The History of health care Unit 1

History of Health Care Introduction Why is it important to understand the history of health care?

Introduction You have an infected finger and the doctor orders leeches to treat the infection. History of Health Care

Introduction Is this an ancient or modern treatment? Does it work? History of Health Care

I. Health Care Through Time 4000 BC-3000 BC Primitive Times History of Health Care I. Health Care Through Time 4000 BC-3000 BC Primitive Times Illness & disease caused by spirits and demons Average life span = 20 years

I. Health Care Through Time 3000 BC-300 BC Ancient Egyptians History of Health Care I. Health Care Through Time 3000 BC-300 BC Ancient Egyptians Believed body was system of channels (ducts) Bloodletting was used when channels were “blocked” Average life span = 20-30 years

I. Health Care Through Time 1700 BC-AD 220 Ancient Chinese History of Health Care I. Health Care Through Time 1700 BC-AD 220 Ancient Chinese Used acupuncture to relieve pain and congestion Average life span = 20-30 years

I. Health Care Through Time 1200 BC-200 BC Ancient Greeks History of Health Care I. Health Care Through Time 1200 BC-200 BC Ancient Greeks Hippocrates – Father of Medicine Developed organized method to observe human body Recorded Signs & Symptoms

I. Health Care Through Time 1200 BC-200 BC Ancient Greeks History of Health Care I. Health Care Through Time 1200 BC-200 BC Ancient Greeks Hippocrates – Father of Medicine Created high standard of ethics: “The Hippocratic Oath” used by physicians today.

I. Health Care Through Time 1200 BC-200 BC Ancient Greeks History of Health Care I. Health Care Through Time 1200 BC-200 BC Ancient Greeks Aristotle – Dissected animals; founder of what is known today as anatomy Avg. life span= 25-35 years

I. Health Care Through Time 753 BC-AD 410 Ancient Romans History of Health Care I. Health Care Through Time 753 BC-AD 410 Ancient Romans First to provide medical care for injured soldiers Physicians cared for ill people in their homes Hospitals established in religious institutions

I. Health Care Through Time 753 BC-AD 410 Ancient Romans History of Health Care I. Health Care Through Time 753 BC-AD 410 Ancient Romans Began public health & sanitation systems Aqueducts to carry clean water to cities Sewers to carry waste away from cities

I. Health Care Through Time 753 BC-AD 410 Ancient Romans History of Health Care I. Health Care Through Time 753 BC-AD 410 Ancient Romans Claudius Galen: physician; body is controlled by a balance of fluids (humors), blood, phlegm and bile. Imbalance in fluids lead to illness. Average life span = 25-35 years

I. Health Care Through Time AD 400- AD 800 Dark Ages History of Health Care I. Health Care Through Time AD 400- AD 800 Dark Ages Prayer & divine intervention used to treat illness & disease Study of medicine was prohibited Average life span = 20-30 years

I. Health Care Through Time AD 800- AD 1400 Middle Ages History of Health Care I. Health Care Through Time AD 800- AD 1400 Middle Ages Medical universities were created Pandemic killed ¾ of the population of Europe & Asia Arab physicians required to pass exam before getting license to practice Average life span = 20-35 years

I. Health Care Through Time AD 1350- AD 1650 Renaissance History of Health Care I. Health Care Through Time AD 1350- AD 1650 Renaissance Body dissection was performed Michelangelo & Leonardo da Vinci drew human body Printing press allowed for distribution of information First anatomy book published

I. Health Care Through Time AD 1350- AD 1650 Renaissance History of Health Care I. Health Care Through Time AD 1350- AD 1650 Renaissance Average life span = 30-40 years

I. Health Care Through Time 16th & 17th Centuries History of Health Care I. Health Care Through Time 16th & 17th Centuries Cause of diseases still not known Ambrose Pare: Father of modern surgery William Harvey: described circulation to and from the heart

I. Health Care Through Time 16th & 17th Centuries History of Health Care I. Health Care Through Time 16th & 17th Centuries Anton van Leeuwenhoek: invented microscope Average life span = 35-45 years

I. Health Care Through Time 18th Century History of Health Care I. Health Care Through Time 18th Century Gabriel Fahrenheit: invented first mercury thermometer

I. Health Care Through Time 18th Century History of Health Care I. Health Care Through Time 18th Century Benjamin Franklin: invented bifocals Edward Jenner: developed vaccination for smallpox

I. Health Care Through Time 18th Century History of Health Care I. Health Care Through Time 18th Century Average life span = 40-50 years

I. Health Care Through Time 19th Century History of Health Care I. Health Care Through Time 19th Century French barbers: acted as surgeons by extracting teeth, using leeches for treatment and giving enemas

I. Health Care Through Time 19th Century 1st Blood transfusion (1818) History of Health Care I. Health Care Through Time 19th Century 1st Blood transfusion (1818)

I. Health Care Through Time 19th Century History of Health Care I. Health Care Through Time 19th Century Rene Laennec: invented stethoscope (1819)

I. Health Care Through Time 19th Century History of Health Care I. Health Care Through Time 19th Century Elizabeth Blackwell: first female physician in the U.S. (1849)

I. Health Care Through Time 19th Century History of Health Care I. Health Care Through Time 19th Century Florence Nightingale: Founder of modern nursing; Began education for nurses (1850’s & 1860’s)

I. Health Care Through Time 19th Century History of Health Care I. Health Care Through Time 19th Century Joseph Lister: began use of disinfectants and antiseptics in surgery to prevent infection (1865)

I. Health Care Through Time 19th Century History of Health Care I. Health Care Through Time 19th Century Louis Pasteur: “pasteurized” milk to kill bacteria Created rabies vaccine (1885)

I. Health Care Through Time 19th Century History of Health Care I. Health Care Through Time 19th Century Dimitri Ivanofski: discovered viruses (1892)

I. Health Care Through Time 19th Century History of Health Care I. Health Care Through Time 19th Century Wilhelm Roentgen: discovered x-rays (1895)

I. Health Care Through Time 19th Century History of Health Care I. Health Care Through Time 19th Century Average life span = 40-60 years

I. Health Care Through Time 20th Century History of Health Care I. Health Care Through Time 20th Century Most rapid growth in modern healthcare occurred during this time period Many diseases were specifically identified, treated and cured

I. Health Care Through Time 20th Century History of Health Care I. Health Care Through Time 20th Century Standards of care were established Technology is integrated into healthcare and is used in every aspect of medical care today

I. Health Care Through Time 20th Century History of Health Care I. Health Care Through Time 20th Century Carl Landsteiner: Classified ABO blood groups (1901)

I. Health Care Through Time 20th Century History of Health Care I. Health Care Through Time 20th Century Sigmund Freud: formed the basis for psychology & psychiatry (early 1900’s)

I. Health Care Through Time 20th Century History of Health Care I. Health Care Through Time 20th Century Frederick Banting & Charles Best: discovered & used insulin to treat diabetes (1922)

I. Health Care Through Time 20th Century History of Health Care I. Health Care Through Time 20th Century Sir Alexander Fleming: discovered the antibiotic penicillin (1928)

I. Health Care Through Time 20th Century History of Health Care I. Health Care Through Time 20th Century George Papanicolaou: developed the “pap smear” to detect cervical cancer in females

I. Health Care Through Time 20th Century History of Health Care I. Health Care Through Time 20th Century Jonas Salk: developed the polio vaccine using dead polio virus (1952)

I. Health Care Through Time 20th Century History of Health Care I. Health Care Through Time 20th Century Francis Crick & James Watson: discovered the structure of DNA, our genetic blue- print (1953)

I. Health Care Through Time 20th Century History of Health Care I. Health Care Through Time 20th Century Christian Barnard: Performed 1st heart transplant (1968)

I. Health Care Through Time 20th Century CAT Scan: developed (1975) History of Health Care I. Health Care Through Time 20th Century CAT Scan: developed (1975)

I. Health Care Through Time 20th Century History of Health Care I. Health Care Through Time 20th Century Louise Brown: first “test- tube” baby, conceived in a laboratory (1978)

I. Health Care Through Time 20th Century History of Health Care I. Health Care Through Time 20th Century Acquired Immune Deficiency Syndrome (AIDS): first identified as a disease (1981) HIV (1984)

I. Health Care Through Time 20th Century History of Health Care I. Health Care Through Time 20th Century Ben Carson: First to separate conjoined twins; has pioneered many new procedures (1987)

I. Health Care Through Time 20th Century History of Health Care I. Health Care Through Time 20th Century Sheep Cloned: “Dolly” the sheep was cloned by Dr. Ian Wilmut (1997)

History of Health Care I. Health Care Through Time 20th Century Average life span = 60-70 years

I. Health Care Through Time 21st Century History of Health Care I. Health Care Through Time 21st Century What impact will YOU have on the history of health care? What will YOU discover? What will YOU cure? Average life span = 100 yrs plus?

History of Health Care II. Trends In Health Care Cost Containment

II. Trends In Health Care History of Health Care II. Trends In Health Care A. Cost Containment: controlling the rising cost of health care - Reasons high costs: Technological advances Aging population (Rx) Lawsuits (malpractice Ins.)

History of Health Care II. Trends In Health Care B. Diagnostic Related Groups: DRG’s place a limit on the cost of health care. Example: (?) Surgery $5,000 Limit If hospital costs are less than $5,000 then hospital makes $$, otherwise hospital loses $$

II. Trends In Health Care B. Diagnostic Related Groups: History of Health Care II. Trends In Health Care B. Diagnostic Related Groups: 1) Combination of Services: health care facilities shop for services (laboratory, x-ray, etc.) to save $$.

History of Health Care II. Trends In Health Care C. Outpatient Services: Patients receive care and are discharged home without being admitted to the hospital. Examples: Surgical Centers, Physical Therapy, etc.

History of Health Care II. Trends In Health Care D. Energy Conservation: Energy is a large expense for health care facilities. - Energy Efficient Bulbs - Consolidating Work Areas - Recycling

History of Health Care II. Trends In Health Care E. Summary: The quality of health care should not be lowered simply to control costs. - Provider responsibility: provide the best health care while being conscious of costs

History of Health Care II. Trends In Health Care E. Summary: The quality of health care should not be lowered simply to control costs. - Personal responsibility: take preventative measures to avoid or limit injury, illness & disease

History of Health Care II. Trends In Health Care Home Health Care

History of Health Care II. Trends In Health Care A. Home Health Care: Created mainly as a result of DRG’s. History shows that this is not a new concept.

II. Trends In Health Care Home Health Care: Services include: History of Health Care II. Trends In Health Care Home Health Care: Services include: - Nursing care - Physical/occupational therapies - Respiratory therapy - Social services - Nutrition & food services

History of Health Care II. Trends In Health Care Geriatric Care

History of Health Care II. Trends In Health Care A. Geriatric Care: Care of the elderly. People are living longer.

History of Health Care II. Trends In Health Care A. Geriatric Care: Omnibus Budget Reconciliation Act of 1987 (OBRA) Government Act which requires states to establish competency standards which nursing assistants must meet. (Exam)

History of Health Care II. Trends In Health Care A. Geriatric Care: Omnibus Budget Reconciliation Act of 1987 (OBRA) Requires long-term health care workers to attend continuing education courses

History of Health Care II. Trends In Health Care A. Geriatric Care: Omnibus Budget Reconciliation Act of 1987 (OBRA) Loss of license/certificate can occur if compliance is not maintained. Facility can also be fined and even shut down.

History of Health Care II. Trends In Health Care A. Geriatric Care: Types of Facilities: - Adult day care centers - Retirement communities - Assisted living care centers - Long-term care centers

History of Health Care II. Trends In Health Care Telemedicine

History of Health Care II. Trends In Health Care A. Telemedicine: Involves using technology to provide care Methods: - Computerized (EKG’s) - Remote (robotics) - Video (surgery) - Phone/Fax (Reports)

History of Health Care II. Trends In Health Care Wellness

History of Health Care II. Trends In Health Care A. Wellness: A state of being in optimum health as it relates to physical, mental and social health. Preventative measures: diet, exercise, rest, stress reduction, habit cessation

Alternative & Complementary Methods of Health Care History of Health Care II. Trends In Health Care Alternative & Complementary Methods of Health Care

History of Health Care II. Trends In Health Care A. Alternative Medicine: Involves evaluating and treating illness and disease in ways which may differ from current, modern medical treatment; or enhance medical treatment being used.

History of Health Care II. Trends In Health Care A. Alternative Medicine: Practitioners: - Ayurvedic: harmonizing body and mind - Chinese: Acupressure Acupuncture; Life Energy (Chi)

History of Health Care II. Trends In Health Care A. Alternative Medicine: Practitioners: - Chiropractors: energy through nerves; spinal alignment - Homeopaths: body can heal itself with immune system

History of Health Care II. Trends In Health Care A. Alternative Medicine: Practitioners: - Hypnotist: trance-like state; verbal suggestions; follow - Naturopaths: natural therapies only; fasting, diets, lifestyle changes

National Health Care Plan History of Health Care II. Trends In Health Care National Health Care Plan

History of Health Care II. Trends In Health Care A. National Health Care Plan: Nationalizing health care is being considered as a result of rising health costs.

II. Trends In Health Care History of Health Care II. Trends In Health Care A. National Health Care Plan: - Government Health Care - taxes to help pay - Health Care Co-op - grouping of health care providers which provide care at lower costs

II. Trends In Health Care History of Health Care II. Trends In Health Care A. National Health Care Plan: - Managed Care - employers provide ins. & government helps pay for poor - State-run Health Care - Each state develops plan

History of Health Care II. Trends In Health Care A. National Health Care Plan: Goal: Health Care For All Potential Drawbacks: - Insured paying for uninsured - Limited choices of providers - Limited care

History of Health Care End of Lecture