1. History of Health Care

2. 4000 BC – 3000 BC Primitive Times
Illness and diseases were a punishment from the Gods
Tribal witch doctors treated illness with ceremonies
Herbs and plants used as medicines (morphine and digitalis)
Trepanation or trephining (surgically removing a piece of bone from the skull)
Average life span was 20 years

3. Early Beginning Medicines
Medicines of early times still used today
Digitalis (foxglove plant) used to slow & strengthen heart
Quinine (bark of cinchona tree) used for fever, muscle spasms, malaria
Morphine (opium poppy) used to relieve severe pain; is addicting

4. 3000 BC – 300 BC Ancient Egyptians
Physicians were priests
Bloodletting or leeches used as medical treatment
Average life span was years
Egyptians kept accurate health records
Developed the art of splinting fractures,

5. 1700 BC – AD 220 Ancient Chinese
Believed in the need to treat the whole body by curing the spirit and nourishing the body
Recorded a pharmacopoeia of medications based mainly on the use of herbs
Used therapies such as acupuncture
Began to search for medical reasons for illness
Average life span was years

6. 1200 BC –200 BC Ancient Greeks
First to observe the human body and the effects of disease – led to modern medical sciences.
Chinese monitored the pulse/blood pressure to determine condition of the body; believed in treating the whole body; used acupuncture.
Believed illness is a result of natural causes
Stressed diet and exercise as ways to prevent disease
Average life span was years

7. 753 BC – AD 410 Ancient Romans
First to organize medical care by providing care for injured soldiers
Later hospitals were religious and charitable institutions in monasteries and convents
First public health and sanitation systems by building sewers and aqueducts
Doctors kept the sick in their home. They wore a death mask.
Life span was years

8. AD 400 – AD 800 Dark Ages
Emphasis on saving the soul and study of medicine was prohibited
Prayer and divine intervention were used to treat illness & disease
Monks and priests provided custodial care for ill people
Medications were mainly herbal mixtures
Average life span was years

9. AD 800 – AD Middle Ages
Bubonic Plague killed 75% of population in Europe and Asia. The “Black Death” or killed 60 million people
Major diseases included smallpox, diptheria, tuberculosis, typhoid, the plaque, and malaria
Arabs began requiring physicians pass examinations and obtain licenses
Average life span was years

10. AD 1350 – AD Renaissance
Dissection of body led to increased understanding of anatomy and physiology
Invention of printing press allowed medical knowledge to be shared
First anatomy book was published by Andreas Vesalius ( )
Michelangelo and Leonardo da Vinci used dissection to draw more realistic pictures of the human body
Average life span was years

11. 16th and 17th Centuries
Cause of disease still not known – many people died from infections
Invention of the microscope allowed physicians to see disease-causing organisms.
Apothecaries (early pharmicists) made, prescribed, and sold medications
Ambroise Pare ( ), a French surgeon, known as the Father of Modern Surgery established use of ligatures to stop bleeding
Average life span years

12. 16th-17th Centuries Scientists
William Harvey- heart is a pump which pumps blood through out the body
Gabrielle Fallopius- identifies and names fallopian tubes and vagina and tympanic membrane
Bartolomeo Eustachio identified and named the tube leading from ear to the throat

13. 18th Century
Gabriel Fahrenheit ( ) created the first mercury thermometer
John Hunter ( ), established scientific surgical procedures and introduced tube feeding
Joseph Priestly discovered the element oxygen
Benjamin Franklin invented bifocals
Average life span years

14. 19th Century
Rapid advancements due to discoveries of microorganisms, anesthesia, and vaccinations
Infection control developed once microorganisms were associated with disease
Paul Ehrlich discovered a treatment for syphilis on his 606th experiment
Formal training for nurses began
Women became active participants in health care
Lillian Wald started the public health nursing and visited homes to give care in New York City in 1893
Average life span years

15. 20th Century Increased knowledge about the role of blood in the body
ABO blood groups discovered
Found out how white blood cells protect against disease
New medications were developed
Insulin discovered and used to treat diabetes
Antibiotics developed to fight infections
Vaccines were developed
New machines developed
Kidney Dialysis Machine
Heart Lung Machine
Surgical and diagnostic techniques developed to cure once fatal conditions

16. 20th Century (continued)
Organ Transplants
Test tube babies
Implanted first artificial heart
Health Care Plans developed to help pay the cost of care
Medicare and Medicaid marked the entry of the federal government into the health care arena
HMOs provided an alternative to private insurance
Hospice organized
Walter Reed found that mosquitoes carried yellow fever in His vaccine helped the building of the Panama Canal

17. 21st Century
The first totally implantable artificial heart was placed in a patient in Louisville, Ky. In 2001
The threat of bioterrorism lead to smallpox vaccination of the military and first responders in 2002
The Netherlands became the first country in the world to legalize euthanasia in 2002
The Human Genome Project to identify all of the approximately 20,000 to 25,000 genes in the human

18. 21st Century
Stem cells were used in the treatments of disease early in the 2000’s and lead to increased research in the treatment of cancer and other diseases
President George W. Bush approved federal funding for research using only existing lines of embryonic stem cells in 2001
Advanced Cell Technology announced it cloned a human embryo in 2001 but the embryo did not survive
The U.S. FDA approved the use of the abortion pill RU-486 IN 200

19. 21st Century
The standards for Privacy of Individually Identifiable Health Information, required under the Health Insurance Portability and Accountability Act (HIPPA) of 1996, went into effect in 2003
The Medicare Prescription Drug Improvement and Modernization Act was passed in 2003
Vaccinations for cervical cancer and herpes zoster (shingles) in 2006

20. Potential for 21st Century
Cures for AIDS, cancer, and heart disease
Genetic manipulation to prevent inherited disease
Nerves in the brain and spinal cord are regenerated to prevent paralysis
Antibiotics are developed that do not allow pathogens to develop resistance
Average life span years

21. Individual Contributions
What Georgian surgeon was believed to be the first person to use anesthesia but never given credit for it?

22. Hippocrates (460 – 377 BC)
Greek physician known as the “Father of Medicine
Authored code of conduct for doctors known as the “Hippocratic Oath” that is the basis of medical practice today
Believed illness was not caused
by evil spirits and stressed
importance of good diet, fresh
air, cleanliness, and exercise

23. Anton van Leeuwenhoek (1632-1723)
Invented the microscope lens that allowed visualization of organisms
Scraped his teeth
and observed the
bacteria that
causes tooth
decay

24. Benjamin Franklin ( )
Invented bifocals
Found that colds could
be passed from person
to person

25. Edward Jenner ( )
Developed a vaccination for smallpox in 1796

26. Rene Laennec ( )
Invented the stethoscope in 1819
First stethoscope was made of wood

27. Elizabeth Blackwell (1821-1910)
First female physician in the United States in 1849

28. F lorence Nightingale (1820-1910)
Known as the “Founder of Modern Nursing”
Established efficient and sanitary nursing units during the Crimean War in 1854
Invented the call bell system and use of dumbwaiters to deliver meals
Begin the professional education of nurses

29. Louis Pasteur (1822-1895) Known as the “Father of Microbiology”
His germ theory proved that microorganisms cause disease
Proved that heat can be used
to destroy germs through a
process called pasteurization
Created a vaccine for rabies in
1885
Founded the basic rules for
sterilization

30. Joseph Lister (1827-1912) Used carbolic acid on wounds to kill germs
First doctor to use an antiseptic during surgery

31. Clara Barton ( )
Volunteer nurse for wounded soldiers during the Civil War
After Civil War, established a bureau of records to search for missing men
Campaigned for the USA to sign
the Treaty of Geneva, which
provided relief for sick and
wounded soldiers
Formed American Red Cross
in 1881 and served as its first
president

32. Robert Koch ( )
Developed the culture plate method to identify pathogens
Isolated the bacterium
that causes tuberculosis

33. Wilhelm Roentgen ( )
Discovered X-rays in 1895
Let doctors see inside the body
X-rayed wife’s hand

34. Sigmund Freud ( )
Discovered the conscious and unconscious part of the mind
His studies were the basis for psychology and psychiatry

35. Sir Alexander Fleming (1881-1955)
Discovered penicillin in 1928 which is considered one of the most
important
discoveries of
the twentieth
century

36. Jonas Salk (1914-1995) Albert Sabin (1906 – 1993)
Discovered polio vaccine
Saved many people from
this virus that paralyzed
thousands of adults and
children each year.

37. Francis Crick (1916 – 2004) James Watson (1928 - )
Described the structure of DNA and how it carries genetic information in 1953
Built a three-dimensional
model of the molecules
of DNA
Shared the Noble Prize
in 1962

38. Christian Barnard (1922 – 2001)
Performed first successful heart transplant in 1968

39. Robert Jarvik Creator of the first artificial heart
On December 2, 1982, it was implanted into Barney Clark, who lived for the next 112 days
The second patient, William Schroeder, lived for 620 days

40. Ben Carson ( )
Famous for his surgeries to separate Siamese twins
Currently Director of
Pediatric Neurosurgery
at John Hopkins
He has refined
hemispherectomy, a
surgery on the brain
to stop seizures

41. How much money does Healthcare bring in a day???????
Health Care Systems
How much money does Healthcare bring in a day???????

42. Private Health Care Facilities
Hospitals: an institution that provides medical/surgical care and treatment for the sick and injured.
Vary in size and types of service provided.
General, burn centers, heart, oncology, children…etc
Can be private, religious, nonprofit or government owned.
Long-term care Facilities: mainly provide assistance and care for the elderly. Usually all in one.
Nursing/Geriatric Homes: provides help with ADL’s, promote social interactions and provide safety and security.
Extended care facilities: long term rehabilitative care
Independent Living: Rent apartments but are provided with services

43. Private Health Care Facilities cont…
Omnibus Budget Reconciliation Act (OBRA)
Regulations regarding long term care and home health care.
Requires state to establish training and competence evaluations for nursing and geriatric assistants.
CEU’s, evaluations, registrations and certifications

44. Private Health Care Facilities cont…
Medical Offices: can be privately owned by one doctor or employ many doctors
Services: diagnostic, evaluations, treatment, examinations, minor surgeries, and testing
Specialties: pediatrics, cardiology, obstetrics
Dental Offices: can provide general or specialized care
Orthodontist, periodontics, prosthodontics, etc

45. Private Health Care Facilities cont…
Clinics: health care facilities found in many types of health care.
Some offer free services
Optical Centers: provide vision care
Emergency Care Services: provides special care for victims of accidents or sudden illnesses
Can be both governmental or private
Laboratories: can perform diagnostic tests such as blood or urine
Home Health Care: exactly what it says

46. Private Health Care Facilities cont…
Hospice: provide care for terminally ill persons with life expectancies of 6 months or less.
Mental Health: facilities that treat patients with mental dis orders and diseases.
Rehabilitation: provide care to help patients with physical or mental disabilities to obtain maximum self-care and function
Health Maintenance Organizations: centers geared towards preventative healthcare.

47. Government Agencies
World Health Organization: information about health issues around the world
U.S. Department of Health and Human Services: health issues in the U.S.
National Institute of Health: disease research
Center for Disease Control and Prevention: concerned with causes, spread and control of diseases
Food and Drug Administration regulating food and drugs
Agency for Health Care Policy and Research: healthcare quality
Occupational Safety and Health Administration: protect workers from job related injuries and illnesses

48. Voluntary/Nonprofit Agencies
Supported by donations, membership fees, fundraisers and federal or state grants.
Examples: American Cancer Society, The American Heart Association, the American Respiratory Disease Association, the American Diabetes Association, National Association of Mental Health, Nation Foundation of the March of Dimes, American Red Cross

49. Health Insurance Plans
What's the Purpose?
To assist with the rising cost of health care
How does it work?
The amount of payment and the type of services vary from plan to plan
Deductibles: set amounts that must be paid before the insurance will pay for anything.
Co-Insurance: patient responsible for a certain percentage of the cost
Co-Payment: specific amount of money that must be paid before receiving services

50. Health Insurance Plans cont…
Health Maintenance Organization (HMO): provides a managed care plan for the delivery of healthcare services
Set fee regardless of the amount of health care used
Insured can only use certain doctors
Preferred Provider Organization: contracts with certain doctors/dentist to provide health care at reduced rates
More options
Usually requires co-payments and deductibles

51. Health Insurance Plans cont…
Medicare: government program that provides healthcare for all individuals over the age of 65, disabled persons receiving SS and a few other exceptions
Medicaid: Government program but people covered varies from state to state.
Individuals with low income, children who qualify, all disabled and blind people.
Workers Compensation: insurance for workers injured on the job
TRICARE: Government military health insurance

52. Organizational Structure
All Health Care Facilities must have one.
Hierarchy/Chain of Command

53. Current Trends in Health Care

54. Cost Containment Cost of health care began rising due to:
Technological advances
Aging population
Health-related lawsuits
Cost Containment measures include:
Diagnostic related groups (DRG)
Combination of services
Outpatient services
Mass or bulk purchasing
Early intervention and preventive services

55. Technological Advances
Procedures such as heart, lung, liver or kidney transplants
Computers used for diagnostic exams
People are living longer buuuuttt…….the result is …

56. The Aging Population More pharmaceuticals Chronic diseases
More frequent healthcare

57. Health Related Lawsuits
Expensive malpractice insurance
Unnecessary Diagnostic Tests

58. Is there a firm answer to controlling health costs?

59. Cost Containment Efforts
Diagnostic Related Groups
Medicaid/Medicare:
Set amounts for all services
Can be a gain or a loss????
Combination of Services:
Clinics and laboratories shared by different agencies
Decreased cost for the provider means decreased cost for the patient.

60. Cost Containment Efforts cont…
Outpatient Services
Reducing the length of hospital stays… i.e. open heart surgery
…Surgeries, diagnostic services, radiographs
Mass/Bulk purchasing
Buying in larger quantities at reduced prices.
Computerized inventory
Early Intervention/Prevention
Patient education, immunizations, physicals, incentives, easy access

61. Cost Containment Efforts cont…
Energy Conservation
Better building designs
Managing heating/cooling services
Making repairs immediately
Infrared Faucets
Could controlling costs turn into decreased quality of healthcare?
Agency for Health Care Policy and Research(AHCRP)
As a patient what can you do to help control costs?

62. Telemedicine
Involves the use of video, audio and computer systems to provide medical/health care services.
Decreases the need for trips to the “doctor”
Great for rural areas? How?

63. Wellness Emphasis on promoting wellness of the whole individual:
Physical wellness: promoted by a well balanced diet, exercise, routine physicals.
Emotional wellness: promoted by an understanding of ones own personal feelings
Social wellness: promoted by showing fairness, concern, tolerance, etc…
Mental and intellectual wellness: promoted by being creative, logical, curious, open minded individuals
Spiritual Wellness: promoted by using values, morals, ethics, etc
Holistic Health: promotes treating the whole person; all aspects of wellness

64. Alternative and Complementary (CAM) Methods of Health Care
Complementary Therapies: used in conjunction with conventional medical therapies
Alternative Therapies: used in place of biomedical therapies
Integrative health care: uses both mainstream and CAM therapies to treat patiendts

65. Alternative and Complementary Methods of Health Care
Chinese medicine practitioners: holistic based healing practice based on the belief that a life energy (CHI) flows through every living person
Chiropractors: practice base on the belief that the brain sends vital energy to all body parts through nerves is the spinal cord
Homeopaths: belief in the body’s abilities to heal itself using the immune system; no medicine, if so all natural
Naturopaths: only natural therapies

66. Current Concerns National Health Care Plan
Has become a leading topic of debate due to the increasing number of uninsured Americans
Education and preparation for a potential pandemic
A pandemic exists when the outbreak of a disease occurs over a wide geographic area and affects a high proportion of the population
Due to the high rate international travel, the possibility for a devastating pandemic has increased