1. Chapter 01
Trends of Health Care

2. 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

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

4. 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

5. 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

6. OBRA
Omnibus Budget Reconciliation Act (OBRA) of 1987 (AKA The Federal Nursing Home Reform Act)
creates a set of national minimum set of standards of care and rights for people living in certified nursing facilities.
Federal regulation for long-term care, nursing homes and home health care
States must establish training and competency evaluation programs for nursing/geriatric assistants

7. 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

8. 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
1:39

9. 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

10. Wellness (continued)
Physical wellness – diet, exercise, physical exams, immunizations, dental & vision exams, avoiding alcohol, drugs, caffeine, contaminants, risky sexual behavior
Emotional wellness – understand personal feelings & expressing them appropriately, adjusting to change, coping with stress, enjoying life
Social wellness – showing concern, fairness, affection, tolerance, & respect for others
Mental and intellectual wellness – using common sense, being creative, logical, curious, open minded, and continually learning
Spiritual wellness – using values, ethics, morals to find meaning, direction, and purpose to life; includes higher authority and religious practice

11. 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

12. 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
meditation

13. 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
- National Center for Complementary and Alternative Medicine

14. Types of CAM Practitioners
Ayurvedic - Ayurvedic Medicine, is the traditional medicine of India, which originated there over 5,000 years ago. It emphasizes on re-establishing balance in the body through diet, lifestyle, exercise, body cleansing, and on the health of the mind, body, and spirit. It is considered a form of alternative medicine. Like traditional Chinese medicine, Ayurveda is a whole medical system, meaning that it is based on theories of health and illness and on methods of preventing and treating health conditions.

15. Types of CAM Practitioners (continued)
Chinese medicine - is a system of medicine partly based on the idea that an energy, called qi (say "chee"), flows along pathways in the body called meridians. In this belief, if the flow of qi along these meridians is blocked or unbalanced, illness can occur. In China, doctors have practiced Chinese medicine for thousands of years, and it is gaining in popularity in many Western countries.
Causes of qi imbalance are thought to involve:
External forces, such as wind, cold, or heat.
Internal forces, such as emotions of joy, anger, or fear.
Lifestyle factors, such as poor diet, too little sleep, or too much alcohol.

16. Types of CAM Practitioners (Continued)
Chiropractic medicine - A form of alternative medicine that emphasizes diagnosis, treatment, and prevention of mechanical disorders of the musculoskeletal system, especially the spine, under the belief that these disorders affect general health via the nervous system.

17. Types of CAM Practitioners (Continued)
Hypnotists - Hypnosis is a psychological state, superficially resembling sleep and marked by a level of awareness different to the ordinary conscious state. Another description is an altered mental state, while another links it to imaginative role-enactment.
A person under hypnosis is said to have heightened focus and concentration with the ability to concentrate intensely on a specific thought or memory, while blocking out sources of distraction. Hypnotized subjects are said to show an increased response to suggestions.
It is used for phobias and other anxiety disorders, pain management, weight loss, to stop smoking, and a variety of other applications. It is still considered controversial, as many mental health professionals dispute its effectiveness and many clients are afraid to try it.

18. Homeopaths - A medical philosophy and practice based on the idea that the body has the ability to heal itself. It views symptoms of illness as normal responses of the body as it attempts to regain health.
It is based on the idea that "like cures like." That is, if a substance causes a symptom in a healthy person, giving the person a very small amount of the same substance may cure the illness. In theory, a homeopathic dose enhances the body's normal healing and self-regulatory processes.
A homeopathic health practitioner uses pills or liquid solutions containing only a little of an active ingredient (usually a plant or mineral) for treatment of disease. These are known as highly diluted or "potentiated" substances. There is some evidence to show that homeopathic medicines may have helpful effects.

19. Types of Therapies Refer to Table 1-8 in Text
Most are noninvasive (not
cutting into the body) and
holistic
Often less expensive than
traditional treatments but usually not covered by insurance
National Center for complementary and Alternative Medicine established in 1992
meditation
hypnosis

20. Pandemic
Disease outbreak over a wide geographic area affecting high proportion of population (worldwide)
WHO (World Health Organizations) - An international agency concerned with serious health problems throughout the world
Viruses can mutate and
exchange genetic information

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

22. Epidemic
An infectious disease that affects a large number of people within a population, community, or region at the same time

23. 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

24. Resources National Center for Complementary and
Alternative Medicine
Information about how the government is preparing for possible future pandemics