Trends in Health Care 1.2

Many events lead to changes in health care

Health care workers must be aware of these changes/trends

Cost Containment

• Means trying to control the rising cost of health care and achieving the maximum benefit for every dollar spent

• Reasons for increased cost• Technological advances• Aging population• Lawsuits• Cost could rise to levels that prohibit

providing services to all individuals

Methods Used to Contain Cost

• Diagnostic Related Groups (DRGs)• Attempt by Congress to control costs for

Medicare and Medicaid• Payment based on diagnosis• Certain amount paid for each disease condition• Agencies providing care for less can keep

money• Agencies accept loss if care costs more than

payment allowed

Combination of Services

• Agencies combine services to avoid duplication

• Share clinics, labs, and so on• HMO and PPO are examples of sharing

services• Care is provided for a larger number of

people at a lower cost

Outpatient Services

• Patients receive care without being admitted to hospitals or other care facilities

• Hospital care is expensive• Reducing the length of stay or decreasing

the need for hospital stay lowers the cost

Mass or Bulk Purchasing

• Buying equipment and supplies in larger quantities at reduced price

• Combining purchases from several departments

• Computerized inventory prevents waste and overstocking

Preventative Medicine

• Providing care before acute or chronic disease occurs

• Preventing illness is more cost effective than treating illness

• Methods used to prevent illness are education, immunization, examinations, and incentives to participate

Energy Conservation

• Monitoring the use of energy to control cost and conserve resources

• Major expense for every health care agency is electricity, water, and gas

• Methods to reduce cost are insulation, energy saving lighting systems, automatic turn off of plumbing fixtures

Quality of Care

• Should not be lowered just to save costs• Agency for Health Care Policy and

Research (AHCPR)• Federal agency established in 1990 to

research the quality of health care delivery and identify the standards of treatment that should be provided

Home Health

• Rapidly growing field that results in shorter hospital stays so patient can receive care at home

• Less expensive to provide• Covers all aspects of nursing care,

occupational and physical therapy, respiratory therapy, social services, nutrition, homemaking

Geriatric Care

• Care of the elderly• Number of people in older age groups will

continue to grow more than twice as rapidly as the total population

• Will lead to growth of different facilities; adult day care, retirement communities, assisted/independent living, long term care facilities

• Omnibus Budget Reconciliation Act- regulates long term facilities

Telemedicine

• Uses videos, audio, computer systems to provide medical and or health services

• Technology allows interaction between health care providers even though they are at different locations

Wellness

• State of being in optimum health with balanced relationship between physical, mental, and social health

• Improves quality of life• Saves cost• Recognizes the importance of exercise,

sleep, weight control, health living habits

Complimentary and Alternative Methods of Health Care (CAM)

• Most common health care system in the US is the biomedical or western system

• Based on evaluating the physical signs of a patient, determining the cause of disease, and treating the cause

• Major trend is an increase in the use of complementary or alternative health care therapies

• Complimentary- treatment used in conjunction with conventional medical therapies

• Alternative- treatment used in place of biomedical therapies

Integrative Health Care

• Uses both mainstream medical treatments and CAM

• Based on the theory that individuals have the ability to bring greater wellness and healing into their own lives and that the mind affects the healing process

• Recognizes that each person in unique and may require different medical treatment

• Referred to as Holistic Treatment

National Health Care Plan

• High cost of health care and a large number of uninsured individuals has created a demand for a national health care plan

• High cost to taxpayers• Lack of free choice

Pandemics

• Exists when the outbreak of a disease occurs over a wide geographic area and affects a high proportion of the population

• Major concern today is that world wide pandemics will become more frequent because society is global

• World Health Organization (WHO) monitors the spread of pandemics

Pandemics• 1918 Spanish Flu killed 2.6 percent of individuals who

contacted it or about 40 million people• H5N1 virus, the avian bird flu, jumped directly to humans• Viruses readily pass from birds to birds, but infection in

humans had been rare with most cases resulting from direct contact with infected birds

• H1N1 virus, swine flu went global in 2010• Hantavirus spread by rodents• Severe acute respiratory syndrome (SARs)• Monkeypox• Ebola

Pandemics

• Viruses are prone to mutating and to exchanging genetic information so the creation of a new lethal virus can occur at any time

• WHO estimates that between 2 and 7 million people world wide could die

Pandemic Plans

• Education- information about the pandemic and ways to avoid its spread must be given to the entire population

• Vaccine production- more research must be directed toward producing effective vaccine in large quantities and in shorter periods of time; swine flu vaccine 2010, cervical cancer and shingles vaccine in 2006

Plans• Antiviral drugs- stockpile so they will be ready for

immediate use, and research to develop better drugs• Protective Public Health Measures-influenza must be

diagnosed rapidly and accurately, strict infection control methods must be implemented to limit the spread, first responder must be immunized, quarantine when needed

• International cooperation- countries must be willing to work with each other to create an international plan that will limit the spread of lethal viruses and decrease the severity of a pandemic