trends in healthcare. change you must be aware of changes and trends as a health care worker
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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
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
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
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 Consumers
• Responsible for their own care
• Better informed of all of their options
• Preventive measures
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
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
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
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