1. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Chapter 01 History and Trends of Health Care

2. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

4. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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. (many people could not read so knowledge was limited to an educated few)

5. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

6. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

7. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Ancient Times (continued) Chinese believed in the need to cure the spirit and nourish the body (important today – holistic health methods stress treating the the entire pt. Mind, Body and Soul) Hippocrates and other physicians in ancient Greece established the importance of diet and cleanliness in preventing illness and disease

8. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

9. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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 (diseases such as typhoid, cholera, malaria, dysentery, leprosy and small pox infected many individuals) Average life span of 20 to 35 years

10. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

11. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Small Pox

12. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. The Dark Ages and Middle Ages During the Dark Ages, interest in the medical practices of Greeks and Romans stopped. Renewed interest in medical practices came during the Middle Ages 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

13. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Bubonic Plague

14. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. The Renaissance (1350 -1650 AD) “Rebirth of the science of medicine” Human dissection to view body organs was accepted Printing press allowed publication of medical books (knowledge spread rapidly – physicians were more educated) Causes of disease were still a mystery Average life span of 30 to 40 years

15. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Human dissection

16. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Leonardo de vinci

17. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. The 16th, 17th, and 18th Centuries Knowledge of human body greatly increased Invention of microscope (Anton van Leeuwenhoek “Father of Microbiology”) Apothecaries (early pharmacists) made, prescribed, and sold medications Smallpox vaccine discovered Average life span of 40 to 50 years

18. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. First microscope

19. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. The 19th Century Industrial Revolution (major progress in medical science occurred because of the development of machines and ready access to books) Invention of stethoscope, nurse training programs Infection control (physicians began to associate tiny microorganisms seen in the microscope with diseases) Average life span of 40 to 65 years

20. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

21. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

22. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

23. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. The 20th Century (continued) President Franklin Roosevelt established the March of Dimes to fight Polio in 1937 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

24. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

25. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. The 21st Century Human Genome Project (genome- the total mass of genetic instruction humans inherit from their parents) Embryonic stem cell and cloned cell research Threat of bioterrorism with the use of biologic agents as weapons Viruses that can cause pandemics (pandemic- an infectious disease that affects many people over a wide geographic area; a world wide epidemic). (epidemic- an infectious disease that affects a large number of people within a population, community, or region at the same time).

26. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 1:2 Trends in Health Care: Cost Containment 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

27. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Cost Containment (continued) Methods – Diagnostic related groups (DRGs) (encourages agency/hospitals to make every effort to provide care within the expense limit allowed) – Combination of services (when health care agencies join together or share specific services) – Outpatient services ( patients receive care without being admitted to hospitals or other care facilities)

28. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Cost Containment (continued) – Mass or bulk purchasing – buying equipment and supplies in larger quantities at a reduced price. – Early intervention and preventive services- providing care before acute or chronic disease occurs. – Energy conservation –monitoring the use of energy to control costs and conserve resources.

29. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Home Health Care 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- ( less expensive to provide this type of care)

30. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

31. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. geriatric

32. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

33. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

34. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

35. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. telemedicine

36. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Wellness Wellness - State of optimum health with a balanced relationship between physical, social, and mental health. Focus on disease prevention and quality of life – Saves costs Individuals recognize the importance of exercise, nutrition, weight control, and healthy living habits.

37. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Wellness (continued) Physical wellness – diet, exercise, physicals, immunizations, dental and vision exam. Emotional wellness – understanding personal feelings, limitations, adjusting to change, coping with stress, optimistic outlook. Social wellness – showing concern, fairness, affection, tolerance and respect to others.

38. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Wellness (continued) Mental and intellectual wellness – creative, logical, curious and open minded ( common sense) Spiritual wellness – values, ethics and morals

39. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

40. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

41. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Complementary and Alternative Methods of Health Care Complementary therapies: used in conjunction with conventional medical therapies Alternative therapies: treatment used in place of biomedical therapies Integrative health care: uses both mainstream and CAM therapies to treat patients.

42. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

43. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Types of CAM Practitioners Ayurvedic Chinese medicine Chiropractors Homeopaths Hypnotists Naturopaths

44. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

45. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.

46. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

47. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. Pandemic (continued) Government plans – Education – Vaccine production – Antiviral drugs – Developing protective public health measures – International cooperation

48. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part. 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

49. Copyright © 2014 Cengage Learning. All Rights Reserved. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in whole or in part.