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Current Health Care Systems and Trends
Chapter 2 Current Health Care Systems and Trends
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Today’s Health Care Industry
Largest service employer in U.S. Americans spent $2.9 trillion on health care in 2013 Projected to grow 5.7% annually between 2013 and 2023
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Technological Advancements
Health care changed very gradually until beginning of 20th century Progress now increases rapidly Infectious diseases previously major causes of death Now largely under control
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Question True or False:
Penicillin and antibiotics were discovered in the mid-1800s.
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Answer False Penicillin and antibiotics not discovered until 20th century
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Technological Advancements
Recent advancements: Organ transplants Microscopic and robotic surgery Gene therapy Targeted drug therapy
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Question The purpose of targeted drug therapy is to _____ .
Prevent drug abuse Destroy cancer cells Create personalized pharmaceutical products
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Answer B. Destroy cancer cells
Targeted drug therapy aims to destroy cancer cells or prevent them from dividing
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Highlights of Health Care History
Ancient and medieval times Early beliefs in supernatural causes Hippocrates Physician in ancient Greece Considered father of medicine Plagues during Middle Ages killed majority of population
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Question Chronic illnesses were rare in ancient times because _____ .
The average person did not live longer than 35 years The environment did not contain synthetic chemicals as it does today Physicians were unable to diagnose most diseases
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Answer Chronic illnesses are most common in older adults
A. The average person did not live longer than 35 years Chronic illnesses are most common in older adults
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Highlights of Health Care History
Renaissance Brought interest in science Experiments and observation
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Highlights of Health Care History
Surgery became respected form of treatment Body functions still poorly understood Technique of vaccination discovered by Jenner
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Highlights of Health Care History
Building of large hospitals Dentists introduced anesthesia Pasteur proved that bacteria caused certain diseases Advancements in public health and preventive medicine
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Question Elizabeth Blackwell, the first female physician in the U.S., opened the first _____ . Hospital Nursing school Treatment center for mental illness
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Answer B. Nursing school
Blackwell opened first school of nursing in 1860 Enabled nursing to become established profession
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Highlights of Health Care History
Many discoveries E.g., blood groups, vitamins, penicillin and antibiotics, synthetic drugs to treat specific problems Health care specialties developed E.g., physical and occupational therapy Great advances in surgical techniques Emphasis on scientific approach to medicine
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Hopes for the 21st Century
Vaccine to prevent human immunodeficiency virus (HIV) Cure for acquired immune deficiency syndrome (AIDS) Cure for obesity Organ cloning
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Hopes for the 21st Century
Cures for cancer and heart disease More effective treatment for mental illness Less invasive treatments Drugs with fewer side effects
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Specialization Effects on health care:
Improved diagnosis and treatment More technical and fragmented medical practice Increased health care costs Breakdown of patient-provider relationships Increased job opportunities for health care professionals
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Aging Population Life expectancy increase
1900 47 years Today 79 to 81 years Large number of “baby boomers” becoming older adults
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Aging Population Older adults Needs of older adults:
Heaviest users of health care services Needs of older adults: Long-term care facilities Home care services Treatment for chronic conditions
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Question True or False:
“Chronic” describes a health condition experienced as a result of aging.
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Answer False Chronic Conditions and illnesses that cannot be cured quickly Persist over period of time
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Increasing Costs of Health Care
Costs increasing dramatically Technological advances Increased use of services due to aging population Rising costs of pharmaceutical products Increased use of expensive diagnostic tests Lack of competition in some areas
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Increasing Costs of Health Care
Costs increasing dramatically Rising expectations of patients More effective treatments Therefore, more patients seeking care Poor geographic distribution of health care providers
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Costs of Health Care Sources of health care dollars, 2004
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Costs of Health Care Uses of health care dollars, 2004
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Health Care Facilities and Services
Wide variety of health care facilities Many patient services for different needs Range in size from private individual offices to national organizations Many employment options available for today’s health care professionals
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Hospitals Traditional health care setting
Now high-tech facility limited to patients who need sophisticated treatment and 24-hour care Costs have increased dramatically Major challenge: Controlling expenses
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Hospitals Various levels of care provided Trauma center
Emergency department (ER) Intensive care unit (ICU) Cardiac care unit (CCU) General unit Transitional care unit (TCU) Rehabilitation unit
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Question A patient who is hospitalized following a myocardial infarction (heart attack) would most likely be cared for in the _____ . CCU ICU Trauma center
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Answer A. CCU Cardiac care unit (CCU)
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ER VISITS Emergency departments used by some for routine care
Extremely expensive Patient Protection and Affordable Care Act may alleviate the overuse of ERs Patient education necessary on use of insurance
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Accreditation of Health Care Facilities
The Joint Commission Private, non-profit organization Encourages high standards Provides guidelines Performs on-site inspections Accreditation voluntary But may be required to qualify for Medicare reimbursement
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Ambulatory/Outpatient Services
Patients do not require hospitalization Most surgeries today are outpatient Majority of ambulatory services performed in physicians’ offices
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Ambulatory/Outpatient Services
Facilities that offer outpatient services: Adult day care Dental offices Diagnostic centers Emergency and urgent care centers Health care services in companies, schools, and prisons
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Ambulatory/Outpatient Services
Facilities that offer outpatient services: Medical offices Rehabilitation centers Specialty clinics and offices Surgical centers Wellness centers
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Long-Term Care Facilities
Individuals do not need hospital But unable to live at home Fastest growing area of health care services
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Long-Term Care Facilities
Nursing home Skilled nursing facility Intermediate nursing facility Adult foster home Assisted living residence Continuing care community
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Home Health Care Services
Provide care to patients in their homes Tremendous growth in need for services Factors contributing to its growth: Shorter hospital stays Increase in older population Medical equipment that can be used at home Desire of individuals to stay at home
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Home Health Care Providers
Examples of professionals who provide care at home: Nurses Physical therapists and assistants Occupational therapists and assistants
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Home Health Care Providers
Examples of professionals who provide care at home: Speech therapists Medical social workers Nursing assistants and home health aides
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Hospice Palliative care and support for dying patients and their families Team of professionals and volunteers Medical, emotional, and spiritual support Make patient’s last days as pain-free and meaningful as possible
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Question True or False:
Palliative care provides comfort and pain relief, but does not offer a cure.
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Answer True Palliative care relieves But does not cure
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Consolidation of Health Care Services
Combines facilities under one ownership to control costs Buy supplies in large quantities Share expensive equipment Avoid duplication of lab and diagnostic services Share knowledge and management expertise Consolidate services
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Consolidation of Health Care Services
Provides more consistent and coordinated care for patients But reduces competition Thus, patients have fewer choices Can result in higher prices and lower quality
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New Types of Facilities
Expanded functions for pharmacies Immunizations, mini-clinics Medical malls Cluster of services in vacated retail malls
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Government Health Services
Supported by taxpayers Conduct research, regulatory, and educational activities
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Government Health Services
Examples of federal agencies: National Institutes of Health (NIH) Centers for Disease Control and Prevention (CDC) Occupational Safety and Health Administration (OSHA)
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Question Which of the following service is provided by the National Institutes of Health? Make health care available for the uninsured Control the spread of diseases Conduct medical research
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Answer C. Conduct medical research
Role of National Institutes of Health: Conduct medical research
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Government Health Services
Examples of state services: License personnel and facilities Provide laboratory services Establish health data systems Conduct public health planning
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Government Health Services
Examples of local government services: Collect vital statistics Conduct sanitary inspections Screen for diseases Provide immunizations
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Trends in Health Care New approaches:
Search for alternatives to surgery and drugs Desire to use natural products Belief in mind-body connection Focus on prevention rather than cure More personal responsibility for health Patient access to information Desire for humanization of medicine
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Wellness Promotion of health through preventive measures and practice of good habits Leading causes of death influenced by lifestyle habits
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Wellness Wellness centers Routine physicals Immunizations
Exercise and nutrition classes
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Expanding Consciousness
Theory developed by Margaret Newman Wellness is more than the absence of disease or disability
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Question True or False Wellness means not having an illness or injury.
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Answer False Wellness means more than the absence of disease or injury. It includes the practice of good lifestyle habits and promoting good health through preventive measures.
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Complementary and Alternative Medicine
Complementary medicine Used together with conventional medicine Alternative medicine Used instead of conventional medicine
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Complementary and Alternative Medicine
Integrative medicine Conventional used with nonconventional practices for which there is scientific evidence of effectiveness
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Complementary and Alternative Medicine
Whole medical systems Homeopathic Naturopathic Traditional Chinese Including acupuncture Ayurveda
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Complementary and Alternative Medicine
Mind-body medicine Patient support groups Meditation Prayer Guided imagery Creative activities Yoga
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Complementary and Alternative Medicine
Biologically based practices Aromatherapy Herbs Dietary supplements Natural products E.g., shark cartilage
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Complementary and Alternative Medicine
Manipulative and body-based practices Chiropractic Osteopathic Massage therapy Reflexology Relaxation exercises
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Question Which of the following health care practices involves manipulating the spine to relieve pain or correct dysfunction? Naturopathy Acupuncture Chiropractic
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Answer C. Chiropractic Chiropractic care
Based on belief that pressure on nerves leaving spinal column causes pain and dysfunction
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Complementary and Alternative Medicine
Energy therapies Biofield Qi gong Reiki Therapeutic touch Bioelectromagnetic
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Complementary and Alternative Medicine
Susceptible to fraud Signs of fraudulent products: Claims to cure variety of problems Claims to be miraculous and/or secret Uses terms for which no definitions exist Provides undocumented case histories Requires payment in advance
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Holistic Medicine Expanded view of traditional medicine
Emphasizes prevention of disease and personal responsibility for health Reduce stress Proper nutrition Physical activity Positive attitude
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Holistic Medicine All aspects contribute to health Physical Mental
Emotional Spiritual
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Challenges in Health Care Today
Providing affordable care Patient Protection and Affordable Care Act of 2010 Subsidies for lower-income individuals Problem of high cost remains Some Medicare recipients cannot afford supplemental insurance
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Challenges in Health Care Today
Providing long-term care Increased need Costs increasing Medicare covers only certain short-term stays Funding may be inadequate
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Challenges in Health Care Today
Social conditions Poverty Homelessness Violence Substance abuse Spousal, child, and elder abuse Malnutrition
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Challenges in Health Care Today
Maintaining quality of care High costs encourage cutting expenses Amount of care may be decreased Decisions made by insurance companies rather than health care providers Preauthorization
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Question There is concern about the quality of care in the U.S. because of the A. poor training of physicians B. high cost of providing health care C. lack of government support for health care research
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Answer B. The high cost of health care sometimes influences the quality of care provided.
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Treating Alzheimer’s Disease
Progressive disease marked by dementia 6th leading cause of death in U.S. Cost of care Estimated to be $1.2 trillion by 2050
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Challenges in Health Care Today
Public health concerns Pandemics Influenza Ebola
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Challenges in Health Care Today
Medication adherence Failure to take medication results in expensive preventable health conditions May be due to high cost of drugs and/or side effects Providers must explain importance of medications
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Challenges in Health Care Today
Prescription drug overuse Painkiller prescriptions quadrupled since 1999 Almost 2 millions Americans abusing Deaths from overdose tripled since 1999
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Challenges in Health Care Today
Preventing prescription drug overuse Create prescribing guidelines Regulate pain clinics Identify fraudulent prescriptions Teach other pain control methods Educate patients about risk Improve access to antidotes
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Challenges in Health Care Today
Preventing antibiotic resistance Only effective against bacteria Bacteria can adapt so drugs are ineffective Can result from over and inappropriate use Considered a serious public health threat
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Question Patients who request prescriptions for antibiotics when they have a cold are A. contributing to the problem of antibiotic resistance B. practicing good health habits C. likely to get well quickly
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Answer A. Colds are caused by viruses and antibiotics are not effective against viruses. Taking unnecessary antibiotics leads to their being ineffective when needed.
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Challenges in Health Care Today
Personal responsibility for health Lifestyle choices influence incidence of heart disease, cancer, and stroke Healthy habits should be encouraged
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Implications for Health Care Professionals
Stay informed about important issues Contribute to delivery of high-quality care Model good health habits Provide effective patient education
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