Trends in Healthcare

CHANGE You must be aware of changes and trends as a Health Care worker.

Cost containment Trying to control the rising cost of healthcare and achieving the maximum benefit for every dollar spent

Reasons for high health care costs Technological Advances –Transplants –Artificial hearts –Computers

The Aging Population –More medications –More chronic diseases –Frequency of health care services

Health Related Lawsuits expensive malpractice insurance unnecessary diagnostic tests defensive health care

The Big Issue Health care costs prohibit services to all individuals Everyone should have equal access to care regardless of their ability to pay

Goal: Try to provide quality care at lowest possible price

Methods of cost containment Diagnostic Related Groups (DRGs) –Congress uses this to control costs for government insurance such as Medicaid and Medicare –Certain diagnoses who are admitted to hospitals are placed in one payment group –Limits are placed on cost of care and the agency only receives this set amount –If costs of care less than amount paid, agency keeps the extra money, if more the agency must accept the loss

Combination of Services Eliminate duplication of services Health care agencies join together or share specific services to provide care for larger number of people at a decreased cost per person Example: Labs

Outpatient Services Not admitted Reduces hospital length of stay lowers the cost Surgeries, xrays, diagnostic tests, etc done as outpatient services

Mass or Bulk Purchasing buy in large amounts at reduced prices Prevents overstocking and waste

Early Intervention and Preventive Services Providing care before acute or chronic disease occurs

Prevention more cost effective than treatment! patient education immunizations regular physical exams incentives for preventive health care services easy access for all individuals cost efficient avoids emergency rooms and acute care facilities

Energy Conservation Monitoring the use of energy to control costs and conserve resources

Methods to Conserve Energy Design and build new energy efficient facilities monitor/maintain Heating/cooling systems insulation and thermopane windows to prevent hot/cool air loss

Conserving Energy Repair plumbing replace energy consuming lightbulbs install infrared sensors to turn water on and off alternative forms of energy such as solar power recycling

Agency for Health Care Policy and Research (AHCPR) This agency researches the quality of health care delivery and identifies the standard of treatment that should be provided.

Health Care Workers Provide quality care Avoid waste Keep expenditures down

Health Care Consumers Responsible for their own care Better informed of all of their options Preventive measures

Home Health Care Care in the home Less expensive All aspects of healthcare can be envolved

Geriatric Care Care for the elderly Experiencing rapid growth due to a large number of people experiencing longer life spans due to advances in health care Baby BOOM generation – born after WW II

Increased Demand for Services Adult Daycare Retirement Communities Assisted and independent living facilities Other Organizations

OBRA Omnibus Budget Reconciliation Act of 1987 Led to the development of many organizations with regulations in long term care and home health care

OBRA Established training and competency evaluations for nursing and geriatric assistants Must be certified or registered as a certified nursing assistant

OBRA Continuing education, evaluation of performance and retraining/or testing if CNA has not worked in Health care facility for over 2 years State registry Patient/resident rights Must comply with these regulations

Telemedicine Involves use of video, audio and computer systems Allows interactive services between Health care worker’s in different locations Robotic surgery Computers help patients receive care in their own homes

Wellness State of being in optimum health and with a balanced relationship between physical, mental and social health

Wellness Exercise Nutrition Weight control Healthy living habits

Wellness is determined by lifestyle choices

Promoting Wellness Physical Wellness –Diet –Exercise –Physical exams –Immunizations –Dental and vision care –Avoidance of alcohol, tobacco, caffeine, drugs, environmental contaminants and risky sexual behavior

Emotional Wellness Understanding personal feelings and expressing them appropriately Accepting one’s limitations Adjust to change Cope with stress Enjoy life Be optimistic

Social Wellness Show concern Fairness Affection Tolerance Respect for others Communication Sharing ideas and thoughts Honesty and integrity

Mental and Intellectual Wellness Be creative Logical Curious Open minded Use common sense Obtain continual learning Question and evaluate Learn from life’s experiences Be flexible Be creative

Spiritual Wellness Values Ethics and Morals To find meaning Direction and Purpose in life Religious practices

Holistic Health Care Care that promotes physical, emotional, social, intellectual, and spiritual well- being by treating the whole body, mind and soul

Holistic Health Care Each patient is unique Variety of methods of diagnosis and treatment Treatment directed toward protection and restoration Natural healing Personal choices

Complementary and Alternative Methods of Health Care Complementary treatments are used in conjunction with conventional medical therapies Alternative methods of treatment are used in place of biomedical therapies

Integrative (integrated) Health Care Uses both mainstream medical treatments and CAM therapies to treat a patient

CAM Therapies Consider whole individual and recognize that the health of each part has an effect on the person’s total health status

CAM Therapies Each person has a life force or special type of energy that can be used in the healing process Skilled practitioners, rituals, and specialized practices are a part of therapy

Cultural Values and Beliefs

CAM Therapies Antioxidants: Nutritional therapy that encourages the use of substances to prevent or inhibit oxidation and neutralize free radicals Heart disease, cataracts, and some cancers

Meditation Therapies that teach breathing and muscle relaxation techniques to quiet the mind and focusing attention or obtaining a sense of oneness within oneself Reduce stress, slow heart rate, decrease blood pressure

Ayruvedic Practitioners Developed in India, an ancient philosophy to determine a person’s predominant dosha (body type) and prescribe diet, herbal treatment, exercise, yoga, massage, etc. to restore harmony in the body

Chinese Medicine Ancient holistic-based healing practice based on the belief that a life energy (CHI) flows through every living person in an invisible system of pathways to link the organs with the universe Accupuncture, tai chi

Chiropractors Believe that the brain sends vital energy to all body parts through nerves in the spinal cord and when there is a misalignment of the vertebrae, exerts pressure, resulting in disease and pain Use spinal manipulation, massage and exercise

Homeopaths Believe in the ability of the body to heal itself through the actions of the immune system Use diluted substances to cause similar symptoms of the disease to activate the immune system

Hypnotists Help an individual obtain a trance-like state with the belief that the person will be receptive to verbal suggestions and able to make a desired behavior change Smoking cessation, weight loss, phobias, etc.

Naturopaths Use only natural therapies such as fasting, special diets, lifestyle changes, and supportive approaches to promote healing Avoid use of surgery or medicinal agents to treat disease

Play therapy Therapy that uses toys to allow children to learn about situations, share experiences and express their emotions Psychotherapy for children with limited language ability

Aromatherapy Use selected fragrances (concentrated essences or essential oils) that have been extracted from roots, plants, bark, and/or flowers to alter the mood and restore the body, mind and spirit

Tai Chi Based on the ancient theory that health is harmony with nature and the universe and a balanced state of yin (cold) and yang (heat) Series of movements and breathing techniques

National Center for Complementary and Alternative Medicine NCCAM Researches various therapies and determines standards of quality care

State Requirements Some have established standards for CAMs Forbidden in some states Labeled as experimental Require a license or certain educational requirements before practicing Learn the legal requirements for your state Patient has the right to choose their care Nonjudgmental attitude

CAM Therapies Noninvasive Holistic Less expensive than other traditional treatments

National Health Care Plan The main goal is health care reform to ensure that all Americans can get health coverage

Pandemic Outbreak of disease that occurs over a wide geographic area and affects a high proportion of the population

World Health Organization WHO WHO is concerned about influenza pandemics occurring now and in the near future

Historically Influenza pandemics have killed large numbers of people Example: 1918 Spanish Flu Pandemic killed about 40 million people who contracted the disease

Avian (Bird) Flu Virus was identified as the cause of an epidemic. Virus jumped directly to humans H5N1 present in countries in Asia and elsewhere Passed from bird to bird and devastated flocks of birds in 11 countries

H5N1 and Humans Most cases resulted from persons who had contact with infected poultry or contaminated surfaces Spread from person to person rare Death rate in humans was % Concern was mutation of the virus

Hantavirus Spread by rodents Severe acute respiratory syndrome (SARS), Monkeypox, Filoviruses such as Ebola virus, and Marburg virus can cause hemorrhagic fever WHO estimates that 2-7 million people worldwide could die from infections from these types of viruses

Pandemic Flu Plans Education- info about pandemics and ways to avoid its spread Antiviral drugs - must be stockpiled and ready for immediate use More research to develop and produce effective antivirals Development of protective public health measures- Influenza must be diagnosed rapidly. Strict infection control methods to limit the spread of the virus

Planning First Responders and Health Care personnel must be immunized so they can care for the infected individuals Quarantine measures- to control the spread of disease International cooperation- countries must be willing to work with each other to create international plans to limit the spread of lethal viruses and decrease the severity of a pandemic

Swine Flu (H1N1) Respiratory disease of pigs caused by Type A influenza virus First isolated in 1930 High levels of illness and low death rates in pigs Do not normally infect humans, but sporadic infections have occurred

H1N1 in humans Most commonly occurs in persons with direct exposure to pigs Symptoms of swine flu are fever, lethargy, lack of appetite, coughing which are similar symptoms to the seasonal flu Some other symptoms maybe runny nose, sore throat, nausea, vomiting and diarrhea

H1N1 You can not get H1N1 from eating pork It can be spread from pigs to people and people to pigs You may also have human to human transmission There are medications to treat the H1N1 virus

Who is at risk? Children under the age of 2 People who suffer with heart disease or diabetes Asthmatics and pregnant women Teenagers and young adults are also more vulnerable Health Care Workers

Prevention Wash your hands Stay away from crowded areas Cover your mouth when you sneeze or cough REMEMBER: It is a treatable and curable disease

Stay abreast of changes and make every attempt to learn about them!!!!