Unit 1 Health care systems

1. Unit 1 Health care systems

2. Objectives • 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

3. History of Health CarePrimitive Times • 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

4. 3,000 BC – 300 BCAncient Egyptians • 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

5. 1700 BC – 220 ADAncient Chinese • 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

6. 1200 BC – 200 BCAncient Greeks • 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

7. 750 BC – 410 ADAncient Romans • First to organize medical care • Early hospitals • Began public health • Sanitation • Sewers • Water filtration • First to study infectious diseases • Life Span 25- 35

8. 400 – 800 ADDark Ages • 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

9. 800 – 1400 ADMiddle 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

10. 1350 – 1650renaissance • 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

11. 16th & 17th Centuries • Ambrose Pare - father of modern surgery • Established ligatures to bind arteries • Improved treatment of fractures & promoted artificial limbs • Invention of the micrscope

12. 18th Century • First mercury thermometer • Surgery standards were developed • Invention of eye glasses (Ben Franklin) • Vaccines were developed • Lifespan 40 – 50

13. 19th 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

14. 20th 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

15. 21st Century • Cell regeneration • Future Possibilities • Genetic Manipulation • Nerve and brain regeneration or transplant • Cures for AIDS & Cancer

16. Healthcare FacilitiesPrivate – fee for service • 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

17. Facilities • 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.

18. 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

19. Facilities • Health Maintenance Organizations (HMOs) – total healthcare focused on prevention • Industrial Health Centers – Work on site • School Health Services

20. Government Agencies • 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

22. 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

23. Voluntary & Non Profit Agencies • American Cancer Society • American Heart Association • American Red Cross • Many others • Supported by Donations • Provide health services at national level

24. Health Insurance Plans • 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

25. 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.

26. 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

27. Organizational Structure • Hospital vs Medical Office

28. Cost Containment • 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

29. Cost Containment • Outpatient Services – clinics instead of hospital • Mass or Bulk purchasing • Early Intervention or Preventative • Energy Conservation

30. Home Health Care • 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

31. Geriatric 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

32. Telemedicine • 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

33. Wellness • 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

34. Alternative &Complimentary Healthcare • Alternative – methods used in place of biological therapies • Complimentary – methods used with conventional medicine

35. 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

36. Alternative 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