Current Trends in Current Trends in Health CareHealth Care

Cost ContainmentCost Containment Trying to control the rising cost of health Trying to control the rising cost of health

care and achieving the maximum benefit care and achieving the maximum benefit for every dollar spent.for every dollar spent.

All aspects of health care are directed All aspects of health care are directed toward cost containment.toward cost containment.

Some reasons for high health care costs Some reasons for high health care costs include technological advances, aging include technological advances, aging population, and health-related lawsuits.population, and health-related lawsuits.

Technological AdvancesTechnological Advances Highly technical procedures such as Highly technical procedures such as

heart, lung, liver, or kidney transplants heart, lung, liver, or kidney transplants can cost hundreds of thousands of can cost hundreds of thousands of dollars.dollars.

Computers that can be used to examine Computers that can be used to examine internal body parts are valuable internal body parts are valuable diagnostic tools but expensive.diagnostic tools but expensive.

Aging PopulationAging Population

Older individuals use more Older individuals use more pharmaceutical products (medications), pharmaceutical products (medications), have more chronic diseases, and often have more chronic diseases, and often need frequent health care services.need frequent health care services.

Health-related LawsuitsHealth-related Lawsuits Lawsuits force health care providers to Lawsuits force health care providers to

obtain expensive malpractice insurance, obtain expensive malpractice insurance, order diagnostic tests even though they order diagnostic tests even though they might not be necessary, and make every might not be necessary, and make every effort to avoid lawsuits by practicing effort to avoid lawsuits by practicing defensive health care.defensive health care.

Methods of Cost Methods of Cost ContainmentContainment

Diagnostic related groups (DRGs)Diagnostic related groups (DRGs) Combination of servicesCombination of services Outpatient servicesOutpatient services Mass or bulk purchasingMass or bulk purchasing Early intervention and preventive Early intervention and preventive

servicesservices Energy conservationEnergy conservation

Diagnostic Related Diagnostic Related Groups (DRGs)Groups (DRGs)

One way Congress is trying to control costs for One way Congress is trying to control costs for government insurance plans such as Medicare government insurance plans such as Medicare and Medicaidand Medicaid

A limit is placed on patient’s cost of care and A limit is placed on patient’s cost of care and the agency providing care receives that set the agency providing care receives that set amount.amount.

If the cost of care is less than the amount paid, If the cost of care is less than the amount paid, the agency keeps the money; if it’s more, the the agency keeps the money; if it’s more, the agency must accept the loss.agency must accept the loss.

Combination of ServicesCombination of Services

Done to eliminate duplication of servicesDone to eliminate duplication of services Health care agencies join together or Health care agencies join together or

share specific services so care can be share specific services so care can be provided to a larger number of people at provided to a larger number of people at a decreased cost per persona decreased cost per person

Outpatient ServicesOutpatient Services Patients receive care without being Patients receive care without being

admitted to hospitals or other care admitted to hospitals or other care facilitiesfacilities

Reducing the length of hospital stays or Reducing the length of hospital stays or decreasing the need for hospital decreasing the need for hospital admissions lowers the cost of health careadmissions lowers the cost of health care

Mass or Bulk PurchasingMass or Bulk Purchasing Buying equipment and supplies in larger Buying equipment and supplies in larger

quantities at reduced pricesquantities at reduced prices Can be done by combining the purchases of Can be done by combining the purchases of

different departments in a single agency or by different departments in a single agency or by combining the purchases of several different combining the purchases of several different agenciesagencies

Computerized inventory can determine when Computerized inventory can determine when supplies are needed and prevent overstocks supplies are needed and prevent overstocks and wasteand waste

Early Intervention and Early Intervention and Preventive ServicesPreventive Services

Providing care before acute or chronic Providing care before acute or chronic disease occursdisease occurs

Methods include patient education, Methods include patient education, immunizations, regular physical immunizations, regular physical examinations to detect problems early, examinations to detect problems early, incentives for individuals to participate in incentives for individuals to participate in preventive activities, and easy access for preventive activities, and easy access for all individuals to preventive health care all individuals to preventive health care servicesservices

Energy ConservationEnergy Conservation

Monitoring the use of energy to control Monitoring the use of energy to control costs and conserve resourcescosts and conserve resources

Recycling is also a form of energy Recycling is also a form of energy conservation and most health care conservation and most health care facilities recycle many different materialsfacilities recycle many different materials

Home Health CareHome Health Care Diagnostic related groups and shorter Diagnostic related groups and shorter

hospital stays have created a need for hospital stays have created a need for providing care in the homeproviding care in the home

Another form of cost containment Another form of cost containment because it is usually less expensivebecause it is usually less expensive

Multiple types of care can be provided in Multiple types of care can be provided in the home environmentthe home environment

Geriatric CareGeriatric Care Will continue to show rapid growth as Will continue to show rapid growth as

“baby boomers” reach geriatric age“baby boomers” reach geriatric age Examples:Examples:

Adult day care centersAdult day care centers Retirement communitiesRetirement communities Assisted/independent living facilitiesAssisted/independent living facilities Long-term care facilitiesLong-term care facilities

Omnibus Budget Omnibus Budget Reconciliation Act (OBRA)Reconciliation Act (OBRA)

19871987 Led to the development of many Led to the development of many

regulations regarding long-term care and regulations regarding long-term care and home health carehome health care

Requires states to establish training and Requires states to establish training and competency evaluation programs for competency evaluation programs for nursing and geriatric assistantsnursing and geriatric assistants

Regulations serve to ensure certain Regulations serve to ensure certain standards of carestandards of care

TelemedicineTelemedicine Involves the use of video, audio, and Involves the use of video, audio, and

computer systems to provide medical computer systems to provide medical and/or health care servicesand/or health care services

New technology allows interactive New technology allows interactive services between health care providers services between health care providers even though they are in different even though they are in different locationslocations

WellnessWellness State of being in optimum health with a State of being in optimum health with a

balanced relationship between physical, balanced relationship between physical, mental, and social healthmental, and social health

Examples:Examples: Physical wellnessPhysical wellness Emotional wellnessEmotional wellness Social wellnessSocial wellness Mental and intellectual wellnessMental and intellectual wellness Spiritual wellnessSpiritual wellness Holistic HealthHolistic Health

Physical WellnessPhysical Wellness Promoted by a well-balanced diet, Promoted by a well-balanced diet,

regular exercise, routine physical regular exercise, routine physical examinations and immunizations, regular examinations and immunizations, regular dental and vision examinations, and dental and vision examinations, and avoidance of alcohol, tobacco, caffeine, avoidance of alcohol, tobacco, caffeine, drugs, environmental contaminants, and drugs, environmental contaminants, and risky sexual behaviorrisky sexual behavior

Emotional WellnessEmotional Wellness

Promoted by understanding personal Promoted by understanding personal feeling and expressing them feeling and expressing them appropriately, accepting one’s limitations, appropriately, accepting one’s limitations, adjusting to change, coping with stress, adjusting to change, coping with stress, enjoying life, and maintaining and enjoying life, and maintaining and optimistic outlookoptimistic outlook

Social WellnessSocial Wellness Promoted by showing concern, fairness, Promoted by showing concern, fairness,

affection, tolerance, and respect for affection, tolerance, and respect for othersothers

Also by communicating and interacting Also by communicating and interacting well with others, sharing ideas and well with others, sharing ideas and thought, and practicing honesty and thought, and practicing honesty and loyaltyloyalty

Mental and Intellectual Mental and Intellectual WellnessWellness

Promoted by being creative, logical, Promoted by being creative, logical, curious, and open-minded; using curious, and open-minded; using common sense; obtaining continual common sense; obtaining continual learning; questioning and evaluating learning; questioning and evaluating information and situations; learning from information and situations; learning from life experiences; and using flexibility and life experiences; and using flexibility and creativity to solve problemscreativity to solve problems

Spiritual WellnessSpiritual Wellness

Promoted by using values, ethics, and Promoted by using values, ethics, and morals to find meaning, direction, and morals to find meaning, direction, and purpose to lifepurpose to life

Often includes believing in a higher Often includes believing in a higher authority and observing religious authority and observing religious practicespractices

Holistic HealthHolistic Health

Care that promotes physical, emotional, Care that promotes physical, emotional, social, intellectual, and spiritual well-social, intellectual, and spiritual well-being by treating the whole body, mind, being by treating the whole body, mind, and spiritand spirit

Based on the body’s natural healing Based on the body’s natural healing powerspowers

Complementary and Complementary and Alternative Methods of Alternative Methods of Health Care (CAM)Health Care (CAM)

Complementary therapies: methods of Complementary therapies: methods of treatment that are used in conjunction with treatment that are used in conjunction with conventional medical therapiesconventional medical therapies

Alternative therapies: methods of treatment Alternative therapies: methods of treatment that are used in place of biomedical therapiesthat are used in place of biomedical therapies

Even though the terms are different, Even though the terms are different, alternativealternative is usually applied whether or not the therapy is is usually applied whether or not the therapy is used in place of or in conjunction with used in place of or in conjunction with conventional medical therapiesconventional medical therapies

Examples of CAM Examples of CAM PractitionersPractitioners

AyurvedicAyurvedic Chinese medicineChinese medicine ChiropractorsChiropractors HomeopathsHomeopaths HypnotistsHypnotists NaturopathsNaturopaths

Ayurvedic PractitionersAyurvedic Practitioners Use an ancient philosophy, ayurveda, Use an ancient philosophy, ayurveda,

developed in India to determine a developed in India to determine a person’s predominant dosha (body type) person’s predominant dosha (body type) and prescribe diet, herbal treatment, and prescribe diet, herbal treatment, exercise, yoga, massage, minerals, and exercise, yoga, massage, minerals, and living practices to restore and maintain living practices to restore and maintain harmony in the bodyharmony in the body

Chinese MedicineChinese Medicine Use ancient holistic-based healing Use ancient holistic-based healing

practice based on the belief that an life practice based on the belief that an life energy (Chi) flows through every living energy (Chi) flows through every living person in an invisible system of person in an invisible system of meridians (pathways) to link the organs meridians (pathways) to link the organs together and connect them to the together and connect them to the external environment or universeexternal environment or universe

Examples: acupuncture, acupressure, tai Examples: acupuncture, acupressure, tai chi, and herbal remedieschi, and herbal remedies

ChiropractorsChiropractors Believe that the brain sends vital energy Believe that the brain sends vital energy

to all parts of the body through nerves in to all parts of the body through nerves in the spinal cordthe spinal cord

Use spinal manipulation, massage, and Use spinal manipulation, massage, and exercise to adjust the position of the exercise to adjust the position of the vertebrae and restore the flow of energyvertebrae and restore the flow of energy

HomeopathsHomeopaths Believe in the ability of the body to heal Believe in the ability of the body to heal

itself through the actions of the immune itself through the actions of the immune systemsystem

Use minute diluted doses of drugs made Use minute diluted doses of drugs made from plant, animal, and mineral from plant, animal, and mineral substances to cause symptoms similar to substances to cause symptoms similar to the disease and activate the immune the disease and activate the immune systemsystem

HypnotistsHypnotists

Help an individual obtain a trance-like Help an individual obtain a trance-like state with the belief that the person will state with the belief that the person will be receptive to verbal suggestions and be receptive to verbal suggestions and able to make a desired behavior changeable to make a desired behavior change

NaturopathsNaturopaths Use only natural therapies such as Use only natural therapies such as

fasting, special diets, lifestyle changes, fasting, special diets, lifestyle changes, and supportive approaches to promote and supportive approaches to promote healinghealing

Avoid the use of surgery or medicinal Avoid the use of surgery or medicinal agents to treat diseaseagents to treat disease

NCCAMNCCAM Because of the increased us of CAM Because of the increased us of CAM

therapies, the federal government therapies, the federal government established the National Center for established the National Center for Complementary and Alternative Medicine Complementary and Alternative Medicine in 1992.in 1992.

Purpose is to research the various Purpose is to research the various therapies and determine standards of therapies and determine standards of quality of carequality of care

AND….AND….

We are done with another We are done with another one! one!