Trends in

Healthcare

CHANGE

• You must be aware of changes and trends as a Health Care worker.

Cost containment• Trying to control the rising cost of

healthcare and achieving the maximum benefit for every dollar spent

Reasons for high health care costs

• Technological Advances– Transplants– Artificial hearts– Computers

• The Aging Population– More medications

– More chronic diseases

– Frequency of health care services

Health Related Lawsuits

expensive malpractice insurance

unnecessary diagnostic tests

defensive health care

The Big Issue

• Health care costs prohibit services to all individuals

• Everyone should have equal access to care regardless of their ability to pay

Goal: Try to provide quality care at lowest possible price

Methods of cost containment• Diagnostic Related Groups (DRGs)

– Congress uses this to control costs for government insurance such as Medicaid and Medicare

– Certain diagnoses who are admitted to hospitals are placed in one payment group

– Limits are placed on cost of care and the agency only receives this set amount

– If costs of care less than amount paid, agency keeps the extra money, if more the agency must accept the loss

Combination of Services

• Eliminate duplication of services

• Health care agencies join together or share specific services to provide care for larger number of people at a decreased cost per person

• Example: Labs

Outpatient Services

• Not admitted• Reduces hospital

length of stay• lowers the cost• Surgeries, xrays,

diagnostic tests, etc done as outpatient services

Mass or Bulk Purchasing

• buy in large amounts at reduced prices

• Prevents

overstocking and waste

Early Intervention and Preventive Services

• Providing care before acute or chronic disease occurs

Prevention more cost effective than treatment!

• patient education• immunizations• regular physical

exams• incentives for

preventive health care services

• easy access for all individuals

• cost efficient• avoids emergency

rooms and acute care facilities

Energy Conservation

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

Methods to Conserve Energy

• Design and build new energy efficient facilities

• monitor/maintain Heating/cooling systems

• insulation and thermopane windows to prevent hot/cool air loss

Conserving Energy• Repair plumbing• replace energy

consuming lightbulbs• install infrared

sensors to turn water on and off

• alternative forms of energy such as solar power

• recycling

Agency for Health Care Policy and Research (AHCPR)

• This agency researches the quality of health care delivery and identifies the standard of treatment that should be provided.

Health Care Workers

• Provide quality care

• Avoid waste

• Keep expenditures down

Health Care Consumers

• Responsible for their own care

• Better informed of all of their options

• Preventive measures

Home Health Care

• Care in the home

• Less expensive

• All aspects of healthcare can be envolved

Geriatric Care

• Care for the elderly• Experiencing rapid

growth due to a large number of people experiencing longer life spans due to advances in health care

• Baby BOOM generation – born after WW II

Increased Demand for Services

• Adult Daycare• Retirement

Communities• Assisted and

independent living facilities

• Other Organizations

OBRA

• Omnibus Budget Reconciliation Act of 1987

• Led to the development of many organizations with regulations in long term care and home health care

OBRA

• Established training and competency evaluations for nursing and geriatric assistants

• Must be certified or registered as a certified nursing assistant

OBRA

• Continuing education, evaluation of performance and retraining/or testing if CNA has not worked in Health care facility for over 2 years

• State registry• Patient/resident rights• Must comply with these

regulations

Telemedicine

• Involves use of video, audio and computer systems

• Allows interactive services between Health care worker’s in different locations

• Robotic surgery• Computers help patients

receive care in their own homes

Wellness

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

Wellness

• Exercise

• Nutrition

• Weight control

• Healthy living habits

Wellness is determined by lifestyle choices

Promoting Wellness

• Physical Wellness– Diet – Exercise– Physical exams– Immunizations– Dental and vision care– Avoidance of alcohol,

tobacco, caffeine, drugs, environmental contaminants and risky sexual behavior

Emotional Wellness

• Understanding personal feelings and expressing them appropriately

• Accepting one’s limitations

• Adjust to change• Cope with stress• Enjoy life• Be optimistic

Social Wellness

• Show concern• Fairness• Affection• Tolerance• Respect for others• Communication• Sharing ideas and

thoughts• Honesty and integrity

Mental and Intellectual Wellness

• Be creative• Logical• Curious• Open minded• Use common sense• Obtain continual

learning• Question and evaluate• Learn from life’s

experiences• Be flexible • Be creative

Spiritual Wellness

• Values

• Ethics and Morals

• To find meaning

• Direction and Purpose in life

• Religious practices

Holistic Health Care

• Care that promotes physical, emotional, social, intellectual, and spiritual well-being by treating the whole

body, mind and soul

Holistic Health Care

• Each patient is unique• Variety of methods of

diagnosis and treatment

• Treatment directed toward protection and restoration

• Natural healing• Personal choices

Complementary and Alternative Methods of Health Care

• Complementary treatments are used in conjunction with conventional medical therapies

• Alternative methods of treatment are used in place of biomedical therapies

Integrative (integrated) Health Care

• Uses both mainstream medical treatments and CAM therapies to treat a patient

CAM Therapies

• Consider whole individual and recognize that the health of each part has an effect on the person’s total health status

CAM Therapies

• Each person has a life force or special type of energy that can be used in the healing process

• Skilled practitioners, rituals, and specialized practices are a part of therapy

Cultural Values and Beliefs

CAM Therapies

• Antioxidants: Nutritional therapy that encourages the use of substances to prevent or inhibit oxidation and neutralize free radicals

• Heart disease, cataracts, and some cancers

Meditation

• Therapies that teach breathing and muscle relaxation techniques to quiet the mind and focusing attention or obtaining a sense of oneness within oneself

• Reduce stress, slow heart rate, decrease blood pressure

Ayruvedic Practitioners

• Developed in India, an ancient philosophy to determine a person’s predominant dosha (body type) and prescribe diet, herbal treatment, exercise, yoga, massage, etc. to restore harmony in the body

Chinese Medicine

• Ancient holistic-based healing practice based on the belief that a life energy (CHI) flows through every living person in an invisible system of pathways to link the organs with the universe

• Accupuncture, tai chi

Chiropractors

• Believe that the brain sends vital energy to all body parts through nerves in the spinal cord and when there is a misalignment of the vertebrae, exerts pressure, resulting in disease and pain

• Use spinal manipulation, massage and exercise

Homeopaths

• Believe in the ability of the body to heal itself through the actions of the immune system

• Use diluted substances to cause similar symptoms of the disease to activate the immune system

Hypnotists

• 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

• Smoking cessation, weight loss, phobias, etc.

Naturopaths

• Use only natural therapies such as fasting, special diets, lifestyle changes, and supportive approaches to promote healing

• Avoid use of surgery or medicinal agents to treat disease

Play therapy

• Therapy that uses toys to allow children to learn about situations, share experiences and express their emotions

• Psychotherapy for children with limited language ability

Aromatherapy

• Use selected fragrances (concentrated essences or essential oils) that have been extracted from roots, plants, bark, and/or flowers to alter the mood and restore the body, mind and spirit

Tai Chi

• Based on the ancient theory that health is harmony with nature and the universe and a balanced state of yin (cold) and yang (heat)

• Series of movements and breathing techniques

National Center for Complementary and Alternative

Medicine

• NCCAM

• Researches various therapies and determines standards of quality care

State Requirements

• Some have established standards for CAMs• Forbidden in some states• Labeled as experimental• Require a license or certain educational

requirements before practicing• Learn the legal requirements for your state• Patient has the right to choose their care• Nonjudgmental attitude

CAM Therapies

• Noninvasive

• Holistic

• Less expensive than other traditional treatments

National Health Care Plan

• The main goal is health care reform to ensure that all Americans can get health coverage

Pandemic• Outbreak of disease that

occurs over a wide geographic area and affects a high proportion of the population

World Health Organization

• WHO

• WHO is concerned about influenza pandemics occurring now and in the near future

Historically

• Influenza pandemics have killed large numbers of people

• Example: 1918 Spanish Flu Pandemic killed about 40 million people who contracted the disease

Avian (Bird) Flu

• Virus was identified as the cause of an epidemic.

• Virus jumped directly to humans

• H5N1 present in countries in Asia and elsewhere

• Passed from bird to bird and devastated flocks of birds in

11 countries

H5N1 and Humans

• Most cases resulted from persons who had contact with infected poultry or contaminated surfaces

• Spread from person to person rare

• Death rate in humans was 50-60 %

• Concern was mutation of the virus

Hantavirus

• Spread by rodents• Severe acute

respiratory syndrome (SARS), Monkeypox, Filoviruses such as Ebola virus, and Marburg virus can cause hemorrhagic fever

• WHO estimates that 2-7 million people worldwide could die from infections from these types of viruses

Pandemic Flu Plans

• Education- info about pandemics and ways to avoid its spread

• Antiviral drugs - must be stockpiled and ready for immediate use

• More research to develop and produce effective antivirals

• Development of protective public health measures- Influenza must be diagnosed rapidly. Strict infection control methods to limit the spread of the virus

Planning

• First Responders and Health Care personnel must be immunized so they can care for the infected individuals

• Quarantine measures- to control the spread of disease

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

Swine Flu (H1N1)

• Respiratory disease of pigs caused by Type A influenza virus

• First isolated in 1930• High levels of illness

and low death rates in pigs

• Do not normally infect humans, but sporadic infections have occurred

H1N1 in humans

• Most commonly occurs in persons with direct exposure to pigs

• Symptoms of swine flu are fever, lethargy, lack of appetite, coughing which are similar symptoms to the seasonal flu

• Some other symptoms maybe runny nose, sore throat, nausea, vomiting and diarrhea

H1N1

• You can not get H1N1 from eating pork

• It can be spread from pigs to people and people to pigs

• You may also have human to human transmission

• There are medications to treat the H1N1 virus

Who is at risk?

• Children under the age of 2

• People who suffer with heart disease or diabetes

• Asthmatics and pregnant women

• Teenagers and young adults are also more vulnerable

• Health Care Workers

Prevention

• Wash your hands• Stay away from

crowded areas• Cover your mouth

when you sneeze or cough

• REMEMBER: It is a treatable and curable disease

Stay abreast of changes and make every attempt to learn

about them!!!!