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Current Trends in
Health Care
Cost Containment
 Trying to control the rising cost of health
care and achieving the maximum benefit
for every dollar spent.
 All aspects of health care are directed
toward cost containment.
 Some reasons for high health care costs
include technological advances, aging
population, and health-related lawsuits.
Technological Advances
 Highly technical procedures such as
heart, lung, liver, or kidney transplants
can cost hundreds of thousands of
 Computers that can be used to examine
internal body parts are valuable
diagnostic tools but expensive.
Aging Population
 Older individuals use more
pharmaceutical products (medications),
have more chronic diseases, and often
need frequent health care services.
Health-related Lawsuits
 Lawsuits force health care providers to
obtain expensive malpractice insurance,
order diagnostic tests even though they
might not be necessary, and make every
effort to avoid lawsuits by practicing
defensive health care.
Methods of Cost
Diagnostic related groups (DRGs)
Combination of services
Outpatient services
Mass or bulk purchasing
Early intervention and preventive
 Energy conservation
Diagnostic Related Groups
 One way Congress is trying to control costs for
government insurance plans such as Medicare
and Medicaid
 A limit is placed on patient’s cost of care and
the agency providing care receives that set
 If the cost of care is less than the amount paid,
the agency keeps the money; if it’s more, the
agency must accept the loss.
Combination of Services
 Done to eliminate duplication of services
 Health care agencies join together or
share specific services so care can be
provided to a larger number of people at
a decreased cost per person
Outpatient Services
 Patients receive care without being
admitted to hospitals or other care
 Reducing the length of hospital stays or
decreasing the need for hospital
admissions lowers the cost of health care
Mass or Bulk Purchasing
 Buying equipment and supplies in larger
quantities at reduced prices
 Can be done by combining the purchases of
different departments in a single agency or by
combining the purchases of several different
 Computerized inventory can determine when
supplies are needed and prevent overstocks
and waste
Early Intervention and
Preventive Services
 Providing care before acute or chronic
disease occurs
 Methods include patient education,
immunizations, regular physical
examinations to detect problems early,
incentives for individuals to participate in
preventive activities, and easy access for
all individuals to preventive health care
Energy Conservation
 Monitoring the use of energy to control
costs and conserve resources
 Recycling is also a form of energy
conservation and most health care
facilities recycle many different materials
Home Health Care
 Diagnostic related groups and shorter
hospital stays have created a need for
providing care in the home
 Another form of cost containment
because it is usually less expensive
 Multiple types of care can be provided in
the home environment
Geriatric Care
 Will continue to show rapid growth as
“baby boomers” reach geriatric age
 Examples:
Adult day care centers
Retirement communities
Assisted/independent living facilities
Long-term care facilities
Omnibus Budget
Reconciliation Act (OBRA)
 1987
 Led to the development of many
regulations regarding long-term care and
home health care
 Requires states to establish training and
competency evaluation programs for
nursing and geriatric assistants
 Regulations serve to ensure certain
standards of care
 Involves the use of video, audio, and
computer systems to provide medical
and/or health care services
 New technology allows interactive
services between health care providers
even though they are in different
 State of being in optimum health with a
balanced relationship between physical,
mental, and social health
 Examples:
Physical wellness
Emotional wellness
Social wellness
Mental and intellectual wellness
Spiritual wellness
Holistic Health
Physical Wellness
 Promoted by a well-balanced diet,
regular exercise, routine physical
examinations and immunizations, regular
dental and vision examinations, and
avoidance of alcohol, tobacco, caffeine,
drugs, environmental contaminants, and
risky sexual behavior
Emotional Wellness
 Promoted by understanding personal
feeling and expressing them
appropriately, accepting one’s limitations,
adjusting to change, coping with stress,
enjoying life, and maintaining and
optimistic outlook
Social Wellness
 Promoted by showing concern, fairness,
affection, tolerance, and respect for
 Also by communicating and interacting
well with others, sharing ideas and
thought, and practicing honesty and
Mental and Intellectual
 Promoted by being creative, logical,
curious, and open-minded; using
common sense; obtaining continual
learning; questioning and evaluating
information and situations; learning from
life experiences; and using flexibility and
creativity to solve problems
Spiritual Wellness
 Promoted by using values, ethics, and
morals to find meaning, direction, and
purpose to life
 Often includes believing in a higher
authority and observing religious
Holistic Health
 Care that promotes physical, emotional,
social, intellectual, and spiritual wellbeing by treating the whole body, mind,
and spirit
 Based on the body’s natural healing
Complementary and
Alternative Methods of
Health Care (CAM)
 Complementary therapies: methods of
treatment that are used in conjunction with
conventional medical therapies
 Alternative therapies: methods of treatment
that are used in place of biomedical therapies
 Even though the terms are different, alternative
is usually applied whether or not the therapy is
used in place of or in conjunction with
conventional medical therapies
Examples of CAM
Chinese medicine
Ayurvedic Practitioners
 Use an ancient philosophy, ayurveda,
developed in India to determine a
person’s predominant dosha (body type)
and prescribe diet, herbal treatment,
exercise, yoga, massage, minerals, and
living practices to restore and maintain
harmony in the body
Chinese Medicine
 Use ancient holistic-based healing
practice based on the belief that an life
energy (Chi) flows through every living
person in an invisible system of
meridians (pathways) to link the organs
together and connect them to the
external environment or universe
 Examples: acupuncture, acupressure, tai
chi, and herbal remedies
 Believe that the brain sends vital energy
to all parts of the body through nerves in
the spinal cord
 Use spinal manipulation, massage, and
exercise to adjust the position of the
vertebrae and restore the flow of energy
 Believe in the ability of the body to heal
itself through the actions of the immune
 Use minute diluted doses of drugs made
from plant, animal, and mineral
substances to cause symptoms similar to
the disease and activate the immune
 Help an individual obtain a trance-like
state with the belief that the person will
be receptive to verbal suggestions and
able to make a desired behavior change
 Use only natural therapies such as
fasting, special diets, lifestyle changes,
and supportive approaches to promote
 Avoid the use of surgery or medicinal
agents to treat disease
 Because of the increased us of CAM
therapies, the federal government
established the National Center for
Complementary and Alternative Medicine
in 1992.
 Purpose is to research the various
therapies and determine standards of
quality of care
 We are done with another
one! 