Transcript Health Care Systems

Health Care Systems
Historical Events In Health Care
• Hippocrates (400 BC) --- father of medicine
• Created high standards of ethics
• Ancient Greek
• 18th Century
• Edward Jenner (1796) --- first vaccination; smallpox
• 19th Century
• Ignaz Semmelweis (1840) – wash hands
• Florence Nightingale (1860) – founder of modern nursing
• Gregory Mendel (1870) --- father of genetics & inheritance
• Robert Koch (1890) --- father of microbiology
• William Roentgen (1895) – discovered X-rays
• 20th Century
• 1920’s --- health insurance plans first appeared
• Sir Alexander Fleming(1928) – discovered penicillin
• Dr Papanicolaou (1940) --- exfoliative cytology
• Dr Jonas Salk (1955) --- polio vaccine
• 1960 – birth control pills
• 1960’s – organ transplants
• 1970’s – HMO concept appeared
• 1978 – IVF
• 1980’s– AIDS pandemic
• 1997 – sheep cloned
Health Care Facilities
• Hospitals
– Private (proprietary)
– Nonprofit
– Government
– General care hospitals
– Specialty care hospitals
• Long Term Care
Facilities(LTC)
– Nursing homes
– Geriatric homes
– Extended care facilities
• Independent/assisted Living
Facilities
• Medical offices
• Dental Offices
• Optical Centers
• Clinics
– Multispecialty
– Single specialty
– Surgicenters
– Urgent/emergency care
– Mental health
– Substance abuse
• Home Health Care
• Hospice
• Rehabilitation centers
• HMO organizations
• Industrial care centers
• School health services
Government Agencies
• WHO
• USDHHS
• NIH
• CDC
• FDA
• OSHA
• State & local health departments
Voluntary/Nonprofit Agencies
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American Cancer Society
American Red Cross
March of Dimes
American Diabetes Association
National Association of Mental Health
These agencies provide:
– Special services to victims of disease
– Research into the disease
Health Insurance Plans
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1960’s = all covered (subscriber & beneficiaries); no exclusions; no co-payment
1970’s = coverage limited ; exclusion of pre-existing conditions; no co-payment
1980’s = coverage limited; exclusions; co-payments
1990’s = HMO’s with all covered; private plans as in 1980’s but larger co-payments
• Managed care plans emerge(HMO’s, PPO’s, etc)
» Develop lists of “what is medically necessary” (see next slide)
Health Insurance Plans
• Health Insurance Terminology
• Deductibles
• Co-insurance ( usually in percentages)
• Co-payment (usually in dollar amounts)
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HMO
Private fee-for-service plans
PPO
Medicare
• Type A -- the facilities
• Type B – the health deliverer
• Medicaid
• Worker’s Compensation
Organizational Structure
• This refers to the chain of command
• It indicates areas of responsibility
• Shows one their immediate supervisor
Trends in Health Care
• Cost Containment Methods
• DRG’s (diagnostic related groups)
• Combination of services
• Outpatient services
• Mass purchasing
• Preventive services
• Energy conservation
• Home Health Care
• Can involve all aspects of health care
Trends in Health Care
• Geriatric care
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Adult day care centers
Retirement communities
Assisted living facilities
Long term care facilities
OBRA = omnibus budget reconciliation act (1987& 1989)
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Established regulations for nursing assistants
Develop measures of health care quality
Compliance with patient’s rights
Regulations regarding long-term & home health care
Key = to ensure certain “standards of care”
• Telemedicine
Trends in Health Care
• Wellness
• Holistic Health Care = promotes physical, emotional, social,
intellectual, by treating the whole body, mind and spirit and
spiritual well being
• Physical wellness
• Emotional wellness (e.g. stress management) (cup half full)
• Social wellness --- tolerance
• Mental & intellectual wellness --- open-minded, continual
education
• Spiritual wellness --- ethics & morals
• Wellness is determined by lifestyle choices
Alternative Methods of Health Care
• Acupressure (Shiatsu)---- use of hands to apply pressure to specific points of the
body to stimulate the flow of energy
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Acupuncture---------------- use of needles to stimulate the flow of energy
Antioxidants --------------- inhibit oxidation of free radicals
Aromatherapy------------- use of aromas to alter mood & restore spirit
Biofeedback---------------- use of devices to show pts their response to stress
Healing touch (Reiki) ---- use of hand pressure to energy centers of body to stimulate
healing
• Homeopathy--------------- use of chemicals to stimulate disease to encourage ones
immune system to go into action
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Hydrotherapy
Hypnosis -------------------- use of trance-like state to make pt more receptive to suggestion
Imagery --------------------- images to induce soothing
Ionization therapy -------- use of ionizers to make negatively charged air particles to treat
respiratory illness
Alternative Methods of Health Care
• Macrobiotic diet ------ use of diet to balance “yin & yang”
• Yin= dark; yang = light/ everything has its opposite
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Meditation ---------- use of breathing & muscle relaxation to quiet the mind (reduce stress)
Pet therapy ------------- use of animals to stimulate interest in life
Phytochemicals ------ use of plant chemicals to treat disease
Play therapy------------- use of toys to stimulate children to “come out of their shells”
Positive thought------- develop self esteem & self-love to allow the body to heal
Reflexology -------------- uses foot pressure to send energy to an affected body part
Spiritual therapies--- use of prayer to get spiritual guidance to produce a sense of well-being
Tai Chi ---------------use of slow, graceful body movements & breathing to improve energy flow
Therapeutic massage (Swedish)
Therapeutic touch ----- use of hands to locate changes in body’s energy field
Yoga --------------------- use concentration & positions to balance energy flow