History of Health CareHistory of Health Care

4000 BC – 3000 BC Primitive 4000 BC – 3000 BC Primitive TimesTimes

Illness and diseases were a Illness and diseases were a punishment from the Godspunishment from the Gods

Tribal witch doctors treated illness Tribal witch doctors treated illness with ceremonieswith ceremonies

Herbs and plants used as medicines Herbs and plants used as medicines (morphine and digitalis)(morphine and digitalis)

Trepanation or trephining (surgically Trepanation or trephining (surgically removing a piece of bone from the removing a piece of bone from the skull)skull)

Average life span was 20 yearsAverage life span was 20 years

Early Beginning MedicinesEarly Beginning Medicines

Medicines of early times still Medicines of early times still used todayused today Digitalis (foxglove plant) used to Digitalis (foxglove plant) used to

slow & strengthen heartslow & strengthen heart Quinine (bark of cinchona tree) Quinine (bark of cinchona tree)

used for fever, muscle spasms, used for fever, muscle spasms, malariamalaria

Morphine (opium poppy) used to Morphine (opium poppy) used to relieve severe pain; is addictingrelieve severe pain; is addicting

3000 BC – 300 BC 3000 BC – 300 BC Ancient EgyptiansAncient Egyptians

Physicians were priestsPhysicians were priests Bloodletting or leeches used as Bloodletting or leeches used as

medical treatmentmedical treatment Average life span was 20-30 Average life span was 20-30

yearsyears Egyptians kept accurate health Egyptians kept accurate health

recordsrecords Developed the art of splinting Developed the art of splinting

fractures,fractures,

1700 BC – AD 220 1700 BC – AD 220 Ancient ChineseAncient Chinese

Believed in the need to treat the Believed in the need to treat the whole body by curing the spirit and whole body by curing the spirit and nourishing the bodynourishing the body

Recorded a pharmacopoeia of Recorded a pharmacopoeia of medications based mainly on the use medications based mainly on the use of herbsof herbs

Used therapies such as acupunctureUsed therapies such as acupuncture Began to search for medical reasons Began to search for medical reasons

for illness for illness Average life span was 20-30 yearsAverage life span was 20-30 years

1200 BC –200 BC 1200 BC –200 BC Ancient GreeksAncient Greeks

First to observe the human body and the First to observe the human body and the effects of disease – led to modern medical effects of disease – led to modern medical sciences.sciences.

Chinese monitored the pulse/blood Chinese monitored the pulse/blood pressure to determine condition of the pressure to determine condition of the body; believed in treating the whole body; body; believed in treating the whole body; used acupuncture. used acupuncture.

Believed illness is a result of natural causesBelieved illness is a result of natural causes Stressed diet and exercise as ways to Stressed diet and exercise as ways to

prevent diseaseprevent disease Average life span was 25-35 yearsAverage life span was 25-35 years

753 BC – AD 410 753 BC – AD 410 Ancient RomansAncient Romans

First to organize medical care by First to organize medical care by providing care for injured soldiersproviding care for injured soldiers

Later hospitals were religious and Later hospitals were religious and charitable institutions in monasteries and charitable institutions in monasteries and convents convents

First public health and sanitation systems First public health and sanitation systems by building sewers and aqueductsby building sewers and aqueducts

Doctors kept the sick in their home. They Doctors kept the sick in their home. They wore a death mask.wore a death mask.

Life span was 25-35 yearsLife span was 25-35 years

AD 400 – AD 800 AD 400 – AD 800 Dark AgesDark Ages

Emphasis on saving the soul and Emphasis on saving the soul and study of medicine was prohibitedstudy of medicine was prohibited

Prayer and divine intervention were Prayer and divine intervention were used to treat illness & diseaseused to treat illness & disease

Monks and priests provided Monks and priests provided custodial care for ill peoplecustodial care for ill people

Medications were mainly herbal Medications were mainly herbal mixturesmixtures

Average life span was 20-30 yearsAverage life span was 20-30 years

AD 800 – AD 1400 AD 800 – AD 1400 Middle AgesMiddle Ages

Bubonic Plague killed 75% of Bubonic Plague killed 75% of population in Europe and Asia. The population in Europe and Asia. The “Black Death” or killed 60 million “Black Death” or killed 60 million peoplepeople

Major diseases included smallpox, Major diseases included smallpox, diptheria, tuberculosis, typhoid, the diptheria, tuberculosis, typhoid, the plaque, and malariaplaque, and malaria

Arabs began requiring physicians pass Arabs began requiring physicians pass examinations and obtain licensesexaminations and obtain licenses

Average life span was 20-35 yearsAverage life span was 20-35 years

AD 1350 – AD 1650 AD 1350 – AD 1650 RenaissanceRenaissance

Dissection of body led to increased Dissection of body led to increased understanding of anatomy and understanding of anatomy and physiologyphysiology

Invention of printing press allowed Invention of printing press allowed medical knowledge to be sharedmedical knowledge to be shared

First anatomy book was published by First anatomy book was published by Andreas Vesalius (1514-1564)Andreas Vesalius (1514-1564) Michelangelo and Leonardo da Vinci used dissection to Michelangelo and Leonardo da Vinci used dissection to

draw more realistic pictures of the human bodydraw more realistic pictures of the human body

Average life span was 30Average life span was 30-40 years-40 years

1616thth and 17 and 17thth Centuries Centuries

Cause of disease still not known – Cause of disease still not known – many people died from infectionsmany people died from infections

Invention of the microscope allowed Invention of the microscope allowed physicians to see disease-causing physicians to see disease-causing organisms.organisms.

Apothecaries (early pharmicists) Apothecaries (early pharmicists) made, prescribed, and sold made, prescribed, and sold medicationsmedications

Ambroise Pare (1510-1590), a French Ambroise Pare (1510-1590), a French surgeon, known as the Father of surgeon, known as the Father of Modern Surgery established use of Modern Surgery established use of ligatures to stop bleedingligatures to stop bleeding

Average life span 35-45 yearsAverage life span 35-45 years

1616thth-17-17thth Centuries Scientists Centuries Scientists

William Harvey- heart is a pump William Harvey- heart is a pump which pumps blood through out which pumps blood through out the bodythe body

Gabrielle Fallopius- identifies and Gabrielle Fallopius- identifies and names fallopian tubes and names fallopian tubes and vagina and tympanic membranevagina and tympanic membrane

Bartolomeo Eustachio identified Bartolomeo Eustachio identified and named the tube leading and named the tube leading from ear to the throat from ear to the throat

1818thth Century Century

Gabriel Fahrenheit (1686-1736) Gabriel Fahrenheit (1686-1736) created the first mercury thermometercreated the first mercury thermometer

John Hunter (1728-1793), established John Hunter (1728-1793), established scientific surgical procedures and scientific surgical procedures and introduced tube feedingintroduced tube feeding

Joseph Priestly discovered the element Joseph Priestly discovered the element oxygenoxygen

Benjamin Franklin invented bifocalsBenjamin Franklin invented bifocals Average life span 40-50 yearsAverage life span 40-50 years

19th Century19th Century

Rapid advancements due to discoveries of Rapid advancements due to discoveries of microorganisms, anesthesia, and vaccinationsmicroorganisms, anesthesia, and vaccinations

Infection control developed once microorganisms Infection control developed once microorganisms were associated with diseasewere associated with disease

Paul Ehrlich discovered a treatment for syphilis on his Paul Ehrlich discovered a treatment for syphilis on his 606606thth experiment experiment

Formal training for nurses beganFormal training for nurses began Women became active participants in health careWomen became active participants in health care Lillian Wald started the public health nursing and Lillian Wald started the public health nursing and

visited homes to give care in New York City in 1893visited homes to give care in New York City in 1893 Average life span 40-60 yearsAverage life span 40-60 years

20th Century20th Century

Increased knowledge about the role of blood Increased knowledge about the role of blood in the bodyin the body

ABO blood groups discoveredABO blood groups discovered Found out how white blood cells protect Found out how white blood cells protect

against diseaseagainst disease New medications were developedNew medications were developed

Insulin discovered and used to treat diabetesInsulin discovered and used to treat diabetes Antibiotics developed to fight infections Antibiotics developed to fight infections Vaccines were developedVaccines were developed

New machines developed New machines developed Kidney Dialysis Machine Kidney Dialysis Machine Heart Lung Machine Heart Lung Machine Surgical and diagnostic techniques developed to Surgical and diagnostic techniques developed to

cure once fatal conditionscure once fatal conditions

20th Century (continued)20th Century (continued)

Organ TransplantsOrgan Transplants Test tube babiesTest tube babies Implanted first artificial heartImplanted first artificial heart Health Care Plans developed to help pay the cost Health Care Plans developed to help pay the cost

of careof care Medicare and Medicaid marked the entry of the Medicare and Medicaid marked the entry of the

federal government into the health care arenafederal government into the health care arena HMOs provided an alternative to private insuranceHMOs provided an alternative to private insurance Hospice organizedHospice organized Walter Reed found that mosquitoes carried yellow Walter Reed found that mosquitoes carried yellow

fever in 1900. His vaccine helped the building of fever in 1900. His vaccine helped the building of the Panama Canalthe Panama Canal

2121stst Century Century

The first totally implantable artificial The first totally implantable artificial heart was placed in a patient in heart was placed in a patient in Louisville, Ky. In 2001Louisville, Ky. In 2001

The threat of bioterrorism lead to The threat of bioterrorism lead to smallpox vaccination of the military smallpox vaccination of the military and first responders in 2002and first responders in 2002

The Netherlands became the first The Netherlands became the first country in the world to legalize country in the world to legalize euthanasia in 2002euthanasia in 2002

The Human Genome Project to identify The Human Genome Project to identify all of the approximately 20,000 to all of the approximately 20,000 to 25,000 genes in the human25,000 genes in the human

2121stst Century Century

Stem cells were used in the treatments of Stem cells were used in the treatments of disease early in the 2000’s and lead to disease early in the 2000’s and lead to increased research in the treatment of cancer increased research in the treatment of cancer and other diseasesand other diseases

President George W. Bush approved federal President George W. Bush approved federal funding for research using only existing lines funding for research using only existing lines of embryonic stem cells in 2001of embryonic stem cells in 2001

Advanced Cell Technology announced it Advanced Cell Technology announced it cloned a human embryo in 2001 but the cloned a human embryo in 2001 but the embryo did not surviveembryo did not survive

The U.S. FDA approved the use of the The U.S. FDA approved the use of the abortion pill RU-486 IN 200abortion pill RU-486 IN 200

2121stst Century Century

The standards for Privacy of The standards for Privacy of Individually Identifiable Health Individually Identifiable Health Information, required under the Health Information, required under the Health Insurance Portability and Insurance Portability and Accountability Act (HIPPA) of 1996, Accountability Act (HIPPA) of 1996, went into effect in 2003went into effect in 2003

The Medicare Prescription Drug The Medicare Prescription Drug Improvement and Modernization Act Improvement and Modernization Act was passed in 2003was passed in 2003

Vaccinations for cervical cancer and Vaccinations for cervical cancer and herpes zoster (shingles) in 2006herpes zoster (shingles) in 2006

Potential for 21Potential for 21stst Century Century

Cures for AIDS, cancer, and heart Cures for AIDS, cancer, and heart disease disease

Genetic manipulation to prevent Genetic manipulation to prevent inherited diseaseinherited disease

Nerves in the brain and spinal cord Nerves in the brain and spinal cord are regenerated to prevent paralysisare regenerated to prevent paralysis

Antibiotics are developed that do Antibiotics are developed that do not allow pathogens to develop not allow pathogens to develop resistanceresistance

Average life span 90-100 yearsAverage life span 90-100 years

Individual Individual ContributionsContributionsWhat Georgian surgeon was What Georgian surgeon was

believed to be the first person to believed to be the first person to use anesthesia but never given use anesthesia but never given

credit for it?credit for it?

Hippocrates Hippocrates (460 – 377 BC)(460 – 377 BC)

Greek physician known as the Greek physician known as the “Father of Medicine“Father of Medicine

Authored code of conduct for Authored code of conduct for doctors known as the “Hippocratic doctors known as the “Hippocratic Oath” that is the basis of medical Oath” that is the basis of medical practice todaypractice today

Believed illness was not caused Believed illness was not caused by evil spirits and stressed by evil spirits and stressed importance of good diet, fresh importance of good diet, fresh air, cleanliness, and exerciseair, cleanliness, and exercise

Anton van Leeuwenhoek Anton van Leeuwenhoek (1632-1723)(1632-1723)

Invented the microscope Invented the microscope lens that allowed lens that allowed visualization of organismsvisualization of organisms

Scraped his teeth Scraped his teeth

and observed the and observed the

bacteria that bacteria that

causes tooth causes tooth

decaydecay

Benjamin Franklin Benjamin Franklin (1706-1790)(1706-1790)

Invented bifocalsInvented bifocals

Found that colds could Found that colds could

be passed from person be passed from person

to personto person

Edward Jenner Edward Jenner (1749-1823)(1749-1823)

Developed a vaccination for Developed a vaccination for smallpox in 1796smallpox in 1796

Rene Laennec Rene Laennec (1781-1826)(1781-1826)

Invented the stethoscope in Invented the stethoscope in 18191819

First stethoscope was made of First stethoscope was made of woodwood

Elizabeth Blackwell Elizabeth Blackwell (1821-1910)(1821-1910)

First female physician in the First female physician in the United States in 1849United States in 1849

F lorence Nightingale (1820-F lorence Nightingale (1820-1910)1910)

Known as the “Founder of Known as the “Founder of Modern Nursing”Modern Nursing”

Established efficient and Established efficient and sanitary nursing units during sanitary nursing units during the Crimean War in 1854the Crimean War in 1854

Invented the call bell system Invented the call bell system and use of dumbwaiters to and use of dumbwaiters to deliver mealsdeliver meals

Begin the professional Begin the professional education of nurseseducation of nurses

Louis Pasteur (1822-1895)Louis Pasteur (1822-1895)

Known as the “Father of Microbiology”Known as the “Father of Microbiology” His germ theory proved that His germ theory proved that

microorganisms cause diseasemicroorganisms cause disease Proved that heat can be used Proved that heat can be used to destroy germs through a to destroy germs through a process called pasteurizationprocess called pasteurization Created a vaccine for rabies in Created a vaccine for rabies in 18851885 Founded the basic rules for Founded the basic rules for sterilizationsterilization

Joseph Lister (1827-1912)Joseph Lister (1827-1912)

Used carbolic acid on wounds to Used carbolic acid on wounds to kill germskill germs

First doctor to use an antiseptic First doctor to use an antiseptic during surgery during surgery

Clara Barton (1821-1912)Clara Barton (1821-1912)

Volunteer nurse for wounded soldiers during the Volunteer nurse for wounded soldiers during the Civil WarCivil War

After Civil War, established a bureau of records After Civil War, established a bureau of records to search for missing mento search for missing men

Campaigned for the USA to sign Campaigned for the USA to sign the Treaty of Geneva, which the Treaty of Geneva, which provided relief for sick and provided relief for sick and wounded soldierswounded soldiers Formed American Red Cross Formed American Red Cross in 1881 and served as its first in 1881 and served as its first presidentpresident

Robert Koch (1843-1910)Robert Koch (1843-1910)

Developed the culture plate Developed the culture plate method to identify pathogensmethod to identify pathogens

Isolated the bacterium Isolated the bacterium

that causes tuberculosisthat causes tuberculosis

Wilhelm Roentgen (1845-1923)Wilhelm Roentgen (1845-1923)

Discovered X-Discovered X-rays in 1895rays in 1895

Let doctors see Let doctors see inside the bodyinside the body

X-rayed wife’s X-rayed wife’s handhand

Sigmund Freud (1836-Sigmund Freud (1836-1939)1939)

Discovered the Discovered the conscious and conscious and unconscious part of unconscious part of the mindthe mind

His studies were the His studies were the basis for psychology basis for psychology and psychiatryand psychiatry

Sir Alexander Fleming Sir Alexander Fleming (1881-1955)(1881-1955)

Discovered penicillin in 1928 Discovered penicillin in 1928 which is considered one of the which is considered one of the most most

important important

discoveries of discoveries of

the twentieth the twentieth

centurycentury

Jonas Salk (1914-1995) Jonas Salk (1914-1995) Albert Sabin (1906 – 1993)Albert Sabin (1906 – 1993)

Discovered polio vaccineDiscovered polio vaccine Saved many people from Saved many people from

this virus that paralyzed this virus that paralyzed

thousands of adults and thousands of adults and

children each year.children each year.

Francis Crick (1916 – 2004) Francis Crick (1916 – 2004) James WatsonJames Watson (1928 - )(1928 - )

Described the structure of DNA and Described the structure of DNA and how it carries genetic information in how it carries genetic information in 19531953

Built a three-dimensional Built a three-dimensional

model of the molecules model of the molecules

of DNA of DNA Shared the Noble Prize Shared the Noble Prize

in 1962in 1962

Christian BarnardChristian Barnard (1922 – 2001)(1922 – 2001)

Performed first successful heart Performed first successful heart transplant in 1968transplant in 1968

Robert JarvikRobert Jarvik

Creator of the first artificial heartCreator of the first artificial heart

On December 2, 1982, it was On December 2, 1982, it was implanted into Barney Clark, who implanted into Barney Clark, who lived for the next 112 dayslived for the next 112 days

The second patient, William The second patient, William Schroeder, lived for 620 daysSchroeder, lived for 620 days

Ben Carson (1951 - )Ben Carson (1951 - )

Famous for his surgeries to Famous for his surgeries to separate Siamese twins separate Siamese twins

Currently Director of Currently Director of Pediatric Neurosurgery Pediatric Neurosurgery at John Hopkinsat John Hopkins He has refined He has refined hemispherectomy, a hemispherectomy, a surgery on the brain surgery on the brain to stop seizuresto stop seizures

Health Care SystemsHealth Care Systems

How much money does Healthcare bring in a How much money does Healthcare bring in a day???????day???????

Private Health Care FacilitiesPrivate Health Care Facilities

Hospitals: Hospitals: an institution that provides an institution that provides medical/surgical care and treatment for the sick and medical/surgical care and treatment for the sick and injured.injured.

Vary in size and types of service provided.Vary in size and types of service provided. General, burn centers, heart, oncology, children…etcGeneral, burn centers, heart, oncology, children…etc

Can be private, religious, nonprofit or government owned.Can be private, religious, nonprofit or government owned.

Long-term care Facilities: Long-term care Facilities: mainly provide mainly provide assistance and care for the elderly. Usually all in one.assistance and care for the elderly. Usually all in one.

Nursing/Geriatric Homes: Nursing/Geriatric Homes: provides help with ADL’s, provides help with ADL’s, promote social interactions and provide safety and security.promote social interactions and provide safety and security.

Extended care facilitiesExtended care facilities: long term rehabilitative care: long term rehabilitative care Independent Living: Independent Living: Rent apartments but are provided with Rent apartments but are provided with

servicesservices

Private Health Care Facilities Private Health Care Facilities cont…cont…

Omnibus Budget Reconciliation Act Omnibus Budget Reconciliation Act (OBRA)(OBRA) Regulations regarding long term care and Regulations regarding long term care and

home health care.home health care. Requires state to establish training and competence Requires state to establish training and competence

evaluations for nursing and geriatric assistants.evaluations for nursing and geriatric assistants. CEU’s, evaluations, registrations and certificationsCEU’s, evaluations, registrations and certifications

Private Health Care Facilities Private Health Care Facilities cont…cont…

Medical Offices: Medical Offices: can be privately owned can be privately owned by one doctor or employ many doctorsby one doctor or employ many doctors Services: diagnostic, evaluations, Services: diagnostic, evaluations,

treatment, examinations, minor surgeries, treatment, examinations, minor surgeries, and testingand testing

Specialties: pediatrics, cardiology, Specialties: pediatrics, cardiology, obstetricsobstetrics

Dental Offices: Dental Offices: can provide general or can provide general or specialized carespecialized care Orthodontist, periodontics, Orthodontist, periodontics,

prosthodontics, etcprosthodontics, etc

Private Health Care Facilities Private Health Care Facilities cont…cont…

Clinics: Clinics: health care facilities found in many types of health care facilities found in many types of health care.health care.

Some offer free servicesSome offer free services

Optical Centers: Optical Centers: provide vision careprovide vision care

Emergency Care Services: Emergency Care Services: provides special provides special care for victims of accidents or sudden illnessescare for victims of accidents or sudden illnesses

Can be both governmental or privateCan be both governmental or private

Laboratories: Laboratories: can perform diagnostic tests such as can perform diagnostic tests such as blood or urineblood or urine

Home Health Care: Home Health Care: exactly what it saysexactly what it says

Private Health Care Facilities Private Health Care Facilities cont…cont…

Hospice: Hospice: provide care for terminally ill persons with provide care for terminally ill persons with

life expectancies of 6 months or lesslife expectancies of 6 months or less.. Mental Health: Mental Health: facilities that treat patients with facilities that treat patients with

mental dis orders and diseases.mental dis orders and diseases.

Rehabilitation: Rehabilitation: provide care to help patients with provide care to help patients with physical or mental disabilities to obtain maximum self-physical or mental disabilities to obtain maximum self-care and functioncare and function

Health Maintenance Organizations: Health Maintenance Organizations: centers centers geared towards preventative healthcare.geared towards preventative healthcare.

Government AgenciesGovernment Agencies

World Health OrganizationWorld Health Organization: information about health : information about health issues around the worldissues around the world

U.S. Department of Health and Human Services:U.S. Department of Health and Human Services: health issues in the U.S.health issues in the U.S.

National Institute of Health: National Institute of Health: disease researchdisease research Center for Disease Control and PreventionCenter for Disease Control and Prevention: :

concerned with causes, spread and control of diseasesconcerned with causes, spread and control of diseases Food and Drug AdministrationFood and Drug Administration regulating food and regulating food and

drugsdrugs Agency for Health Care Policy and Research: Agency for Health Care Policy and Research:

healthcare qualityhealthcare quality Occupational Safety and Health AdministrationOccupational Safety and Health Administration: :

protect workers from job related injuries and illnessesprotect workers from job related injuries and illnesses

Voluntary/Nonprofit AgenciesVoluntary/Nonprofit Agencies

Supported by donations, Supported by donations, membership fees, fundraisers membership fees, fundraisers and federal or state grants.and federal or state grants.

Examples: American Cancer Society, The Examples: American Cancer Society, The American Heart Association, the American American Heart Association, the American Respiratory Disease Association, the Respiratory Disease Association, the American Diabetes Association, National American Diabetes Association, National Association of Mental Health, Nation Association of Mental Health, Nation Foundation of the March of Dimes, Foundation of the March of Dimes, American Red CrossAmerican Red Cross

Health Insurance PlansHealth Insurance Plans

What's the Purpose?What's the Purpose? To assist with the rising cost of health careTo assist with the rising cost of health care

How does it work?How does it work? The amount of payment and the type of The amount of payment and the type of

services vary from plan to planservices vary from plan to plan DeductiblesDeductibles: set amounts that must be paid before the : set amounts that must be paid before the

insurance will pay for anything.insurance will pay for anything. Co-InsuranceCo-Insurance: patient responsible for a certain : patient responsible for a certain

percentage of the costpercentage of the cost Co-Payment: Co-Payment: specific amount of money that must be specific amount of money that must be

paid before receiving servicespaid before receiving services

Health Insurance Plans cont…Health Insurance Plans cont…

Health Maintenance Organization (HMO): Health Maintenance Organization (HMO): provides a managed care plan for the delivery of provides a managed care plan for the delivery of healthcare serviceshealthcare services

Set fee regardless of the amount of health care usedSet fee regardless of the amount of health care used Insured can only use certain doctorsInsured can only use certain doctors

Preferred Provider Organization: Preferred Provider Organization: contracts contracts with certain doctors/dentist to provide health care at with certain doctors/dentist to provide health care at reduced ratesreduced rates

More optionsMore options Usually requires co-payments and deductiblesUsually requires co-payments and deductibles

Health Insurance Plans cont…Health Insurance Plans cont…

Medicare: Medicare: government program that provides government program that provides healthcare for all individuals over the age of 65, healthcare for all individuals over the age of 65, disabled persons receiving SS and a few other disabled persons receiving SS and a few other exceptionsexceptions

Medicaid: Medicaid: Government program but people covered Government program but people covered varies from state to state.varies from state to state.

Individuals with low income, children who qualify, all Individuals with low income, children who qualify, all disabled and blind people.disabled and blind people.

Workers CompensationWorkers Compensation: insurance for workers : insurance for workers injured on the jobinjured on the job

TRICARE: TRICARE: Government military health insuranceGovernment military health insurance

Organizational StructureOrganizational Structure

All Health Care Facilities must All Health Care Facilities must have one.have one. Hierarchy/Chain of CommandHierarchy/Chain of Command

Current Trends in Current Trends in Health CareHealth Care

Cost ContainmentCost Containment

Cost of health care began rising due to:Cost of health care began rising due to: Technological advancesTechnological advances Aging populationAging population Health-related lawsuitsHealth-related lawsuits

Cost Containment measures include:Cost Containment measures include: Diagnostic related groups (DRG)Diagnostic related groups (DRG) Combination of servicesCombination of services Outpatient servicesOutpatient services Mass or bulk purchasingMass or bulk purchasing Early intervention and preventive servicesEarly intervention and preventive services

Technological AdvancesTechnological Advances

Procedures such as heart, lung, Procedures such as heart, lung, liver or kidney transplantsliver or kidney transplants

Computers used for diagnostic Computers used for diagnostic examsexams

People are living longer People are living longer buuuuttt…….the result is …buuuuttt…….the result is …

The Aging PopulationThe Aging Population

More pharmaceuticalsMore pharmaceuticals Chronic diseasesChronic diseases More frequent healthcareMore frequent healthcare

Health Related LawsuitsHealth Related Lawsuits

Expensive malpractice insuranceExpensive malpractice insurance Unnecessary Diagnostic TestsUnnecessary Diagnostic Tests

Cost Containment EffortsCost Containment Efforts

Diagnostic Related GroupsDiagnostic Related Groups Medicaid/Medicare:Medicaid/Medicare:

Set amounts for all servicesSet amounts for all servicesCan be a gain or a loss????Can be a gain or a loss????

Combination of Services:Combination of Services: Clinics and laboratories shared by Clinics and laboratories shared by

different agenciesdifferent agencies Decreased cost for the provider Decreased cost for the provider

means decreased cost for the means decreased cost for the patient.patient.

Cost Containment Efforts Cost Containment Efforts cont…cont…

Outpatient ServicesOutpatient Services Reducing the length of hospital stays… Reducing the length of hospital stays…

i.e. open heart surgeryi.e. open heart surgery ……Surgeries, diagnostic services, radiographsSurgeries, diagnostic services, radiographs

Mass/Bulk purchasingMass/Bulk purchasing Buying in larger quantities at reduced prices.Buying in larger quantities at reduced prices. Computerized inventoryComputerized inventory

Early Intervention/PreventionEarly Intervention/Prevention Patient education, immunizations, physicals, Patient education, immunizations, physicals,

incentives, easy accessincentives, easy access

Cost Containment Efforts Cost Containment Efforts cont…cont…

Energy ConservationEnergy Conservation Better building designsBetter building designs Managing heating/cooling servicesManaging heating/cooling services Making repairs immediatelyMaking repairs immediately Infrared FaucetsInfrared Faucets

Could controlling costs turn into Could controlling costs turn into decreased quality of healthcare?decreased quality of healthcare? Agency for Health Care Policy and Agency for Health Care Policy and

ResearchResearch(AHCRP)(AHCRP)

As a patient what can you do to help control costs?As a patient what can you do to help control costs?

TelemedicineTelemedicine

Involves the use of video, audio and Involves the use of video, audio and computer systems to provide computer systems to provide medical/health care services.medical/health care services.

Decreases the need for trips to the “doctor”Decreases the need for trips to the “doctor” Great for rural areas? How?Great for rural areas? How?

WellnessWellness Emphasis on promoting wellness of the whole Emphasis on promoting wellness of the whole

individual:individual: Physical wellness: Physical wellness: promoted by a well balanced diet, promoted by a well balanced diet,

exercise, routine physicals.exercise, routine physicals. Emotional wellness: Emotional wellness: promoted by an understanding of promoted by an understanding of

ones own personal feelingsones own personal feelings

Social wellnessSocial wellness: : promoted by showing fairness, concern, promoted by showing fairness, concern,

tolerance, etctolerance, etc…… Mental and intellectual wellnessMental and intellectual wellness:: promoted by promoted by

being creative, logical, curious, open minded individualsbeing creative, logical, curious, open minded individuals Spiritual Wellness: Spiritual Wellness: promoted by using values, morals, promoted by using values, morals,

ethics, etcethics, etc Holistic Health: Holistic Health: promotes treating the whole person; all promotes treating the whole person; all

aspects of wellnessaspects of wellness

Alternative and Alternative and Complementary (CAM) Complementary (CAM) Methods of Health CareMethods of Health Care

Complementary Therapies: Complementary Therapies: used in used in conjunction with conventional medical conjunction with conventional medical therapiestherapies

Alternative Therapies: Alternative Therapies: used in place of used in place of biomedical therapiesbiomedical therapies

Integrative health careIntegrative health care: uses both : uses both mainstream and CAM therapies to treat mainstream and CAM therapies to treat patiendtspatiendts

Alternative and Alternative and Complementary Methods of Complementary Methods of

Health CareHealth Care Chinese medicine practitioners: Chinese medicine practitioners: holistic holistic

based healing practice based on the belief that a life based healing practice based on the belief that a life energy (CHI) flows through every living personenergy (CHI) flows through every living person

Chiropractors: Chiropractors: practice base on the belief that the practice base on the belief that the brain sends vital energy to all body parts through brain sends vital energy to all body parts through nerves is the spinal cordnerves is the spinal cord

Homeopaths: Homeopaths: belief in the body’s abilities to heal belief in the body’s abilities to heal itself using the immune system; no medicine, if so all itself using the immune system; no medicine, if so all naturalnatural

Naturopaths: Naturopaths: only natural therapiesonly natural therapies

Current ConcernsCurrent Concerns

National Health Care PlanNational Health Care Plan Has become a leading topic of debate due to the Has become a leading topic of debate due to the

increasing number of uninsured Americansincreasing number of uninsured Americans

Education and preparation for a potential Education and preparation for a potential pandemicpandemic

A pandemic exists when the outbreak of a disease A pandemic exists when the outbreak of a disease occurs over a wide geographic area and affects a occurs over a wide geographic area and affects a high proportion of the populationhigh proportion of the population

Due to the high rate international travel, the Due to the high rate international travel, the possibility for a devastating pandemic has possibility for a devastating pandemic has increasedincreased