Chapter 01

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Chapter 01

History and Trends of Health Care

Leslie Connor

Global regarding repro disclaimer: Core text style is "Web site"; discrepancy OK?


1:1 History of Health Care

• Some treatment methods used today are from ancient times

• Herbs utilized in the past for both food and medicine are found in medications today


Ancient Times

• Illness and disease were believed to be caused by evil spirits and demons or as punishment from the gods

• Health records were first recorded by the ancient Egyptians


Ancient Times (continued)

• Chinese believed in the need to cure the spirit and nourish the body

• Hippocrates and other physicians in ancient Greece established the importance of diet and cleanliness in preventing illness and disease


Ancient Times (continued)

• Romans implemented use of sewers for waste and aqueducts (waterways) for clean water

• In ancient times causes of disease had not been discovered and many illnesses were fatal

• Average life span of 20 to 35 years


The Dark Ages and Middle Ages

• Interest in the medical practices of Greeks and Romans

• In the 1300s an epidemic of bubonic plague killed nearly 75% of the population of Europe and Asia

• Average life span of 20 to 35 years


The Renaissance

• Rebirth of the science of medicine• Human dissection to view body organs• Printing press allowed publication of medical

books• Causes of disease were still a mystery• Average life span of 30 to 40 years


The 16th, 17th, and 18th Centuries

• Knowledge of human body greatly increased• Invention of microscope• Apothecaries (early pharmacists) made,

prescribed, and sold medications• Smallpox vaccine discovered• Average life span of 40 to 50 years


The 19th Century

• Industrial Revolution– Development of machines– Major progress in medical science

• Invention of stethoscope, nurse training programs

• Infection control • Average life span of 40 to 65 years


The 20th Century

• Rapid growth in health care• X-rays, medicines, and vaccines to prevent

disease developed• The structure of DNA and research in gene

therapy (ongoing today)• Health care plans


The 20th Century (continued)

• First open-heart surgery in 1950s• Computer technology in every aspect of

health care• Unlimited possibilities for medical science in

the future• Average life span of 60 to 80 years


The 21st Century

• Human Genome Project• Embryonic stem cell and cloned cell research• Threat of bioterrorism with the use of biologic

agents as weapons• Viruses that can cause pandemics


1:2 Trends in Health Care: Cost Containment

• Control rising cost of health care and achieve maximum benefit for every dollar spent

• Reasons for increasing costs– Technological advances– Aging population– Health-related lawsuits


Cost Containment (continued)

• Methods– Diagnostic related groups (DRGs)– Combination of services– Outpatient services– Mass or bulk purchasing– Early intervention and preventive services– Energy conservation


Home Health Care

• Industry grew rapidly when DRGs were initiated

• Services provided in a patient’s home• Trend is a return to home care of earlier years• Form of cost containment


Geriatric Care

• Care for the elderly• Percentage of elderly population growing

rapidly• Baby boomers entering geriatric age• Need for more and different types of facilities


OBRA

• Omnibus Budget Reconciliation Act (OBRA) of 1987

• Federal regulation for long-term care and home health care

• States must establish training and competency evaluation programs for nursing/geriatric assistants


OBRA (continued)

• States must maintain a registry of qualified individuals

• Requires compliance with patients’ and residents’ rights

• States must establish guidelines so that these rights are observed/enforced


Telemedicine

• Use of video, audio, and computers to provide medical/health care services

• Decreases need for medical center visits• Decreases need for home health visits• Telemedicine will be important to health care

delivery in the future


Wellness

• State of optimum health• Balance between physical, social, and mental

health• Focus on disease prevention and quality of life– Saves costs

• Exercise, nutrition, weight control, and healthy living habits


Wellness (continued)

• Physical wellness• Emotional wellness• Social wellness• Mental and intellectual wellness• Spiritual wellness


Wellness (continued)• Holistic health care– Treats the whole body, mind, and spirit– Each person is unique and has different needs– Uses many methods to diagnose and treatment – Emphasis on protection and restoration– Promotes body’s natural healing powers– Health care worker respects patient choice


Complementary and Alternative Methods of Health Care

• Complementary therapies: used in conjunction with conventional therapies

• Alternative therapies: used in place of biomedical therapies

• Integrative health care: uses mainstream and CAM therapies in treatment


Complementary and Alternative Methods of Health Care (continued)

• Holistic approach– Belief that effect on one part effects whole person

• Based on belief that the person has a life force or energy that can be used in the healing process

• May vary by cultural values or beliefs

Leslie Connor

Change this to "Idea that health of one body part affects overall health"?


Types of CAM Practitioners

• Ayurvedic• Chinese medicine• Chiropractors• Homeopaths• Hypnotists• Naturopaths


Types of Therapies

• Refer to Table 1-8 in Text• Most are noninvasive and holistic• Often less expensive than traditional

treatments• National Center for Complementary and

Alternative Medicine established in 1992


Pandemic

• Disease outbreak over a wide geographic area affecting high proportion of population

• WHO concern about influenza pandemics– H5N1: avian flu– H1N1: swine flu

• Viruses can mutate and exchange genetic information


Pandemic (continued)

• Government plans– Education– Vaccine production– Antiviral drugs– Developing protective public health measures– International cooperation


Conclusion

• Health care has changed and will continue to change

• Workers must be constantly aware of changes that occur

• Workers must make every attempt to learn about trends

Chapter 01

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