Unit 1 Health care systems

Differentiate between early/current beliefs. Identify at least 10 major events in history

of healthcare Describe at least 8 different health care

facilities Describe at least three non profit services Identify five current trends in health care

Objectives

Believed illness were caused by supernatural spirits and demons.◦ Tribal witch doctors treated illnesses◦ Ceremonies, Herbs and plants used as medicine◦ Morphine for pain, Digitalis for heart◦ Average Life span was about 20 years◦ Boring holes in head for insanity, epilepsy and

headaches

History of Health CarePrimitive Times

• First Health Records• Called upon Gods Physicians were

priests who studied medicine and surgery

• Believed body was system of channels, used leaches to unclog channels

• Used magic and medical plants• Lifespan 20 -30

3,000 BC – 300 BCAncient Egyptians

• Religious beliefs prohibited dissection• Monitored pulse to monitor condition of

body• Recorded pharmacology of plants• Used acupuncture• Began search for medical reason for

illness • Life span 20-30

1700 BC – 220 ADAncient Chinese

Began modern medical science by observing effects of disease

Identified brain as physiological site for senses Hippocrates “Father of Modern Medicine”

◦ Developed and organized method to observe◦ Recorded signs and symptoms◦ Created high levels of ethics & standards still used

today◦ Stressed diet and cleanliness◦ Used therapies, massage, art herbal◦ Life span 25-35

1200 BC – 200 BCAncient Greeks

• First to organize medical care• Early hospitals• Began public health•Sanitation•Sewers•Water filtration•First to study infectious diseases

◦ Life Span 25- 35

750 BC – 410 ADAncient Romans

• Emphasis on saving soul• Went back to prayer and divine intervention• Monks and priests provided care for sick

people• Medications were mainly herbal mixtures• Life span 20- 30

400 – 800 ADDark Ages

• Renewed interest in medical practice of Greeks & Romans

• Physicians began gaining knowledge at medical Universities

• Pandemic (world wide epidemic killed 75% of Europe & Asia, Bubonic plague)

• Arab physicians used chemistry to advance pharmaceuticals

• Arabs started requiring physicians to pass exam• Life span 20 - 35

800 – 1400 ADMiddle Ages

• Rebirth of science in medicine• Dissection of body began to better allow

understanding of anatomy & physiology• Michelangelo & Da Vinci began to draw

dissection to make more realistic• First books of medicine published• Lifespan 30 - 40

1350 – 1650renaissance

• Ambrose Pare - father of modern surgery• Established ligatures to bind arteries• Improved treatment of fractures &

promoted artificial limbs• Invention of the micrscope

16th & 17th Centuries

• First mercury thermometer• Surgery standards were developed• Invention of eye glasses (Ben Franklin)• Vaccines were developed • Lifespan 40 – 50

18th Century

• First successful blood transfusion• First Stethoscope• Either was used as an anesthetic• First Nurses program (Florence Nightingale)• Chloroform was used as an esthetic• First use of disinfectants and antiseptics

before surgery• Lifespan 40 -60

19th Century

• Classification of Blood Groups• Study of Psychology and psychiatry• Vaccines• Penicillin• Machines – heart /lung• Organ transplants• Test tube baby• Insurance• Cloning• Lifespan 60 - 70

20th Century

• Cell regenerationFuture Possibilities• Genetic Manipulation• Nerve and brain regeneration or transplant• Cures for AIDS & Cancer

21st Century

Hospitals ◦ Private or Proprietary◦ Vary in size◦ Vary in Services

Long Term Care (LTCs)◦ Provide assistance and care for elderly (ADLs)◦ Residents◦ Care for individuals with disabilities◦ Some called nursing homes or geriatric homes

Healthcare FacilitiesPrivate – fee for service

Independent & Assisted Living◦ Provide care for those that can help themselves◦ Rent or purchase and apartment in facility◦ Services like meals, housekeeping, laundry,

transportation, social & basic medical care.

Medical Offices◦ Doctor run◦ Vary in services – diagnosis, treatment, exam, lab

work, testing & minor surgery.

Facilities

Dental Clinics – satellite clinics Optical Centers Emergency Care services – EMS, Fire & Rescue Laboratories – blood, urine, dental molds Home Health Care – provide care in home Hospice – care for terminally ill, <6 months Mental Health – mental disorders or disease Genetic Counseling – pregnancies Rehabilitation – physical, occupational, speech

Facilities

Health Maintenance Organizations (HMOs) – total healthcare focused on prevention

Industrial Health Centers – Work on site School Health Services

Facilities

World Health Organization (WHO) – International org. compiles statistics & info on diseases, publish health info, addresses serious health issues world wide

US Dept. of Health & Human Services (USDHHS) – Deals with health problems in US

National Institute of Health (NIH) – research on diseases

Centers for Disease Control and Prevention (CDC) – causes, spread control of diseases

Government Agencies

Food and Drug Administration (FDA) – regulates food and drug products sold to public

Agency for Healthcare Policy and Research (AHCPR) – research quality of healthcare & identify standards of treatments

Occupational Safety and Health Administration (OSHA) – establishes and enforces standards that protect workers from job related injuries

Government Agencies

American Cancer Society American Heart Association American Red Cross Many others

Supported by Donations Provide health services at national level

Voluntary & Non Profit Agencies

Health Care Costs 12% of US Economy Insurance helps pay for costs

◦ Limits and/or deductibles –amount paid by patient before insurance

◦ Co-Insurance ie: 80% - 20%◦ Co-payment – specified $ paid each visit

Health Insurance Plans

HMO – premium paid each month and set cost to patient each visit at specific doctor with a “Plan”

PPO (Preferred Provider Organization)- Patients are restricted to who they can use as a physician and patients pay a percentage of charges

Medicare – insurance for over 65, operated by Federal Government

Medicaid – insurance for low income, operated by States.

Health Insurance Plans

Workers Compensation – health insurance for injuries on the job

Managed Care – Ins. Company plans your care. All care must have a purpose, 2nd opinions prior to surgeries.◦ Focus on prevention◦ Keep costs down

Health Insurance Plans

Hospital vs Medical Office

Organizational Structure

Hot topic – trying to control rising costs mainly from new technology, advanced procedures (ie: heart surgery) and liability

Rising age population – use more medicines and more chronic disease

Diagnostic Related Group (DRGs) – one payment to hospital depending on diagnosis. Decreases hospital stay time

Combination of services – shared services to labs, clinics, etc. instead of each having its own

Cost Containment

Outpatient Services – clinics instead of hospital

Mass or Bulk purchasing Early Intervention or Preventative Energy Conservation

Cost Containment

Rapidly growing field Shorter hospital stays created need for

home care Return to day of doctors making house calls

– cheaper than maintaining a office or clinic

Home Health Care

Care for elderly Rapid growing field due to increase age of

population – age expectancy increases Baby Boomers (born after WWII – 1960) Adult Day Care Centers Retirement Communities Assisted/Independent Living Facilities Omnibus Budget Reconciliation Act

(OBRA) – states require training and competency evaluation for workers

Geriatric Care

Involves use of video, audio, and computers to provide medical services◦ EMS transmit EKG to Hospital for diagnosis (dx)◦ Xrays, scans can all be read at home or in office

so Drs can serve multiple facilities◦ Robotics surgery from miles away◦ Electronic machines can send info to Drs from

patient homes

Telemedicine

Physical Wellness – well balanced diet, exercise, routine physicals

Emotional Wellness – understanding feeling, expressing oneself appropriately, accepting limitations, coping with stress

Social Wellness – showing concern for others, interacting well with others

Mental Wellness – being creative, open minded challenging the mind

Spiritual Wellness – values, morals ethics

Wellness

Alternative – methods used in place of biological therapies

Complimentary – methods used with conventional medicine

Alternative &Complimentary Healthcare

Ayurveda practitioners - depending on body type: uses prescribe diet, herbal, yoga to maintain body harmony

Chinese Medicine – holistic based, flow of energy (chi) , acupuncture/pressure Tai Chi & herbal

Chiropractors – brain sends signals down spine to control body, misalignment can interfere with flow from brain

Alternative/Complimentary Healthcare

Homeopaths – body self heals through immune system

Hypnotists- trancelike state uses suggestions to bring about behavioral change

Naturopaths – uses natural therapies like fasting, special diets cleansing to promote healing

Alternative Healthcare