chapter 9 health care delivery system

Chapter 9: Health Care

Copyright © 2012 Cengage Learning, Brooks/Cole Publishing

Social Work: A Competency-Oriented Education

Council on Social Work Education (CSWE)

- Defines Educational Policy and Accreditation Standards (EPAs)

- Developed 10 “Core Competencies” and 41 Related “Practice Behaviors”

Every student should master the Practice Behaviors and Core Competencies before completing the program


Resources Aligned to EPAS 2008

The Textbook –

- “Helping Hands” icons call attention to content that relates to Practice Behaviors and Competencies

- “Competency Notes” at the end of the chapter help put the Practice Behaviors and Competencies in practical context


Resources Aligned to EPAS 2008 (cont’d)

The Practice Behaviors Workbook developed

with the text provides assignable exercises that assist in mastering the Practice Behavior and Competencies

Additional on-line resources can be found at: www.cengage.com/socialwork


Copyright © 2012 Cengage Learning, Brooks/Cole Publishing.

A DefinitionCare provided to individuals to prevent or promote

recovery from illness or disease

EP 2.1.1a, 2.1.3a, 2.1.8a


Rising costs

• National expenses for health care have increased

from $73.2 billion in 1970 to $2.5 trillion in 2009• The U.S. spends billions of dollars annually to

provide health services to uninsured persons• Health Care expenditures are expected to increase

to $4.3 trillion by 2018

EP 2.1.1a, 2.1.3a, 2.1.8a


Moral and ethical issues

• How much of our country’s resources should be spent on health care?

• How should those resources be allocated?

EP 2.1.2b, c

Copyright © 2012 Cengage Learning, Brooks/Cole Publishingc.

Ecological/systems approach

to health care As early as the Greek and Roman eras of civilization,

it was observed that many health problems were

Associated with changes in the environment

EP 2.1.2b, c


Environment and lifestyle play big roles

The greatest contributors to premature death in the

U.S. are not individual hereditary factors, but

environmental and lifestyle factors

EP 2.1.2b, c


Factors that affect health care

• Income• Ethnicity• Gender• Age• Disability• Place of residence

EP 2.1.3a


Income

• Income and health status are positively related• Even those who are employed have difficulty

affording health insurance and health care• Almost 18% of children from low-income families

had no health insurance in 2007

EP 2.1.3a

Ethnicity

• Whites enjoy better health care than people of

color• Life expectancy for groups of color is less than it is

for whites• People of color are more at risk to develop and

suffer from chronic diseases than whites

EP 2.1.3a



Gender

• Average life expectancy for women is greater than

for men• Women are more likely than men to spend their

last years in poverty, which places them at risk to

experience poor health

EP 2.1.3a


Age

• Our country’s oldest and youngest citizens are at

highest risk of poor health• The U.S. has a higher infant mortality rate than any

Western country• Major causes of death vary significantly by age

EP 2.1.3a


Disability

• Persons with temporary or permanent disability are

at greater risk to have serious health problems than

persons without disabilities• Health problems are often compounded by the lack

of affordable, accessible, appropriate health care

EP 2.1.3a


Place of residence• Living in a rural or urban area increases your

chances of health problems • Over half of people who live in poverty live in rural

areas• Individuals in rural areas are more likely to suffer

from emotional disorders than people in urban areas

EP 2.1.3a


Applying an ecological/systems perspective

• Health Risk Factors• Holistic Health

EP 2.1.8a, 2.1.9b


Evolution of health care in America

• Keeping people alive• Control of communicable diseases, sanitation

measures, and public health education• Control of chronic degenerative diseases

EP 2.1.9a


Critical issues in health care

• Funding and costs• Health insurance and managed care• Costs vs. outcomes• Rapidly-growing elderly population• Increased knowledge and technology• Health care for the poor• Malpractice suits

EP 2.1.9a


Current major health care problems• HIV and AIDS• Other illnesses • Catastrophic illness• Teen pregnancy• Environmental factors• Lack of prevention and wellness programs

EP 2.1.3a, 2.1.7b, 2.1.9a


Ethical dilemmas in health care:

Saving lives at what cost?• Baby Doe cases• Right-to-die cases• Bioethics• Alternative medicine

EP 2.1.2b, c


Health planning goals• Eliminate problems in the cost of care• Prevent duplication of care in some areas and gaps

in others• Streamline the interface of public and private sector

delivery of care

EP 2.1.8b, 2.1.9b


Major health care programs

• Medicare • Medicaid• Maternal and Child Health • Healthy Steps for Young Children• CHIP and S-CHIP

EP 2.1.8b, 2.1.9b


Goals of health care reform• Reduce long-term growth of health care costs for

business and government• Protect families from bankruptcy or debt because

of health care costs• Guarantee choice of doctors and health plans• Invest in prevention and wellness• Improve patient safety and quality care

EP 2.1.8b, 2.1.9b


Goals of health care reform (cont’d)• Ensure affordable, high-quality health coverage for

all Americans• Maintain coverage when you change or lose a job• End barriers to coverage for people with

preexisting conditions

EP 2.1.8b, 2.1.9b

EP 2.1.8b, 2.1.9b

Affordable Care Act of 2009

Title Caption

I Quality, affordable health care for all Americans

II Role of public programs

III Improving the quality and efficiency of health care

IV Prevention of chronic disease and improving public health

V Health care workforce



EP 2.1.8b, 2.1.9b

Affordable Care Act of 2009 (cont’d)

Title Caption

VI Transparency and program integrity

VII Improving access to innovative medical therapies

VIII Community assistance services and supports

IX Revenue provisions


Social work and health care

• Hospital settings• Long-term care facilities and nursing homes• Community-based programs• Home health care• State departments of health/health planning agencies• Primary versus secondary settings

EP2.1.1a, c, 2.1.8b, 2.1.9b