Chapter 2 Health Care Systems Health Care Science Technology Copyright © The McGraw-Hill Companies,...
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Transcript of Chapter 2 Health Care Systems Health Care Science Technology Copyright © The McGraw-Hill Companies,...
Chapter 2 Health Care Systems
Health Care Science Technology
Copyright © The McGraw-Hill Companies, Inc.
Chapter 22 Copyright © The McGraw-Hill Companies, Inc.
Objectives
Summarize significant historical changes in health care.
List the reasons for the importance to health care of the scientific method.
Compare ancient and current medical practices.
Chapter 23 Copyright © The McGraw-Hill Companies, Inc.
Identify major trends in health care.
List the types of health care facilities and the services provided in each.
Objectives (cont.)
Chapter 24 Copyright © The McGraw-Hill Companies, Inc.
Objectives (cont.)
List the ways in which health care facilities, government agencies, and nonprofit volunteer agencies contribute to the health of a community and the world.
Identify the clients served by Medicare and Medicaid.
Chapter 25 Copyright © The McGraw-Hill Companies, Inc.
Objectives (cont.)
Discuss the impact of the uninsured on health care costs.
Summarize the purpose of health maintenance organizations (HMOs).
Define the purpose of workers’ compensation.
Chapter 26 Copyright © The McGraw-Hill Companies, Inc.
History of Health Care 2-1
Prehistory and the Ancient WorldThe Middle AgesThe RenaissanceThe Industrial RevolutionModern Times
Chapter 27 Copyright © The McGraw-Hill Companies, Inc.
Prehistory and the Ancient World
Ancient healers used diet, rest, plants, and herbs, and performed surgery.
The caduceus, which is the symbol of the physician, may have evolved from the symbol for Asclepius, the Greek god of healing.
Chapter 28 Copyright © The McGraw-Hill Companies, Inc.
Prehistory and the Ancient World (cont.)
The Hippocratic Oath is a code of ethics developed by Hippocrates around 400 B.C.
This code promotes patient confidentiality and forbids the deliberate harming of a patient.
Chapter 29 Copyright © The McGraw-Hill Companies, Inc.
Prehistory and the Ancient World (cont.)
Galen was a Greek trained by the Egyptians and appointed as physician to the gladiators.– He is credited with performing tracheotomies
and documenting the importance of the spinal cord in the movement of limbs.
– His manuscripts were used to train physicians until the Renaissance, which began in the 14th century.
Chapter 210 Copyright © The McGraw-Hill Companies, Inc.
The Middle Ages
500 A.D. – 1500 A.D. – Reason began to replace belief in
spiritual or superstitious causes for illness.
Rhazes was a Persian doctor.– He wrote about the differences
between smallpox and measles.– He provided a clearer understanding of
the causes of disease.
Chapter 211 Copyright © The McGraw-Hill Companies, Inc.
The Middle Ages (cont.)
The Barber-Surgeon – Barbers performed cataract
surgery, limb amputations, and phlebotomy (bloodletting).
– The red and white barber pole may have begun as a pole to hang bandages, or may have symbolized blood, veins, and bandages (red, blue, and white).
Chapter 212 Copyright © The McGraw-Hill Companies, Inc.
The Middle Ages (cont.)
The Beginning of Medical Care Regulation– Physicians were licensed after
formal training with experienced doctors.
– Women were not allowed to practice medicine.
Chapter 213 Copyright © The McGraw-Hill Companies, Inc.
The Middle Ages (cont.)
Religion and Medicine– Religious principles led to the
founding of many Islamic hospitals and Christian monasteries where the sick were treated.
Chapter 214 Copyright © The McGraw-Hill Companies, Inc.
The Renaissance
14th – 17th Centuries– 15th Century
The invention of the printing press allowed discoveries to be published.
– 16th CenturyThe scientific method came into use
and the microscope was invented.– Age of Enlightenment (1700s)
The study of anatomy was allowed by the church.
Chapter 215 Copyright © The McGraw-Hill Companies, Inc.
The Industrial Revolution
Late 18th and Early 19th Centuries– Stethoscope invented.– Vaccination began.– Marked the beginning of modern medicine.– Louis Pasteur’s experiments formed the basis of
microbiology.– Joseph Lister began disinfecting surgical
equipment and hand washing (medical asepsis).– Robert Koch found that pathogens are the source
of some diseases.– Ether used as an anesthesia.
Chapter 216 Copyright © The McGraw-Hill Companies, Inc.
Modern Times
20th Century– Antibiotics invented.– Radium discovered.– CAT scans, MRI, and
ultrasound are used.– Organ transplants
commonplace.
Chapter 217 Copyright © The McGraw-Hill Companies, Inc.
Section 2-1 Apply Your Knowledge
What did the invention of the printing press allow?
Answer:
The printing press made it possible to publish books about discoveries.
Chapter 218 Copyright © The McGraw-Hill Companies, Inc.
Trends in Health Care 2-2
TechnologyPreventive Medicine and WellnessAging PopulationUnderinsured and UninsuredAmbulatory Care and Outpatient
SurgeryHome Health Care
Chapter 219 Copyright © The McGraw-Hill Companies, Inc.
Technology
Computer technology allows noninvasive diagnosis of soft tissue diseases and injuries.
Ultrasound used to examine body cavities.
Field of radiology no longer limited to X rays.
Chapter 220 Copyright © The McGraw-Hill Companies, Inc.
Technology (cont.)
Miniaturization allows cameras and instruments to be inserted into the body for surgical procedures.
Digital images can be transmitted to a consulting specialist.
Client’s records can be made available anytime and anywhere.
Chapter 221 Copyright © The McGraw-Hill Companies, Inc.
Preventive Medicine and Wellness
Wellness idea began about 20 years ago with the introduction of fitness centers.
Wellness industry growth spurred by baby boomers, physicians, insurance companies, and fitness professionals.
Chapter 222 Copyright © The McGraw-Hill Companies, Inc.
Preventive Medicine and Wellness (cont.)
Hospital wellness centers offer services such as:– Cardiac rehabilitation.– Pulmonary rehabilitation.– Occupational medicine.– Sports medicine.– Clinical weight management.– Physical therapy.
Chapter 223 Copyright © The McGraw-Hill Companies, Inc.
Preventive Medicine and Wellness (cont.)
Most hospital wellness centers offer wellness programs for clients with chronic diseases such as:– Arthritis.– Diabetes.– Osteoporosis.– Neuromuscular disorders.
Chapter 224 Copyright © The McGraw-Hill Companies, Inc.
Preventive Medicine and Wellness (cont.)
Many hospital wellness centers offer complementary classes in:– Yoga.– Nutrition.– Stress management.
Some hospital wellness centers provide screening for diseases that include:– Breast, cervical, and prostate cancer.– High blood pressure.– High cholesterol.
Chapter 225 Copyright © The McGraw-Hill Companies, Inc.
Preventive Medicine and Wellness (cont.)
Factors relating to personal responsibility for wellness include:– Fitness.– Preventive care.– Spiritual health.– Safety.– Nutrition.– Tobacco addiction.– Stress management.
Chapter 226 Copyright © The McGraw-Hill Companies, Inc.
Aging Population
Caused by fewer births and fewer deaths.
Baby Boom, 1946-1964. Population of 65 and older
expected to double between the years 2000 and 2030, from 35 million to 70 million.
As the population ages, demands on the health care services will increase.
Chapter 227 Copyright © The McGraw-Hill Companies, Inc.
Underinsured and Uninsured
16% of U.S. population (42 million) have no health insurance.
Some have health insurance, but coverage is limited by a large co-payment or deductible in addition to the insurance premium.
Chapter 228 Copyright © The McGraw-Hill Companies, Inc.
Underinsured and Uninsured (cont.)
As new technology and products emerge, costs increase.
County hospitals, supported by taxes, care for uninsured low income people.
Costs associated with the uninsured are passed on to those who are insured or can afford to pay.
Chapter 229 Copyright © The McGraw-Hill Companies, Inc.
Ambulatory Care and Outpatient Surgery
Technology, research, and new medications make same-day surgery possible.
Costs can be reduced when patients do not remain overnight.
Chapter 230 Copyright © The McGraw-Hill Companies, Inc.
Home Health Care
Became popular in the late 1980s. Medicare began paying hospitals a
flat fee for diagnostic related groups (DRGs).
Patients are released from the hospital early and receive home visits by a skilled professional.
Patient benefits by exposure to fewer pathogens, lowered stress and anxiety, and decreased cost.
Chapter 231 Copyright © The McGraw-Hill Companies, Inc.
Section 2-2 Apply Your Knowledge
What can be done to contain the cost of health care?
Answers:
1. Home health care.
2. Ambulatory care.
3. Preventive care/wellness.
Chapter 232 Copyright © The McGraw-Hill Companies, Inc.
Health Care Facilities 2-3
Hospitals Long-Term Care Practitioners’ Offices Clinics Laboratories Emergency Medical Services Home Health Care Rehabilitation Hospice
Chapter 233 Copyright © The McGraw-Hill Companies, Inc.
Hospitals
Hospitals Run by Religious Organizations
Private Hospitals Nonprofit Hospitals Hospitals Run by
Government Organizations Specialized Hospitals
Chapter 234 Copyright © The McGraw-Hill Companies, Inc.
Long-Term Care
Residents may be frail, elderly, handicapped, or disabled.
Residents seen by the physician monthly.
Assisted-living centers offer separate living quarters, and provide meals and housekeeping.
Some residents are able to perform many of their own activities of daily living (ADL).
Chapter 235 Copyright © The McGraw-Hill Companies, Inc.
Practitioners’ Offices
Many offer testing and minor surgery.
Dentists and dental hygienists are included in this group.
May be an individual or a group practice.
Chapter 236 Copyright © The McGraw-Hill Companies, Inc.
Clinics
Practitioners have separate clients, but share billing, reception, and record-keeping staff.
Clinic may specialize or offer a wide variety of services.
“Clinic” may refer to a type of care provided on a specific day and may move from location to location.
Chapter 237 Copyright © The McGraw-Hill Companies, Inc.
Laboratories
May perform tests on blood or body tissues.
Can be part of a clinic or hospital.
Some are supported by public money.
Chapter 238 Copyright © The McGraw-Hill Companies, Inc.
Emergency Medical Services
Developed to provide care to ill and injured as quickly as possible.
May be part of the 911 phone system.
Police officers, firefighters, and ambulance staff may perform EMS.
In rural areas, volunteers, park rangers, or ski patrol may provide EMS.
Chapter 239 Copyright © The McGraw-Hill Companies, Inc.
Home Health Care
Can be considered another type of health care facility.
May be long term or short term.
Chapter 240 Copyright © The McGraw-Hill Companies, Inc.
Rehabilitation
Designed to help clients regain physical or mental abilities or to help them live with disabilities.
May be part of a hospital, clinic, or privately owned.
Chapter 241 Copyright © The McGraw-Hill Companies, Inc.
Hospice
Services are provided to the terminally ill.
Includes treatment from doctors, nurses, therapists, dieticians, social workers, clergy, and volunteers.
Chapter 242 Copyright © The McGraw-Hill Companies, Inc.
Hospice (cont.)
Therapy is designed to:– Improve quality of life.– Use pain medications effectively.– Relieve symptoms.– Prepare the person and his or
her family for death.
Chapter 243 Copyright © The McGraw-Hill Companies, Inc.
Section 2-3Apply Your Knowledge
What are four types of care that may be provided in a long-term care facility?
Answer:1. Regular professional health care services2. Therapy3. Physical rehabilitation4. Skilled nursing care
Chapter 244 Copyright © The McGraw-Hill Companies, Inc.
Health Care Agencies 2-4
Government AgenciesVolunteer and Nonprofit Health
Agencies
Chapter 245 Copyright © The McGraw-Hill Companies, Inc.
Government Agencies
Local Health Departments– Provide immunizations, inspections,
and environmental protection.– Collect statistics about communicable
diseases.– May provide health education and
other health-related services to the community.
Chapter 246 Copyright © The McGraw-Hill Companies, Inc.
Government Agencies (cont.)
U.S. Department of Health and Human Services (DHHS)– National agency that deals with health
in the United States.– Important agencies under DHHS
include: Centers for Disease Control (CDC). Food and Drug Administration (FDA). National Institute of Health (NIH).
Chapter 247 Copyright © The McGraw-Hill Companies, Inc.
Government Agencies (cont.)
World Health Organization (WHO)– International agency sponsored
by the United Nations.– Primary goal is to help all
people attain the highest possible level of health.
– Compiles statistics on disease.– Provides training for medical
personnel.
Chapter 248 Copyright © The McGraw-Hill Companies, Inc.
Volunteer and Nonprofit Health Agencies
Can be on the state, local, or national level.
Supported by private contributions and fund-raising.
Usually focus on a single disease.Examples include:
– American Lung Association (ALA).– March of Dimes.– American Heart Association (AHA).
Chapter 249 Copyright © The McGraw-Hill Companies, Inc.
Section 2-4Apply Your Knowledge
What are three ways volunteer and nonprofit organizations have contributed to health and health care?
Answer:
1. Influenced laws.
2. Created standards of care for infants.
3. Educated doctors and other health professionals in new techniques.
Chapter 250 Copyright © The McGraw-Hill Companies, Inc.
Health Insurance 2-5
Paying for Health CareMedicare and MedicaidManaged CareWorkers’ CompensationMilitary Health Care
Chapter 251 Copyright © The McGraw-Hill Companies, Inc.
Paying for Health Care
Insurance company decides what medical services will be covered.
Group insurance coverage is offered to employees by many employers.
Chapter 252 Copyright © The McGraw-Hill Companies, Inc.
Medicare and Medicaid
Programs are result of federal legislation.
Programs target people who lack access to care.
Chapter 253 Copyright © The McGraw-Hill Companies, Inc.
Medicare
Largest health insurance program in the nation.
Must be at least 65 years old or disabled to qualify.
Part A provides for hospital care, limited skilled nursing facility services, home health services, and hospice care.
Chapter 254 Copyright © The McGraw-Hill Companies, Inc.
Medicare (cont.)
Part B helps pay for the services of physicians, outpatient hospital services, and medical equipment and supplies.
The insured pays a premium for Part B and may have to pay a deductible or have other private insurance.
Chapter 255 Copyright © The McGraw-Hill Companies, Inc.
Medicaid
Government insurance for certain low-income people.
Dental coverage may be available.
No co-payment or deductible.
INDIANA MEDICAID AND OTHER MEDICAL ASSISTANCE PROGRAMS
100341842799 001
Danny L. Owens07/19/62
Chapter 256 Copyright © The McGraw-Hill Companies, Inc.
Managed Care
Health care plans specifically designed to control costs.
Advantages– Most include preventive care, such as
annual physicals, mammograms, and well-baby care.
– Monthly premiums and out-of-pocket expenses are usually lower than with traditional insurance.
– Reduced paperwork.
Chapter 257 Copyright © The McGraw-Hill Companies, Inc.
Managed Care (cont.)
Disadvantages– Limited choice of doctors and hospitals,
except for emergency treatment.– Must be referred to specialist by primary
care physician.– Usually more restrictive than ordinary
insurance.– Not all health expenses count toward
deductible.
Chapter 258 Copyright © The McGraw-Hill Companies, Inc.
Health Maintenance Organizations
Focus on prevention and wellness.
Businesses or individuals pay premiums to the HMO instead of an insurance company.
HMOs focus on wellness care not usually covered by insurance.
Popular in the 1980s and 1990s.
Chapter 259 Copyright © The McGraw-Hill Companies, Inc.
Workers’ Compensation
Insurance that covers accidents, injuries, or diseases that occur in the workplace.
Federal law requires businesses to purchase and maintain a minimum amount of workers’ compensation insurance.
Chapter 260 Copyright © The McGraw-Hill Companies, Inc.
Workers’ Compensation (cont.)
Types of services provided for injuries occurring in the workplace:– Basic medical treatment for inpatient and
outpatient care.– Weekly payments to employees for
temporary disabilities.– Monthly payments to employees with
permanent disabilities.– Death benefits.– Rehabilitation costs.
Chapter 261 Copyright © The McGraw-Hill Companies, Inc.
Military Health Care
Provided to current military personnel, retired military personnel, and veterans through CHAMPUS/TRICARE program.
Public Health Service and National Oceanic and Atmospheric Administration are also covered by this benefit.
Chapter 262 Copyright © The McGraw-Hill Companies, Inc.
Section 2-5Apply Your Knowledge
List 3 advantages to managed care.
Answer:1. Most policies include preventive care.2. Monthly premiums and out-of-pocket
expenses are lower than with traditional insurance.
3. Paperwork is reduced, and there are no claim forms.
Chapter 263 Copyright © The McGraw-Hill Companies, Inc.
Chapter 2 Credits
Slide 16 Grantpix/Photo ResearchersSlide 20 Healthcare Medical Communication
Systems, Inc.Slide 21 Daniel Miller/CORBISSlide 26 PhotoDiscSlide 29 Doug MartinSlide 30 KS StudiosSlide 33 Ron Chapple/Getty ImagesSlide 35 Matt MeadowsSlide 41 CORBISSlide 61 David Kelly Crow
