hospitals • Defense Medical Readiness Training Institute • Joint Theater Trauma System (JTTS) Clinical Practice Guidelines • Tactical Combat Casualty Care • Research • Congressionally Directed Medical Research Programs • Military Infectious Diseases Research Program • TriService Nursing Research Program Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  20. Delivering Healthcare (Part 1)Summary – Lecture b • VA • Is a department of the federal government • Serves veterans after discharge • MHS • Run by the U.S. Department of Defense • Serves veterans during military service • Common goals • Benefit all service members and their families • Maximize physical and mental health • Provide logistical and/or financial assistance Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  21. Delivering Healthcare (part 1)References – Lecture b References Department of Veterans Affairs. 2010 Organizational Briefing Book. Washington, DC: Office of Human Resources and Administration, Office of Administration; 2010. Henry J. Kaiser Family Foundation. Military and veterans’ health care. http://www.kaiseredu.org/Issue-Modules/Military-and-Veterans-Health-Care/Background-Brief.aspx. Accessed April 5, 2011. Lumina Foundation. Today’s GI Bill: Connecting America’s veterans to higher education—FAQ. http://www.todaysgibill.org/faq/#6. 2009. Accessed April 6, 2011. Military Health System. Frequently asked questions (FAQs): general MHS questions. http://www.health.mil. Accessed April 5, 2011. Military Health System. TRICARE. http://www.tricare.mil. Accessed April 6, 2011. National Naval Medical Center. National Capital Consortium. http://www.bethesda.med.navy.mil/careers/graduate_medical_education/gme_residencies/pharmacy/PGY1%20Residency%20Packet.pdf. Accessed April 7, 2011. U.S. Army 20th Support Command. Chemical, Biological, Radiological, Nuclear, High-Yield Explosives. http://www.cbrne.army.mil. Accessed April 6, 2011. U.S. Department of Veterans Affairs. http://www.va.gov. Updated April 5, 2011. Accessed April 5, 2011. Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

  22. Delivering Healthcare (part 1) References – Lecture b (continued) Images Slide 13: Map of Veteran’s Integrated Services Network , or VISN, units in the US. Available from http://www2.va.gov/directory/guide/division.asp?dnum=1 Charts, Tables, Figures 1.2 Chart: Organizational chart for the Department of Veterans Affairs. Structure of the VA. Available from http://www.va.gov/ofcadmin/docs/vaorgchart.pdf 1.3 Chart: VA Services. 1.4 Chart: Post-traumatic stress disorder, traumatic brain injury Introduction to Healthcare and Public Health in the US Delivering Healthcare (part 1) Lecture b

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