1. Chapter 2 Health Care Systems
Health Care Science Technology
Copyright © The McGraw-Hill Companies, Inc.

2. Objectives Summarize significant historical changes in health care.
List the reasons for the importance to health care of the scientific method.
Compare ancient and current medical practices.
Chapter 2

3. Objectives (cont.) Identify major trends in health care.
List the types of health care facilities and the services provided in each.
Chapter 2

4. Objectives (cont.)
List the ways in which health care facilities, government agencies, and nonprofit volunteer agencies contribute to the health of a community and the world.
Identify the clients served by Medicare and Medicaid.
Chapter 2

5. Objectives (cont.)
Discuss the impact of the uninsured on health care costs.
Summarize the purpose of health maintenance organizations (HMOs).
Define the purpose of workers’ compensation.
Chapter 2

6. History of Health Care 2-1
Prehistory and the Ancient World
The Middle Ages
The Renaissance
The Industrial Revolution
Modern Times
Chapter 2

7. Prehistory and the Ancient World
Ancient healers used diet, rest, plants, and herbs, and performed surgery.
The caduceus, which is the symbol of the physician, may have evolved from the symbol for Asclepius, the Greek god of healing.
Chapter 2

8. Prehistory and the Ancient World (cont.)
The Hippocratic Oath is a code of ethics developed by Hippocrates around 400 B.C.
This code promotes patient confidentiality and forbids the deliberate harming of a patient.
Chapter 2

9. Prehistory and the Ancient World (cont.)
Galen was a Greek trained by the Egyptians and appointed as physician to the gladiators.
He is credited with performing tracheotomies and documenting the importance of the spinal cord in the movement of limbs.
His manuscripts were used to train physicians until the Renaissance, which began in the 14th century.
Chapter 2

10. The Middle Ages 500 A.D. – 1500 A.D. Rhazes was a Persian doctor.
Reason began to replace belief in spiritual or superstitious causes for illness.
Rhazes was a Persian doctor.
He wrote about the differences between smallpox and measles.
He provided a clearer understanding of the causes of disease.
Chapter 2

11. The Middle Ages (cont.) The Barber-Surgeon
Barbers performed cataract surgery, limb amputations, and phlebotomy (bloodletting).
The red and white barber pole may have begun as a pole to hang bandages, or may have symbolized blood, veins, and bandages (red, blue, and white).
Chapter 2

12. The Middle Ages (cont.) The Beginning of Medical Care Regulation
Physicians were licensed after formal training with experienced doctors.
Women were not allowed to practice medicine.
Chapter 2

13. The Middle Ages (cont.) Religion and Medicine
Religious principles led to the founding of many Islamic hospitals and Christian monasteries where the sick were treated.
Chapter 2

14. The Renaissance 14th – 17th Centuries 15th Century
The invention of the printing press allowed discoveries to be published.
16th Century
The scientific method came into use and the microscope was invented.
Age of Enlightenment (1700s)
The study of anatomy was allowed by the church.
Chapter 2

15. The Industrial Revolution
Late 18th and Early 19th Centuries
Stethoscope invented.
Vaccination began.
Marked the beginning of modern medicine.
Louis Pasteur’s experiments formed the basis of microbiology.
Joseph Lister began disinfecting surgical equipment and hand washing (medical asepsis).
Robert Koch found that pathogens are the source of some diseases.
Ether used as an anesthesia.
Chapter 2

16. Modern Times 20th Century Antibiotics invented. Radium discovered.
CAT scans, MRI, and ultrasound are used.
Organ transplants commonplace.
Chapter 2

17. Section 2-1 Apply Your Knowledge
What did the invention of the printing press allow?
Answer:
The printing press made it possible to publish books about discoveries.
Chapter 2

18. Trends in Health Care 2-2 Technology Preventive Medicine and Wellness
Aging Population
Underinsured and Uninsured
Ambulatory Care and Outpatient Surgery
Home Health Care
Chapter 2

19. Technology
Computer technology allows noninvasive diagnosis of soft tissue diseases and injuries.
Ultrasound used to examine body cavities.
Field of radiology no longer limited to X rays.
Chapter 2

20. Technology (cont.)
Miniaturization allows cameras and instruments to be inserted into the body for surgical procedures.
Digital images can be transmitted to a consulting specialist.
Client’s records can be made available anytime and anywhere.
Chapter 2

21. Preventive Medicine and Wellness
Wellness idea began about 20 years ago with the introduction of fitness centers.
Wellness industry growth spurred by baby boomers, physicians, insurance companies, and fitness professionals.
Might have been better to say in the mid 1980’s…
Chapter 2

22. Preventive Medicine and Wellness (cont.)
Hospital wellness centers offer services such as:
Cardiac rehabilitation.
Pulmonary rehabilitation.
Occupational medicine.
Sports medicine.
Clinical weight management.
Physical therapy.
Chapter 2

23. Preventive Medicine and Wellness (cont.)
Most hospital wellness centers offer wellness programs for clients with chronic diseases such as:
Arthritis.
Diabetes.
Osteoporosis.
Neuromuscular disorders.
Chapter 2

24. Preventive Medicine and Wellness (cont.)
Many hospital wellness centers offer complementary classes in:
Yoga.
Nutrition.
Stress management.
Some hospital wellness centers provide screening for diseases that include:
Breast, cervical, and prostate cancer.
High blood pressure.
High cholesterol.
Chapter 2

25. Preventive Medicine and Wellness (cont.)
Factors relating to personal responsibility for wellness include:
Fitness.
Preventive care.
Spiritual health.
Safety.
Nutrition.
Tobacco addiction.
Stress management.
Chapter 2

26. Aging Population Caused by fewer births and fewer deaths.
Baby Boom,
Population of 65 and older expected to double between the years 2000 and 2030, from 35 million to 70 million.
As the population ages, demands on the health care services will increase.
Chapter 2

27. Underinsured and Uninsured
16% of U.S. population (42 million) have no health insurance.
Some have health insurance, but coverage is limited by a large co-payment or deductible in addition to the insurance premium.
Chapter 2

28. Underinsured and Uninsured (cont.)
As new technology and products emerge, costs increase.
County hospitals, supported by taxes, care for uninsured low income people.
Costs associated with the uninsured are passed on to those who are insured or can afford to pay.
Chapter 2

29. Ambulatory Care and Outpatient Surgery
Technology, research, and new medications make same-day surgery possible.
Costs can be reduced when patients do not remain overnight.
Chapter 2

30. Home Health Care Became popular in the late 1980s.
Medicare began paying hospitals a flat fee for diagnostic related groups (DRGs).
Patients are released from the hospital early and receive home visits by a skilled professional.
Patient benefits by exposure to fewer pathogens, lowered stress and anxiety, and decreased cost.
Chapter 2

31. Section 2-2 Apply Your Knowledge
What can be done to contain the cost of health care?
Answers:
Home health care.
Ambulatory care.
Preventive care/wellness.
Chapter 2

32. Health Care Facilities 2-3
Hospitals
Long-Term Care
Practitioners’ Offices
Clinics
Laboratories
Emergency Medical Services
Home Health Care
Rehabilitation
Hospice
Chapter 2

33. Hospitals Hospitals Run by Religious Organizations Private Hospitals
Nonprofit Hospitals
Hospitals Run by Government Organizations
Specialized Hospitals
Chapter 2

34. Long-Term Care
Residents may be frail, elderly, handicapped, or disabled.
Residents seen by the physician monthly.
Assisted-living centers offer separate living quarters, and provide meals and housekeeping.
Some residents are able to perform many of their own activities of daily living (ADL).
Chapter 2

35. Practitioners’ Offices
Many offer testing and minor surgery.
Dentists and dental hygienists are included in this group.
May be an individual or a group practice.
Chapter 2

36. Clinics
Practitioners have separate clients, but share billing, reception, and record-keeping staff.
Clinic may specialize or offer a wide variety of services.
“Clinic” may refer to a type of care provided on a specific day and may move from location to location.
Chapter 2

37. Laboratories May perform tests on blood or body tissues.
Can be part of a clinic or hospital.
Some are supported by public money.
Chapter 2

38. Emergency Medical Services
Developed to provide care to ill and injured as quickly as possible.
May be part of the 911 phone system.
Police officers, firefighters, and ambulance staff may perform EMS.
In rural areas, volunteers, park rangers, or ski patrol may provide EMS.
Chapter 2

39. Home Health Care
Can be considered another type of health care facility.
May be long term or short term.
Chapter 2

40. Rehabilitation
Designed to help clients regain physical or mental abilities or to help them live with disabilities.
May be part of a hospital, clinic, or privately owned.
Chapter 2

41. Hospice Services are provided to the terminally ill.
Includes treatment from doctors, nurses, therapists, dieticians, social workers, clergy, and volunteers.
Chapter 2

42. Hospice (cont.) Therapy is designed to: Improve quality of life.
Use pain medications effectively.
Relieve symptoms.
Prepare the person and his or her family for death.
Chapter 2

43. Section 2-3 Apply Your Knowledge
What are four types of care that may be provided in a long-term care facility?
Answer:
Regular professional health care services
Therapy
Physical rehabilitation
Skilled nursing care
Chapter 2

44. Health Care Agencies 2-4 Government Agencies
Volunteer and Nonprofit Health Agencies
Chapter 2

45. Government Agencies Local Health Departments
Provide immunizations, inspections, and environmental protection.
Collect statistics about communicable diseases.
May provide health education and other health-related services to the community.
Chapter 2

46. Government Agencies (cont.)
U.S. Department of Health and Human Services (DHHS)
National agency that deals with health in the United States.
Important agencies under DHHS include:
Centers for Disease Control (CDC).
Food and Drug Administration (FDA).
National Institute of Health (NIH).
Chapter 2

47. Government Agencies (cont.)
World Health Organization (WHO)
International agency sponsored by the United Nations.
Primary goal is to help all people attain the highest possible level of health.
Compiles statistics on disease.
Provides training for medical personnel.
Chapter 2

48. Volunteer and Nonprofit Health Agencies
Can be on the state, local, or national level.
Supported by private contributions and fund-raising.
Usually focus on a single disease.
Examples include:
American Lung Association (ALA).
March of Dimes.
American Heart Association (AHA).
Chapter 2

49. Section 2-4 Apply Your Knowledge
What are three ways volunteer and nonprofit organizations have contributed to health and health care?
Answer:
Influenced laws.
Created standards of care for infants.
Educated doctors and other health professionals in new techniques.
Chapter 2

50. Health Insurance 2-5 Paying for Health Care Medicare and Medicaid
Managed Care
Workers’ Compensation
Military Health Care
Chapter 2

51. Paying for Health Care
Insurance company decides what medical services will be covered.
Group insurance coverage is offered to employees by many employers.
Chapter 2

52. Medicare and Medicaid Programs are result of federal legislation.
Programs target people who lack access to care.
Chapter 2

53. Medicare Largest health insurance program in the nation.
Must be at least 65 years old or disabled to qualify.
Part A provides for hospital care, limited skilled nursing facility services, home health services, and hospice care.
Chapter 2

54. Medicare (cont.)
Part B helps pay for the services of physicians, outpatient hospital services, and medical equipment and supplies.
The insured pays a premium for Part B and may have to pay a deductible or have other private insurance.
Chapter 2

55. AND OTHER MEDICAL ASSISTANCE PROGRAMS
Medicaid
Government insurance for certain low-income people.
Dental coverage may be available.
No co-payment or deductible.
INDIANA MEDICAID
AND OTHER MEDICAL ASSISTANCE PROGRAMS
Danny L. Owens
07/19/62
Problem with the text “Each state and federal administrator this program and……..”
Chapter 2

56. Managed Care Health care plans specifically designed to control costs.
Advantages
Most include preventive care, such as annual physicals, mammograms, and well-baby care.
Monthly premiums and out-of-pocket expenses are usually lower than with traditional insurance.
Reduced paperwork.
Chapter 2

57. Managed Care (cont.) Disadvantages
Limited choice of doctors and hospitals, except for emergency treatment.
Must be referred to specialist by primary care physician.
Usually more restrictive than ordinary insurance.
Not all health expenses count toward deductible.
Chapter 2

58. Health Maintenance Organizations
Focus on prevention and wellness.
Businesses or individuals pay premiums to the HMO instead of an insurance company.
HMOs focus on wellness care not usually covered by insurance.
Popular in the 1980s and 1990s.
Chapter 2

59. Workers’ Compensation
Insurance that covers accidents, injuries, or diseases that occur in the workplace.
Federal law requires businesses to purchase and maintain a minimum amount of workers’ compensation insurance.
Chapter 2

60. Workers’ Compensation (cont.)
Types of services provided for injuries occurring in the workplace:
Basic medical treatment for inpatient and outpatient care.
Weekly payments to employees for temporary disabilities.
Monthly payments to employees with permanent disabilities.
Death benefits.
Rehabilitation costs.
Chapter 2

61. Military Health Care
Provided to current military personnel, retired military personnel, and veterans through CHAMPUS/TRICARE program.
Public Health Service and National Oceanic and Atmospheric Administration are also covered by this benefit.
Chapter 2

62. Section 2-5 Apply Your Knowledge
List 3 advantages to managed care.
Answer:
Most policies include preventive care.
Monthly premiums and out-of-pocket expenses are lower than with traditional insurance.
Paperwork is reduced, and there are no claim forms.
Chapter 2

63. Chapter 2 Credits Slide 16 Grantpix/Photo Researchers
Slide 20 Healthcare Medical Communication Systems, Inc.
Slide 21 Daniel Miller/CORBIS
Slide 26 PhotoDisc
Slide 29 Doug Martin
Slide 30 KS Studios
Slide 33 Ron Chapple/Getty Images
Slide 35 Matt Meadows
Slide 41 CORBIS
Slide 61 David Kelly Crow
Chapter 2