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Differentiating Between Primary, Secondary, and Tertiary Care

Primary care, secondary care, and tertiary care are categories of medical practice designed to address the specific needs of patients based on the level of complexity of their medical conditions and the resources required to treat them. Patients who experience common illnesses will generally visit primary-care providers such as general practitioners, family doctors, or pediatricians; patients with more complex or serious illnesses will usually seek out the expertise of secondary-care providers such as specialists, surgeons, or psychiatrists; and patients with life-threatening diseases that may require extensive treatments will generally visit tertiary-care hospitals that offer highly specialized equipment and highly skilled healthcare professionals.

Primary Care – A Medical Home with High Touch

Primary care provides medical services for healthy people who are 18 or older. It usually includes regular check-ups, diagnosing and treating illnesses with simple treatments, managing chronic diseases such as diabetes or high blood pressure, and providing preventive health services like annual physicals. Primary care providers can include doctors of any specialty including family practice, internal medicine, pediatrics, obstetrics/gynecology, or psychiatry.
Primary care providers typically work in a medical home—a place that offers a full range of healthcare services under one roof with a family doctor. The medical home is often the first stop for new patients looking for a provider to take their insurance because it is likely to have an established relationship with the insurance company.
Most medical insurance plans require members to choose a primary care provider (PCP) to handle health-related issues. In other words, you have to go to your PCP for most medical conditions, including those that need more specialized care. That’s a big difference from going straight to a specialist without ever seeing your doctor first. And in some cases—if you have urgent medical problems or are looking for second opinions on surgery or other treatments—you may want to choose another doctor as your primary care provider.

Secondary Care – An Academic Teaching Hospital

In an academic teaching hospital, for example, someone needs surgery after a serious injury and needs quaternary care. Medical professionals who provide quaternary care have extensive knowledge of surgical procedures and are trained to deal with emergencies. They also have access to more advanced treatments, such as mechanical ventilators and extracorporeal membrane oxygenation.
There are situations in which quaternary care is provided outside of academic teaching hospitals. For example, a tertiary care center could provide quaternary care if it has specialized surgical equipment or highly trained personnel. It is also possible to receive quaternary care in some EMS units that have been designed specifically so that ALS procedures and ECMO can be administered.
Hospitals are considered tertiary care facilities. Patients who need specialized treatment from other areas can also find it in your city or state.

Tertiary Care – A Center of Excellence With Interdisciplinary Expertise

A tertiary care center is an institution that specializes in medical conditions that require more complex treatments than what is available at a primary or secondary care facility. A tertiary care hospital can provide the expertise of specialists in fields like cardiac surgery, cancer treatment, and stroke rehabilitation. In some cases, patients are referred to a tertiary care hospital by their primary physician because they are dealing with a condition that falls outside of their scope of practice. Other times, people may come to the facility on their own accord because they’ve been told it’s one of the best facilities for their specific type of injury or illness.
Since tertiary care is a relatively advanced level of care, it’s important that patients get there quickly after they’ve patients must get. This will help ensure they receive fast treatment for their condition and reduce any potential complications. Some people may be admitted to a tertiary care facility before their condition has even been fully diagnosed because emergency room staff have observed signs or symptoms of a serious illness. In some cases, patients with rare illnesses are referred to a tertiary care facility if they are unable to find anyone who can properly treat them at a lower level of care.

Section 4 – A Level IV NICU

A Level IV NICU is a hospital with the most highly trained providers. These hospitals have special pediatric intensive care units (PICUs) to treat critically ill newborns.
A Level IV NICU can also be called a pediatric critical care unit (PCCU) or children’s intensive care unit (CICU). This type of unit is designed to treat seriously ill children with complex medical needs. PICUs are staffed by well-trained doctors and nurses who provide 24-hour monitoring of the patient’s condition. The staff may include pediatricians, neonatologists, cardiologists, neurologists, anesthesiologists, intensivists, and other specialists. A Level IV NICU can treat patients from birth up to 18 years old.
In a Level IV NICU, life-saving care is available around-the-clock. The medical team in a PICU may be able to use special equipment to perform surgery or drain fluid from a patient’s lungs. If heart defects are present in a newborn, for example, catheterization may be performed so that extra blood can be drained away from the heart. This type of service is not offered by hospitals at lower levels of care.

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