While many people are familiar with primary care (at least to the extent that they have a primary care provider), not everyone realizes that there are multiple levels of patient care within the healthcare field. Unless you work directly in healthcare, there’s a chance you’ve never heard of secondary, tertiary or quaternary care. Whether you’re thinking about going into the healthcare field or simply want to be a more informed patient, understanding the different levels of healthcare is important.

What Are the Different Levels of Patient Care?

There are four levels of patient care within the healthcare system: primary, secondary, tertiary and quaternary. However, the concept of quaternary care (the fourth level of care) is contested by some medical professionals and providers (more on that later).

In addition to these main levels of care, other levels of healthcare may included emergency and urgent care, hospice care, long-term care and mental health care.

Importance of Levels of Care in Healthcare

Why do the different levels of healthcare matter, anyway? If every patient ends up receiving the care necessary to address their health needs, is it really necessary to distinguish between different levels of care and care systems?

It is critical to make this distinction for several reasons. For starters, establishing different levels of healthcare creates a comprehensive system for evaluating patients’ medical needs and escalating care to specialists and providers as needed.

Because each level of care comes with its inherent services and responsibilities, providers at each level can personalize their healthcare services to optimize the patient experience while improving patient outcomes.

From a patient’s perspective, understanding different levels of care is just as important. Patients can be empowered to advocate on behalf of their medical and health needs by understanding the care offered by providers at each level, as well as the steps it may take to get a referral.

Levels of Care in Healthcare

Now that you have a better idea of why the levels of care in healthcare are so important, it’s time to dive into what each level entails in terms of the patient experience, services provided and provider responsibilities. It is also worth noting that these levels of healthcare are often intertwined, so knowing how they can relate to each other will also be critical to understanding how the healthcare field operates as a whole.

What Is Primary Care?

Primary care is the first level of healthcare and the one most people are familiar with. Providers at this level include primary care physicians, nurse practitioners, pediatricians and doctors.

Primary care providers are often the first medical professionals a patient will see when they are sick, injured or experiencing symptoms that may require further testing. Primary care providers also help prevent people from getting sick by offering wellness visits and general checkups.

Services and Responsibilities

As the first and broadest level of care, there is a wide range of services that may be offered by a primary care provider. Some examples of services commonly offered at this level include:

  • Immunizations
  • Annual health and wellness visits
  • Care for injuries, such as rashes or minor lacerations
  • Care for some illnesses, such as a cold or an infection
  • Assessment of symptoms or other health problems
  • Referrals to specialists

Primary care providers play a vital role in making sure that patients receive the care they need based on the severity of their symptoms, improving patient outcomes and decreasing the misuse of emergency department visits or other hospital resources.

What Is Secondary Care?

When a patient has health or medical needs that extend beyond the scope of a primary care provider, they will typically be referred to a secondary care provider. These are specialists (such as cardiologists, oncologists and dermatologists) who can provide additional expertise and more tailored services.

Services and Responsibilities

The exact services provided by a secondary care professional will vary depending on the type of provider, but some of the most common secondary care services include:

  • Diagnostic testing (such as heart scans, blood work or X-rays)
  • Acute care (treatment for short-term illness or injury)
  • Inpatient and outpatient care

Day case surgery (when a patient needs a procedure that does not require a hospital stay)

Typically, a referral from a primary care provider is needed for a patient to receive secondary care—but this is not always the case. Secondary care providers play a significant role in ensuring patients receive the right follow-up care by communicating and coordinating with primary care providers to keep all parties informed.

What Is Tertiary Care?

The next level of healthcare is known as tertiary care, which usually occurs when a patient is hospitalized or requires a more specialized level of care than a primary or secondary professional can provide. Working in tertiary care requires a great deal of expertise and the use of highly specialized equipment that can often only be found in a hospital.

Services and Responsibilities

Tertiary care providers can offer a wide range of services depending on a patient’s unique needs. Some examples of the kinds of services and procedures offered in tertiary care include:

  • Complex treatments and procedures
  • Burn treatments
  • Heart surgery and other complicated surgeries
  • Dialysis

Even for patients who have already been hospitalized, it is sometimes necessary to transfer a patient to another hospital for the right tertiary care. This is because not all hospitals are equipped with the same technology or staff the same specialists. Regardless of where care is provided, all tertiary care professionals have a responsibility to communicate with secondary and primary care providers to ensure everyone is on the same page.

What Is Quaternary Care?

There’s a bit of controversy around the concept of quaternary care and whether it constitutes a true level of care. This is because quaternary care is mostly an extension of tertiary care that is provided in situations where a patient’s health needs require an even higher degree of specialization. Because of the highly specialized nature of quaternary care, this level of care is not offered at every hospital.

Services and Responsibilities

There are essentially two types of quaternary care offered at this level: experimental medicine and procedures and highly specialized surgeries. In many cases, patients who require quaternary care will need to travel long distances to receive the services they need. Even at this level, quaternary care providers should be in constant communication with primary, secondary and tertiary providers to provide the most comprehensive care.

Other Levels of Care in Healthcare

In addition to these four main levels of healthcare, there are several other levels of care to consider that often fall outside of these realms. In some cases, these levels may overlap in terms of the services provided and the responsibilities involved. Still, patients and healthcare providers alike need to understand the unique nuances involved with each level of care.

Emergency and Urgent Care

Both emergency and urgent care play an integral role in the overall healthcare system. Patients at this level of care are seeking out medical assistance that requires immediate attention—often due to a sudden injury or illness.

It is worth noting that there are some differences between emergency care and urgent care. Typically, emergency care is provided only in a hospital setting, such as an emergency department. It is offered to patients experiencing severe health problems or injuries requiring immediate medical attention. In some cases, prompt treatment of these illnesses or injuries could be a matter of life and death. Emergency departments are staffed 24 hours a day, seven days a week so patients can receive the care they need at any time.

Urgent care, on the other hand, is slightly less severe than emergency care. Patients will often visit an urgent care provider when experiencing injuries or illnesses that need quick attention but are not necessarily life-threatening. In some cases, patients may also turn to an urgent care provider when they need medical care outside of their primary care provider’s usual business hours—as urgent care facilities are usually open on evenings and weekends.

Hospice Care

Hospice care is typically provided when there is no cure for a patient’s illness and, usually, when the patient’s life expectancy is six months or less. The goal of hospice care is to ensure that the patient has the best quality of life and is as comfortable as possible. Hospice care providers must be available 24 hours a day, seven days a week to ensure that a patient’s needs are met.

Hospice care can be provided in many settings. Some patients may end up at a hospice care facility, whereas others may receive hospice care at home or in a community living facility. This level of care often includes bereavement care and other emotional support services for the families and loved ones of the patient. These services may be available for months or even years after the patient passes away.

Specific services that may be offered by a hospice care provider range greatly but may include:

  • Administration of medication for pain relief and symptom control
  • Physical and occupational therapy
  • Dietary counseling
  • Delivery of medical equipment
  • Grief and loss counseling

Long-Term Care

When a patient is no longer able to perform basic activities (such as dressing, bathing or feeding themselves), a long-term care provider may be involved to improve the patient’s quality of life. Long-term care is most often provided to seniors who may have trouble getting around or may be dealing with medical problems that prevent them from caring for themselves. In these cases, patients may receive long-term care by moving to a care facility or by having long-term care providers visit them at home.

Although most commonly utilized by seniors, long-term care can be provided to people of all ages and backgrounds. Some examples of the types of services offered in long-term care include:

  • Home health care
  • Personal care (dressing, feeding and personal hygiene support)
  • Adult daycare

Mental Health Care

Mental health care addresses a patient’s emotional, social and psychological health and well-being. Providers in this level of care include social workers, psychologists, therapists, counselors and psychiatrists. These professionals help to diagnose, treat and manage any number of mental health disorders, including:

  • Anxiety and depression
  • Bipolar disorder
  • Eating disorders
  • Post-traumatic stress disorder (PTSD)

Treatments for mental health disorders range from therapy and counseling to medication, behavioral therapy, support groups and inpatient/outpatient treatment centers.

Interested in Learning More About Healthcare?

Interested in taking your healthcare career to the next level? Your first step is a quality education. Keiser University offers a variety of graduate programs in the healthcare field, including:

No matter where your interests lie, Keiser University is here to support your healthcare education. Learn more about our graduate-level healthcare degree and certificate programs by speaking with an admissions counselor today.