Health Care Systems

1. Health Care Systems

2. 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

3. 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

4. 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 Health Care Facilities

5. Government Agencies • WHO • USDHHS • NIH • CDC • FDA • OSHA • State & local health departments

6. Voluntary/Nonprofit Agencies • 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

7. Health Insurance Plans • 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)

8. Health Insurance Plans • Health Insurance Terminology • Deductibles • Co-insurance ( usually in percentages) • Co-payment (usually in dollar amounts) • HMO • Private fee-for-service plans • PPO • Medicare • Type A -- the facilities • Type B – the health deliverer • Medicaid • Worker’s Compensation

9. Organizational Structure • This refers to the chain of command • It indicates areas of responsibility • Shows one their immediate supervisor

10. 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

11. Trends in Health Care • Geriatric care • Adult day care centers • Retirement communities • Assisted living facilities • Long term care facilities • OBRA = omnibus budget reconciliation act (1987& 1989) • 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

12. 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

13. Acupressure (Shiatsu)---- use of hands to apply pressure to specific points of the body to stimulate the flow of energy 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 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

14. Alternative Methods of Health Care • Macrobiotic diet ------ use of diet to balance “yin & yang” • Yin= dark; yang = light/ everything has its opposite • 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