Current Health Care Systems And Trends

Today’s Health Care Industry   Largest service employer in U.S. Americans spent $4.1 trillion on health care in 2020 o Americans spent 2.9 trillion on health care in 2013 o Projected to grow 5.4-5.7% annually to ~6.2 trillion on health care in 2028 Technological Advancements     Health care changed very gradually until beginning of 20 th century Progress now increases rapidly Infectious diseases previously major causes of death o Now largely under control Recent advancements: o Organ transplants o Microscopic and robotic surgery o Gene therapy o Targeted drug therapy o Pharmaceuticals are leading prevention and treatment option today Highlights of Health Care History        Ancient and medieval times (…BC-400 & 400-1350) o Early beliefs in supernatural causes o Hippocrates  Physician in ancient Greece  Considered father of medicine Plagues during Middle Ages killed majority of population Renaissance (1350-1650) o Brought interest in science o Experiments and observation o Study of brain and psychology began o Filth still causes spread of disease o Many people still superstitious o Autopsy o Pierre Brissot spoke against blood letting 17th Century (1600s) o William Harvey discovered that blood circulate throughout the body via a continuous network of vessels  Medicines began being injected into the body via this system o Microscope invented – Anton van Leeuwenhoek 16th Century (1700s) o Surgery became respected form of treatment o Body functions still poorly understood o Technique of vaccination discovered by Jenner 19th Century (1800s) o Building of large hospitals o Dentists introduced anesthesia o Pasteur proved that bacteria cause certain diseases o Advancements in public health and preventive medicine th 20 Century (1900s) o Many discoveries  E.g., blood groups, vitamins, penicillin and antibiotics, synthetic dugs to treat specific problems Hopes for the 21st Century         Vaccine to prevent human immunodeficiency virus Cure for acquired immune deficiency syndrome Cure for obesity Organ cloning Cures for cancer and heart disease More effective treatment for mental illness Less invasive treatments Drugs with fewer side effects Specialization  Effects on health care: o Improved diagnosis and treatment o More technical and fragmented mental practice o Increased health care costs o Breakdown of patient-provider relationships o Increased job opportunities for health care professionals Aging Population     Life expectancy increase o 1900  47 years o Today  79 to 81 years Large number of “baby boomers” becoming older adults Older adults o Heaviest users of health care services Needs of older adults: o Long-term care facilities o Home care services o Treatment for chronic conditions Increasing Costs of Health Care  Costs increasing dramatically o Technological advances o Increased use of services due to aging population o Rising costs of pharmaceutical products o Increased use of expensive diagnostic tests o Lack of competition in some areas o Rising expectations of patients o More effective treatments  Therefore, more patients seeking care o Poor geographic distribution of health care providers Health Care Facilities and Services  Wide variety of health care facilities    Many patient services for different needs Range in size from private individual office to national organizations Many options available for today’s health care professionals Hospitals    Traditional health care setting o Now high-tech facility limited to patients who need sophisticated treatment and 24-hour care Costs have increased dramatically o Major challenge:  Controlling expenses Various levels of care provided o Trauma center o Emergency room (ER) o Intensive care unit (ICU) o Cardiac care unit (CCU) o General unit o Transitional care unit (TCU) o Rehabilitation unit o OB/Mother & Baby/NICU ER Visits     Emergency departments used by some for routine care Extremely expensive Patient Protection and Affordable Care Act may alleviate the overuse of ERs Patient education necessary on use of insurance Accreditation of Health Care Facilities  The Joint Commission o Private, non-profit organization o Encourages high standards o Provides guidelines o Performs on-site inspections o Accreditation voluntary  But may be required to qualify for Medicare reimbursement Ambulatory/Outpatient Services     Patients do not require hospitalization Most surgeries today are outpatient Majority of ambulatory services performed in physicians’ offices Facilities that offer outpatient services: o Adult day care o Dental offices o Diagnostic centers o Emergency and urgent care centers o Health care services in companies, schools, and prisons o Medical offices o Rehabilitation centers o Specialty clinics and offices o o Surgical centers Wellness centers Long-Term Care Facilities       Individuals do not need hospital o But unable to live at home Fastest growing area of health care services Nursing home o Skilled nursing facility o Intermediate nursing facility Adult foster home Assisted living residences Continuing care community Home Health Care Services    Provide care to patients in their homes Tremendous growth in need for services Factors contributing to growth: o Shorter hospital stays o Increase in older population o Medical equipment that can be used at home o Desire of individuals to stay at home Home Health Care Providers  Examples of professionals who provide care at home: o Nurses o Physical therapists and assistants o Occupational therapists and assistants o Speech therapists o Medical social workers o Nursing assistants and home health aides Hospice     Palliative care and support for dying patients and their families Team of professionals and volunteers Medical, emotional, and spiritual support Make patient’s last days as pain-free and meaningful as possible