Table of ContentsView AllTable of ContentsPrimary CareSecondary CareTertiary CareQuaternary CareOther Types of Care
Table of ContentsView All
View All
Table of Contents
Primary Care
Secondary Care
Tertiary Care
Quaternary Care
Other Types of Care
In medicine, there are four levels of care: primary, secondary, tertiary, and quaternary. The levels of care refer to the complexity of the medical cases that healthcare providers treat and the skills and specialties of the providers.
Primary care involves consulting with yourprimary care provider. Secondary care refers to seeing a specialist such as anoncologistorendocrinologist. Tertiary careis specialized care in a hospital setting such asrenal dialysisor heart surgery.Quaternarycareis an advanced level of specialized care.
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:
In addition, you’ll probably see a primary care provider (PCP) for regularhealth screenings, general checkups, and wellness visits.
Primary care providers may be:
There are some primary care specialties as well. For instance, obstetrics and gynecology (OB-GYN) specialists, geriatricians who treat older people, andpediatriciansare all primary care providers. But they also happen to specialize in caring for a particular group of people.
Most health insurance policies require you to designate a primary care provider. In most cases, you can choose a family practice physician, internist, OB-GYN, geriatrician, or pediatrician.
Why It’s Important to Understand Levels of CareUnderstanding the four levels of care empowers you to make better healthcare decisions for yourself. When it’s necessary to escalate your care and move to a different level, you can better anticipate what care will involve and where it will occur. You’ll also be better prepared to manage health insurance issues that may arise when you move to a new level.
Why It’s Important to Understand Levels of Care
Understanding the four levels of care empowers you to make better healthcare decisions for yourself. When it’s necessary to escalate your care and move to a different level, you can better anticipate what care will involve and where it will occur. You’ll also be better prepared to manage health insurance issues that may arise when you move to a new level.
Secondary Care: Specialists
Secondary care occurs when your primary care provider refers you to a specialist. Secondary care means your healthcare provider has transferred your care to someone who has more specific expertise in whatever health issue you are experiencing. They remain in contact with the specialist.
Specialists focus either on a specific system of the body or a particular disease or condition. Examples of specialists include:
Your insurance company may require that you receive a referral from your PCP rather than going directly to a specialist.
Sometimes problems arise in secondary care. These may include:
Tertiary Care and Hospitalization
If you are hospitalized and require a higher level of specialty care not available at that facility, your doctor may refer you to a tertiary care center.
While a secondary care hospital is typically a smaller facility that lacks specialized equipment, a tertiary-care hospital provides access to equipment and expertise to treat specific, complex health conditions.
Examples of medicine and procedures performed at tertiary care centers include:
Studies have shown that when you are in tertiary care for certain chronic conditions such as diabetes and chronic kidney disease, your PCP should 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 proceduresUncommon and specialized surgeries
The types of quaternary care include:
In addition to these four levels of care, there are other categories of healthcare that support your treatment. These types of care may be used at more than one level. They include:
Summary
Levels of care refer to the complexity of medical cases, the types of conditions a physician treats, and their specialties.
Primary care involves seeing your PCP for things like acute illnesses and injuries or to coordinate care among specialists. Secondary care involves seeing specialists such as oncologists. Tertiary care is a higher level of specialized care within a hospital. Similarly, quaternary care is an extension of tertiary care, but it’s more specialized.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mallender, J.What are Levels of Care? A Simple Guide.Harvard Medical School.Why do you need a primary care physician?Vimalananda VG, Meterko M, Waring ME, Qian S, Solch A, Wormwood JB,et al.Tools to improve referrals from primary care to specialty care.Am J Manag Care. 2019 Aug 1;25(8):e237-e242. PMID: 31419100.Beheshti L, Kalankesh LR, Doshmangir L, Farahbakhsh M.Telehealth in Primary Health Care: A Scoping Review of the Literature.Perspect Health Inf Manag. 2022 Jan 1;19(1):1n. PMID: 35440933Scaioli G, Schäfer WLA, Boerma WGW, Spreeuwenberg P, van den Berg M, Schellevis FG,et al.Patients' perception of communication at the interface between primary and secondary care: a cross-sectional survey in 34 countries.BMC Health Serv Res. 2019 Dec 30;19(1):1018. doi: 10.1186/s12913-019-4848-9.National Health Service.The healthcare ecosystem.Lo C, Ilic D, Teede H, et al.Primary and tertiary health professionals' views on the health-care of patients with co-morbid diabetes and chronic kidney disease - a qualitative study.BMC Nephrol. 2016;17(1):50. doi:10.1186/s12882-016-0262-2Joshi S, Smith Z, Soman S, Jain S, Yako A, Hojeij M,et al.Low- Versus High-Dose Methylprednisolone in Adult Patients With Coronavirus Disease 2019: Less Is More.Open Forum Infect Dis.2021 Dec 8;9(1):ofab619. doi: 10.1093/ofid/ofab619.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Mallender, J.What are Levels of Care? A Simple Guide.Harvard Medical School.Why do you need a primary care physician?Vimalananda VG, Meterko M, Waring ME, Qian S, Solch A, Wormwood JB,et al.Tools to improve referrals from primary care to specialty care.Am J Manag Care. 2019 Aug 1;25(8):e237-e242. PMID: 31419100.Beheshti L, Kalankesh LR, Doshmangir L, Farahbakhsh M.Telehealth in Primary Health Care: A Scoping Review of the Literature.Perspect Health Inf Manag. 2022 Jan 1;19(1):1n. PMID: 35440933Scaioli G, Schäfer WLA, Boerma WGW, Spreeuwenberg P, van den Berg M, Schellevis FG,et al.Patients' perception of communication at the interface between primary and secondary care: a cross-sectional survey in 34 countries.BMC Health Serv Res. 2019 Dec 30;19(1):1018. doi: 10.1186/s12913-019-4848-9.National Health Service.The healthcare ecosystem.Lo C, Ilic D, Teede H, et al.Primary and tertiary health professionals' views on the health-care of patients with co-morbid diabetes and chronic kidney disease - a qualitative study.BMC Nephrol. 2016;17(1):50. doi:10.1186/s12882-016-0262-2Joshi S, Smith Z, Soman S, Jain S, Yako A, Hojeij M,et al.Low- Versus High-Dose Methylprednisolone in Adult Patients With Coronavirus Disease 2019: Less Is More.Open Forum Infect Dis.2021 Dec 8;9(1):ofab619. doi: 10.1093/ofid/ofab619.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Mallender, J.What are Levels of Care? A Simple Guide.Harvard Medical School.Why do you need a primary care physician?Vimalananda VG, Meterko M, Waring ME, Qian S, Solch A, Wormwood JB,et al.Tools to improve referrals from primary care to specialty care.Am J Manag Care. 2019 Aug 1;25(8):e237-e242. PMID: 31419100.Beheshti L, Kalankesh LR, Doshmangir L, Farahbakhsh M.Telehealth in Primary Health Care: A Scoping Review of the Literature.Perspect Health Inf Manag. 2022 Jan 1;19(1):1n. PMID: 35440933Scaioli G, Schäfer WLA, Boerma WGW, Spreeuwenberg P, van den Berg M, Schellevis FG,et al.Patients' perception of communication at the interface between primary and secondary care: a cross-sectional survey in 34 countries.BMC Health Serv Res. 2019 Dec 30;19(1):1018. doi: 10.1186/s12913-019-4848-9.National Health Service.The healthcare ecosystem.Lo C, Ilic D, Teede H, et al.Primary and tertiary health professionals' views on the health-care of patients with co-morbid diabetes and chronic kidney disease - a qualitative study.BMC Nephrol. 2016;17(1):50. doi:10.1186/s12882-016-0262-2Joshi S, Smith Z, Soman S, Jain S, Yako A, Hojeij M,et al.Low- Versus High-Dose Methylprednisolone in Adult Patients With Coronavirus Disease 2019: Less Is More.Open Forum Infect Dis.2021 Dec 8;9(1):ofab619. doi: 10.1093/ofid/ofab619.
Mallender, J.What are Levels of Care? A Simple Guide.
Harvard Medical School.Why do you need a primary care physician?
Vimalananda VG, Meterko M, Waring ME, Qian S, Solch A, Wormwood JB,et al.Tools to improve referrals from primary care to specialty care.Am J Manag Care. 2019 Aug 1;25(8):e237-e242. PMID: 31419100.
Beheshti L, Kalankesh LR, Doshmangir L, Farahbakhsh M.Telehealth in Primary Health Care: A Scoping Review of the Literature.Perspect Health Inf Manag. 2022 Jan 1;19(1):1n. PMID: 35440933
Scaioli G, Schäfer WLA, Boerma WGW, Spreeuwenberg P, van den Berg M, Schellevis FG,et al.Patients' perception of communication at the interface between primary and secondary care: a cross-sectional survey in 34 countries.BMC Health Serv Res. 2019 Dec 30;19(1):1018. doi: 10.1186/s12913-019-4848-9.
National Health Service.The healthcare ecosystem.
Lo C, Ilic D, Teede H, et al.Primary and tertiary health professionals' views on the health-care of patients with co-morbid diabetes and chronic kidney disease - a qualitative study.BMC Nephrol. 2016;17(1):50. doi:10.1186/s12882-016-0262-2
Joshi S, Smith Z, Soman S, Jain S, Yako A, Hojeij M,et al.Low- Versus High-Dose Methylprednisolone in Adult Patients With Coronavirus Disease 2019: Less Is More.Open Forum Infect Dis.2021 Dec 8;9(1):ofab619. doi: 10.1093/ofid/ofab619.
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