The US health care system has had a far less structured approach to levels of care than the British NHS. With the dispersal model, individuals are allowed to contact a specialist themselves without having to see a primary care physician.

Boston University

There are three models: Primary, secondary, and tertiary care. Lord Dawson proposed that each of the levels of care should correspond with certain unique patient needs.

Models of Organizing Care

8th Edition by Thomas Bodenheimer and Kevin Grumbach

Understanding Health Policy: A Clinical Approach

Primary care involves common health problems (ex: sore throat, stomach aches, diabetes) and preventative medicine. Primary care makes up 80% - 90% of visits to a physician.

Primary Care

Secondary care involves problems that require more specialized clinical expertise such as hospital care for a patient with acute renal failure.

Secondary Care

Tertiary care, which lies at the apex of the organizational pyramid, involves the management of rare disorders such as pituitary tumors and congenital malformations.

Tertiary Care

The British NHS traditionally typified a relatively regimented primary–secondary–tertiary care structure. This is when you go see your physician and they will refer you to a specialist, you won't find your own specialist.

The Regionalized Model: The Traditional British National Health Service

The Dispersal Model: Traditional US Health Care Organization

Vertical and Horizontal integration is the new structures that are forming out of the health care system to assist hospitals to maximize their profits while helping patients be able to afford their care.

Vertical and Horizontal Integration

Premiums are lower in exchange for a high deductible, out of pocket expenses also tend to be high if the person does need care.

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