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Differentiate between early/current beliefs. Identify at least 10 major events in history of healthcare Describe at least 8 different health care facilities Describe at least three non profit services Identify five current trends in health care Believed illness were caused by supernatural spirits and demons. ◦ ◦ ◦ ◦ ◦ Tribal witch doctors treated illnesses Ceremonies, Herbs and plants used as medicine Morphine for pain, Digitalis for heart Average Life span was about 20 years Boring holes in head for insanity, epilepsy and headaches • • • • • First Health Records Called upon Gods Physicians were priests who studied medicine and surgery Believed body was system of channels, used leaches to unclog channels Used magic and medical plants Lifespan 20 -30 • Religious beliefs prohibited dissection • Monitored pulse to monitor condition of body • Recorded pharmacology of plants • Used acupuncture • Began search for medical reason for illness • Life span 20-30 Began modern medical science by observing effects of disease Identified brain as physiological site for senses Hippocrates “Father of Modern Medicine” ◦ Developed and organized method to observe ◦ Recorded signs and symptoms ◦ Created high levels of ethics & standards still used today ◦ Stressed diet and cleanliness ◦ Used therapies, massage, art herbal ◦ Life span 25-35 • First to organize medical care Early hospitals Began public health • • • • Sanitation Sewers Water filtration First to study infectious diseases • • ◦ Life Span 25- 35 • • • • • Emphasis on saving soul Went back to prayer and divine intervention Monks and priests provided care for sick people Medications were mainly herbal mixtures Life span 20- 30 • • • • • • Renewed interest in medical practice of Greeks & Romans Physicians began gaining knowledge at medical Universities Pandemic (world wide epidemic killed 75% of Europe & Asia, Bubonic plague) Arab physicians used chemistry to advance pharmaceuticals Arabs started requiring physicians to pass exam Life span 20 - 35 • • • • • Rebirth of science in medicine Dissection of body began to better allow understanding of anatomy & physiology Michelangelo & Da Vinci began to draw dissection to make more realistic First books of medicine published Lifespan 30 - 40 • • • • Ambrose Pare - father of modern surgery Established ligatures to bind arteries Improved treatment of fractures & promoted artificial limbs Invention of the micrscope • • • • • First mercury thermometer Surgery standards were developed Invention of eye glasses (Ben Franklin) Vaccines were developed Lifespan 40 – 50 • • • • • • • First successful blood transfusion First Stethoscope Either was used as an anesthetic First Nurses program (Florence Nightingale) Chloroform was used as an esthetic First use of disinfectants and antiseptics before surgery Lifespan 40 -60 • • • • • • • • • • Classification of Blood Groups Study of Psychology and psychiatry Vaccines Penicillin Machines – heart /lung Organ transplants Test tube baby Insurance Cloning Lifespan 60 - 70 Cell regeneration Future Possibilities • Genetic Manipulation • Nerve and brain regeneration or transplant • Cures for AIDS & Cancer • Hospitals ◦ Private or Proprietary ◦ Vary in size ◦ Vary in Services Long Term Care (LTCs) ◦ ◦ ◦ ◦ Provide assistance and care for elderly (ADLs) Residents Care for individuals with disabilities Some called nursing homes or geriatric homes Independent & Assisted Living ◦ Provide care for those that can help themselves ◦ Rent or purchase and apartment in facility ◦ Services like meals, housekeeping, laundry, transportation, social & basic medical care. Medical Offices ◦ Doctor run ◦ Vary in services – diagnosis, treatment, exam, lab work, testing & minor surgery. Dental Clinics – satellite clinics Optical Centers Emergency Care services – EMS, Fire & Rescue Laboratories – blood, urine, dental molds Home Health Care – provide care in home Hospice – care for terminally ill, <6 months Mental Health – mental disorders or disease Genetic Counseling – pregnancies Rehabilitation – physical, occupational, speech Health Maintenance Organizations (HMOs) – total healthcare focused on prevention Industrial Health Centers – Work on site School Health Services World Health Organization (WHO) – International org. compiles statistics & info on diseases, publish health info, addresses serious health issues world wide US Dept. of Health & Human Services (USDHHS) – Deals with health problems in US National Institute of Health (NIH) – research on diseases Centers for Disease Control and Prevention (CDC) – causes, spread control of diseases Food and Drug Administration (FDA) – regulates food and drug products sold to public Agency for Healthcare Policy and Research (AHCPR) – research quality of healthcare & identify standards of treatments Occupational Safety and Health Administration (OSHA) – establishes and enforces standards that protect workers from job related injuries American Cancer Society American Heart Association American Red Cross Many others Supported by Donations Provide health services at national level Health Care Costs 12% of US Economy Insurance helps pay for costs ◦ Limits and/or deductibles –amount paid by patient before insurance ◦ Co-Insurance ie: 80% - 20% ◦ Co-payment – specified $ paid each visit HMO – premium paid each month and set cost to patient each visit at specific doctor with a “Plan” PPO (Preferred Provider Organization)Patients are restricted to who they can use as a physician and patients pay a percentage of charges Medicare – insurance for over 65, operated by Federal Government Medicaid – insurance for low income, operated by States. Workers Compensation – health insurance for injuries on the job Managed Care – Ins. Company plans your care. All care must have a purpose, 2nd opinions prior to surgeries. ◦ Focus on prevention ◦ Keep costs down Hospital vs Medical Office Hot topic – trying to control rising costs mainly from new technology, advanced procedures (ie: heart surgery) and liability Rising age population – use more medicines and more chronic disease Diagnostic Related Group (DRGs) – one payment to hospital depending on diagnosis. Decreases hospital stay time Combination of services – shared services to labs, clinics, etc. instead of each having its own Outpatient Services – clinics instead of hospital Mass or Bulk purchasing Early Intervention or Preventative Energy Conservation Rapidly growing field Shorter hospital stays created need for home care Return to day of doctors making house calls – cheaper than maintaining a office or clinic Care for elderly Rapid growing field due to increase age of population – age expectancy increases Baby Boomers (born after WWII – 1960) Adult Day Care Centers Retirement Communities Assisted/Independent Living Facilities Omnibus Budget Reconciliation Act (OBRA) – states require training and competency evaluation for workers Involves use of video, audio, and computers to provide medical services ◦ EMS transmit EKG to Hospital for diagnosis (dx) ◦ Xrays, scans can all be read at home or in office so Drs can serve multiple facilities ◦ Robotics surgery from miles away ◦ Electronic machines can send info to Drs from patient homes Physical Wellness – well balanced diet, exercise, routine physicals Emotional Wellness – understanding feeling, expressing oneself appropriately, accepting limitations, coping with stress Social Wellness – showing concern for others, interacting well with others Mental Wellness – being creative, open minded challenging the mind Spiritual Wellness – values, morals ethics Alternative – methods used in place of biological therapies Complimentary – methods used with conventional medicine Ayurveda practitioners - depending on body type: uses prescribe diet, herbal, yoga to maintain body harmony Chinese Medicine – holistic based, flow of energy (chi) , acupuncture/pressure Tai Chi & herbal Chiropractors – brain sends signals down spine to control body, misalignment can interfere with flow from brain Homeopaths – body self heals through immune system Hypnotists- trancelike state uses suggestions to bring about behavioral change Naturopaths – uses natural therapies like fasting, special diets cleansing to promote healing