1. Health Care Systems

2. Historical Events In Health Care
Hippocrates (400 BC) --- father of medicine
Created high standards of ethics
Ancient Greek
18th Century
Edward Jenner (1796) --- first vaccination; smallpox
19th Century
Ignaz Semmelweis (1840) – wash hands
Florence Nightingale (1860) – founder of modern nursing
Gregory Mendel (1870) --- father of genetics & inheritance
Robert Koch (1890) --- father of microbiology
William Roentgen (1895) – discovered X-rays

3. 20th Century
1920’s --- health insurance plans first appeared
Sir Alexander Fleming(1928) – discovered penicillin
Dr Papanicolaou (1940) --- exfoliative cytology
Dr Jonas Salk (1955) --- polio vaccine
1960 – birth control pills
1960’s – organ transplants
1970’s – HMO concept appeared
1978 – IVF
1980’s– AIDS pandemic
1997 – sheep cloned

4. Health Care Facilities
Hospitals
Private (proprietary)
Nonprofit
Government
General care hospitals
Specialty care hospitals
Long Term Care Facilities(LTC)
Nursing homes
Geriatric homes
Extended care facilities
Independent/assisted Living Facilities
Medical offices
Dental Offices
Optical Centers
Clinics
Multispecialty
Single specialty
Surgicenters
Urgent/emergency care
Mental health
Substance abuse
Home Health Care
Hospice
Rehabilitation centers
HMO organizations
Industrial care centers
School health services

5. Government Agencies WHO USDHHS FDA OSHA
NIH
CDC
FDA
OSHA
State & local health departments

6. Voluntary/Nonprofit Agencies
American Cancer Society
American Red Cross
March of Dimes
American Diabetes Association
National Association of Mental Health
These agencies provide:
Special services to victims of disease
Research into the disease

7. Health Insurance Plans
1960’s = all covered (subscriber & beneficiaries); no exclusions; no co-payment
1970’s = coverage limited ; exclusion of pre-existing conditions; no co-payment
1980’s = coverage limited; exclusions; co-payments
1990’s = HMO’s with all covered; private plans as in 1980’s but larger co-payments
Managed care plans emerge(HMO’s, PPO’s, etc)
Develop lists of “what is medically necessary” (see next slide)

8. Health Insurance Plans
Health Insurance Terminology
Deductibles
Co-insurance ( usually in percentages)
Co-payment (usually in dollar amounts)
HMO
Private fee-for-service plans
PPO
Medicare
Type A -- the facilities
Type B – the health deliverer
Medicaid
Worker’s Compensation

9. Organizational Structure
This refers to the chain of command
It indicates areas of responsibility
Shows one their immediate supervisor

10. Trends in Health Care Cost Containment Methods
DRG’s (diagnostic related groups)
Combination of services
Outpatient services
Mass purchasing
Preventive services
Energy conservation
Home Health Care
Can involve all aspects of health care

11. Trends in Health Care Geriatric care Telemedicine
Adult day care centers
Retirement communities
Assisted living facilities
Long term care facilities
OBRA = omnibus budget reconciliation act (1987& 1989)
Established regulations for nursing assistants
Develop measures of health care quality
Compliance with patient’s rights
Regulations regarding long-term & home health care
Key = to ensure certain “standards of care”
Telemedicine

12. Trends in Health Care Wellness
Holistic Health Care = promotes physical, emotional, social, intellectual, by treating the whole body, mind and spirit and spiritual well being
Physical wellness
Emotional wellness (e.g. stress management) (cup half full)
Social wellness --- tolerance
Mental & intellectual wellness --- open-minded, continual education
Spiritual wellness --- ethics & morals
Wellness is determined by lifestyle choices

13. Alternative Methods of Health Care
Acupressure (Shiatsu)---- use of hands to apply pressure to specific points of the body to stimulate the flow of energy
Acupuncture use of needles to stimulate the flow of energy
Antioxidants inhibit oxidation of free radicals
Aromatherapy use of aromas to alter mood & restore spirit
Biofeedback use of devices to show pts their response to stress
Healing touch (Reiki) ---- use of hand pressure to energy centers of body to stimulate healing
Homeopathy use of chemicals to stimulate disease to encourage ones immune system to go into action
Hydrotherapy
Hypnosis use of trance-like state to make pt more receptive to suggestion
Imagery images to induce soothing
Ionization therapy use of ionizers to make negatively charged air particles to treat respiratory illness

14. Alternative Methods of Health Care
Macrobiotic diet use of diet to balance “yin & yang”
Yin= dark; yang = light/ everything has its opposite
Meditation use of breathing & muscle relaxation to quiet the mind (reduce stress)
Pet therapy use of animals to stimulate interest in life
Phytochemicals use of plant chemicals to treat disease
Play therapy use of toys to stimulate children to “come out of their shells”
Positive thought develop self esteem & self-love to allow the body to heal
Reflexology uses foot pressure to send energy to an affected body part
Spiritual therapies--- use of prayer to get spiritual guidance to produce a sense of well-being
Tai Chi use of slow, graceful body movements & breathing to improve energy flow
Therapeutic massage (Swedish)
Therapeutic touch use of hands to locate changes in body’s energy field
Yoga use concentration & positions to balance energy flow