Chapter 01

1. Chapter 01 History and Trends of Health Care

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. Cost Containment (continued) • Methods • Diagnostic related groups (DRGs) • Combination of services • Outpatient services • Mass or bulk purchasing • Early intervention and preventive services • Energy conservation

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. Wellness (continued) • Physical wellness • Emotional wellness • Social wellness • Mental and intellectual wellness • Spiritual wellness

22. 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

23. 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

24. 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

25. Types of CAM Practitioners • Ayurvedic • Chinese medicine • Chiropractors • Homeopaths • Hypnotists • Naturopaths

26. 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

27. 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

28. Pandemic (continued) • Government plans • Education • Vaccine production • Antiviral drugs • Developing protective public health measures • International cooperation

29. 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