1 CHAPTER 1 HEALTH CARE OF THE PAST, PRESENT, AND FUTURE
2 Health Care of the Past Egyptians, Greeks, and ChineseAncient treatments Witch doctors Herbalists Use of herbs and plants for medication Hippocrates (460–377 B.C.) Father of modern medicine Plagues caused millions of deaths
3 Remedies of Past & PresentBark of a willow tree aspirin Citronella Insect repellant Garlic Promote immunity Foxglove Aka digitalis used to treat heart disease Eucalyptus Clears airways in respiratory disorders Green tea antioxidant Lavender oil Treat cuts & bruises Lemon Oil Purifies water With honey, reduces cough Quinine malaria
4 Box 1-2 Hippocratic Oath
5 Florence Nightingale
6 Health Care of the Present• Focus of health care has shifted from contagious diseases to lifestyle changes Cancer Drug abuse Heart disease Acquired immunodeficiency syndrome Tuberculosis
7 Health Care of the PresentPrimary concerns Emergency response and preparedness services Some communicable diseases still a focus AIDS 351,614 persons in United States living with AIDS in 2003 Tuberculosis 14,517 cases of TB in 2004 Avian flu United States established preparation guidelines of a possible H5N1 flu epidemic
8 Table 1-2 Pandemics and Pandemic Scares in the United StatesPandemic-occurs in a large region Epidemic-smaller area
9 Table 1-3 Agency Health Care Providers
10 Federal Agencies That Oversee Nation’s Health CarePublic Health Service Part of the Department of Health and Human Services (HHS) Established in 1798 Department of Labor Regulates some health concerns through the Occupational Safety and Health Administration (OSHA)
11 Health Care in the United StatesOne of the largest industries in the United States Supply of workers is less than demand Job opportunities and job security in many areas
12 Affordable Care Act Passed in 2010Children with preexisting conditions can not be denied insurance Small business owners receive tax credit up to 35% of premiums to insure employees Mandatory requirement for individuals to have health insurance
13 Health Insurance Insurance company third party payer assumes most health care costs Medicare and Medicaid were established to provide health care benefits for special needs groups and the elderly US in one of the only countries to not provide national health care coverage
14 Medicare Federal health care program for:Individuals age 65 years and older Certain younger people with disabilities People with end-stage renal disease (ESRD) DRGs (Diagnosis-related groupings) Reimbursement based on diagnosis rather than services – limits time allowed for treatment
15 Medicaid Provides health care coverage for people with low income and limited resources Joint program between federal and state governments Programs vary from state to state
16 Figure 1-2 Health Care Insurance Model
17 Other Cost Options Disability insurance Long-term careCovers partial amount of income if person to sick, injured, or unable to work Long-term care Covers expense of care due to chronic illness or disablility Medical savings accounts Contributions made to an account from salary before taxes & can be used for qualified medical expenses Worker’s compensation Covers injuries on the job
18 Health Insurance Portability and Accountability Act (HIPAA)Allows employed individuals to maintain insurance coverage if they lose or change jobs Limits exclusion of coverage because of preexisting conditions Prohibits denial of coverage because of prior illness Guarantees right to purchase insurance if unemployed Mandates the format for electronic data interchange (EDI) of information
19 Factors influencing cost of health careCost of health care continues to increase as a result of: Technological developments Malpractice litigation Increase in longevity Disaster relief expenses
20 Concerns for today for health care workersOptimal health Achieved through prevention of injury & illness Physical emotional, and social needs for patients
21 Factors in Choosing a Career in Health CareEconomic security Nature of the duties Good working environment Opportunities for advancement New challenges Respect
22 Table 1-5 Career Ladder in Health Care
23 The “Patient” of Today Takes on more responsibility for his or her own care Obtains second opinions Shops for the lowest health care costs Seeks alternative and complementary providers
24 Patient and Resident RightsAmerican Hospital Association “Patient’s Bill of Rights” – rights of the client to participate in the system of care Nursing Home Reform Law Enacted by Congress in 1987 to protect nursing home residents Places strong emphasis on individual dignity and self-determination
25 Agencies of AccreditationTraining programs must meet acceptable standards Most agencies of accreditation are provided by the professional association of the health care occupation
26 Credentialing Health care workers may require:Licensure: controlled by the state and is usually based on successful completion of an examination Certification: given by an agency or a training program; indicates successful completion of a particular course Registration: earned through the state or an agency
27 Health Care of the FutureWellness services To include nutritional advice, stress reduction counseling, habit cessation management, and exercise instruction Focus on care of the elderly Alternative medicine Technology
28 Health Care of the FutureSmall hospitals will continue to close doors Large urban institutions & state of the art intensive care units will increase Hospitals will care for severely ill, reducing the number of beds for patients still needing treatment. They will receive treatment from other sources: i.e. home health, LTC Alternative care will continue to develop
29 Health Care Workers of the FutureFlexible Critical thinking skills Independent judgement Multicompetent Trained for a broad range of skills Able to adapt to new technologies Highly regulated to ensure quality of care
30 Health Care Team Making adjustments to a new type of society9/11 Anthrax threats Natural disasters Emergency Preparedness
31 The Modern Healthcare System in the US