In medicine, levels of care refer to the complexity of the medical cases doctors treat and the skills and specialties of the providers. Levels are divided into the following categories:
- Primary care
- Secondary care
- Tertiary care
- Quaternary care
As a patient, you might sometimes hear these terms. So knowing their definitions can help you better understand what your doctor is talking about and help you recognize the level of care you’re receiving.
Primary Care: Essentials
Most people are very familiar with primary care. This office is your first stop for most of your symptoms and medical concerns. You might seek primary care for the following:
- Illness: You may see your primary care doctor when you notice a new symptom or when you come down with a cold, the flu, or some other infection.
- Injury: You may also seek primary care for a broken bone, a sore muscle, a skin rash, or any other acute medical problem.
- Referral: Also, primary care is typically responsible for coordinating your care among specialists and other levels of care, such as with radiology scans (MRIs, CT scans, X-rays, and more)
In addition, you’ll probably see a primary care provider (PCP) for regular screenings, general checkups, and wellness visits.
Primary care providers may be:
- Nurse practitioners
- Physician assistants
There are some primary care specialties as well. For instance, OB-GYNs, geriatricians, and pediatricians are all primary care doctors. But they also happen to specialize in caring for a particular group of people.
Studies have shown that primary care providers benefit the healthcare system by:
- Enhancing access to healthcare services
- Providing better health outcomes
- Decreasing hospitalization and use of emergency department visits
Secondary Care: Specialists
Secondary care is when your primary care provider refers you to a specialist as well as radiology specialists. Secondary care means your doctor has transferred your care to someone who has more specific expertise in whatever health issue you are experiencing.
Specialists focus either on a specific system of the body or a particular disease or condition. Examples of specialists include:
- Cardiologists focus on the heart and blood vessels.
- Endocrinologists focus on hormone systems, including diseases like diabetes and thyroid disease.
- Oncologists specialize in treating cancers, and many focus on a specific type of cancer.
Tertiary Care and Hospitalization
If you are hospitalized and require a higher level of specialty care, your doctor may refer you to tertiary care. Tertiary care requires highly specialized equipment and expertise.
At this level, you will find procedures such as:
- Coronary artery bypass surgery
- Plastic surgeries
- Severe burn treatments
- Complex treatments or procedures
A small, local hospital may not be able to provide these services. So, if you require more advanced care, they may need to transfer you to a medical center that provides highly specialized tertiary level services.
When you are in tertiary care for certain chronic conditions such as diabetes and chronic kidney disease, your PCP must remain involved. That’s because your PCP can help you establish and maintain a management plan for the long term.
Quaternary care is considered an extension of tertiary care. However, it is even more specialized and highly unusual.
Because it is so specific, not every hospital or medical center offers quaternary care. Some may only provide quaternary care for particular medical conditions or systems of the body.
The types of quaternary care include:
- Experimental medicine and procedures
- Uncommon and specialized surgeries
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