Trends in Healthcare

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Identify past trends or changes in healthcare Identify current trends or changes in healthcare Identify at least five methods of cost containment used in healthcare

--- Many events lead to changes in healthcare --- Changes occur almost daily --- Healthcare workers must be aware of these changes/trends --- We will discuss past and current trends in healthcare

--- a means of trying to control the ever rising cost of healthcare --- achieving the maximum benefit for every dollar spent on healthcare

--- Biggest reason healthcare costs increase is the overwhelming use of technology --- Diagnostic and therapeutic procedures involve more technology which is expensive to research, develop and put into practice

--- Second biggest reason for increased cost is aging of the Baby Boomer population ---As this generation ages, more chronic diseases are diagnosed thus increasing frequency of use of healthcare services and pharmaceuticals.

--- Increase in occurrence of health-related lawsuits ---Leads to increased cost of malpractice insurance ---Doctors order diagnostic tests even though testing may not be completely medically necessary --- Every effort is made to avoid lawsuits by practicing defensive healthcare

1. ( s) ---http://www.ehealthmedicare.com/faq-what-are-diagnosisrelated-groups/ --- an attempt by Congress to control costs for and --- a payment is based on diagnosis --- a certain $ amount is paid for each disease condition

1. ( s) --- agencies providing care for less can keep the extra $ --- agencies must accept the loss if the care provided costs more than the assigned DRG allowed

--- agencies combine services to avoid duplication --- sharing of clinics, labs, and so on --- care can be provided to a larger number of people at a decreased cost per person

--- Patients receive care without being admitted to hospitals or having a shorter stay --Inpatient hospital care is much more expensive than outpatient care --- Less expensive home care or transfer to a rehab facility is used for individuals who require assistance but not more intensive acute care

--- Buying equipment and supplies in larger quantities at reduced prices --- Computerizing inventory used to: *determine when supplies are needed *quantities of items used *prevent overstocks and waste

---Preventing illness is more cost effective than treating illness --- Methods used to prevent illness: --- patient education --- immunizations --- regular physical exams --- incentives to participate in preventive activities --- easy access to preventive healthcare services

--- individuals with limited access to health services and restricted finances use expensive emergency rooms and acute care facilities more frequently --- providing early intervention/care to these individuals is more cost efficient

---the major expenses for every healthcare industry/agency are electricity/water/gas ---monitoring use of energy to control costs and conserve resources ---energy audits to calculate ways to conserve energy ---designing/building energy-efficient facilities

7. --- very rapidly growing field --- DRGs result in shorter hospital stays so patients will need care at home --- good method of cost containment because it is less expensive to provide home care

7. --- includes large aspects of healthcare --- in home nursing care --- physical and occupational therapy --- respiratory therapy --- social services --- nutritional and food services --- homemaking services

---It is important to note that even though we need to be concerned with controlling costs we should also ensure that the quality of healthcare should not be lowered to accomplish this goal.

--- Besides the ones listed, what are some personal patient advantages of home healthcare? --- financial savings to the patient --- more at ease in their home environment --- familiarity with the environment --- more able to rest in the home environment than in a medical environment

--- a field of rapid growth for several reasons --- individuals are experiencing longer life spans --- the Baby Boom generation is now entering this age

--- projections from U.S. Census Bureau *rate of population growth during the next fifty years will be slower for all age groups --- the number of people in older age groups will continue to grow-more than twice as rapidly as the total population

the rate of population growth during the next fifty years will be slower for all age groups --- the number of people in older age groups will continue to grow more than twice as rapidly as the total population---why? --- The younger population will decrease due to the use of birth control methods while the older population will continue to grow older

--- the fact of elderly population growth will lead to the need for different facilities such as: --- adult day care centers --- retirement communities --- assisted and independent living facilities --- Long-Term Care Facilities

--- a federal law that created regulations regarding Long-Term Care and Home Healthcare --- states must establish training and competency evaluation programs for nursing assistants

--- Nurse Aides in Long-Term Care must: --- complete a mandatory state-approved training program (MNA) --- pass a written and/or competency examination --- obtain a certification or registration

--- other OBRA requirements for NA: --- continuing education --- periodic evaluation of performance --- retraining and/or testing if NA doesn t work in a facility for more than two years

--- other OBRA requirements: ---states must maintain a registry of qualified persons ---minimum skills required are specified training program developed by the State Boards of Nursing

--- requires compliance with resident s rights --- states establish guidelines to make sure the rights are observed and enforced --- this is done to ensure certain standards of care

--- Uses video, audio, and computer systems to provide medical and/or healthcare services --- New technology allows interactive services between healthcare providers even though they are in different locations

For ex: Emergency Medical Technicians (EMTs) at the scene of an accident or illness can use technology to transmit medical data such as an electrocardiogram to an emergency room physician who can monitor the data and direct the care of the patient

--- surgeons using a computer can guide a remotecontrolled arm (robotic) to perform surgery on a patient many miles away --- a surgeon can direct the work of another surgeon by watching the procedure on video beamed by a satellite system

--- as consumers become computer-literate, more healthcare services will be provided electronically --- allows individuals with chronic illnesses or disabilities to receive care in the comfort of their homes --- decreases needed trips to medical facilities

--- patients can use online self-help courses to learn how to manage their condition --- appointments can be made and kept with a healthcare provider through video monitors on a face-to-face basis

--- patients can receive electronic reminders to take medications or to perform diagnostic tests and receive answers to specific health questions --- provides a patient with access to specialists located thousands of miles away --- patients in rural areas or even 3 rd world countries can receive specialty care which is often limited

The state of being in optimum health with a balanced relationship between physical, mental, and social health Homeostasis --- Holistic Healthcare

--- We must recognize importance of: --- exercise --- good nutrition --- weight control --- healthy living habits

In order for people to try to reach a state of homeostasis the trend has been towards the development of: --- Wellness centers --- Weight control facilities --- Health food stores --- Nutrition services --- Stress reduction counseling --- Habit cessation management

Ways to promote physical wellness:

Physical Wellness Well Balanced Diets

Physical Wellness Regular exercise 3 to 4 days weekly

Physical Wellness Routine physical exams - Annually

Physical Wellness Immunizations As scheduled

Physical Wellness Regular Dental Exams

Physical Wellness Regular Vision Exams

Avoidance of: Alcohol

Avoidance of: Tobacco

Avoidance of:

Avoidance Trends in of: Healthcare Non-therapeutic Drugs

Avoidance Trends in of: Healthcare Environmental Contaminants

Avoidance Trends in of: Healthcare Risky Sexual Behavior

--- What is your definition of values?

--- What is your definition of ethics?

--- What is your definition of morals?

--- What is your definition of purpose?

--- Social/Emotional/Spiritual wellness: ---understanding personalfeelings and expressing them appropriately --- showing concern, fairness, affection, tolerance, and respect for others --- communicating and interacting well with others --- coping with stress, enjoying life, and maintaining an optimistic outlook ---using values, ethics, and morals to find meaning, direction, and purpose

--- Mental/Intellectual wellness: --- being creative, logical, curious, and openminded --- using common sense --- obtaining continual learning --- questioning and evaluating information and situations --- learning from life experiences --- using flexibility/creativity to solve problems

--- The trend toward wellness has led to a type of accepted --- treatment Holistic called: Healthcare --- Involves caring for the emotional being, the social being, the intellectual being, and spiritual being by treating the body, mind, and ---spirit Each of patient the patient is recognized as a unique person with different needs

--- Uses methods of diagnosis and treatment in addition to the most traditional Biomedical or Western system of care --- Treatment is directed more toward protection and restoration --- Based on the body s natural healing powers and the various ways different tissues and systems in the body influence each other, and the effects of the external environment

--- The patient is responsible for choosing the type of healthcare they wish to use --- Healthcare workers must respect the patient s choices and provide care that promotes wellbeing of the whole person

--- The most common health care system in the United States is the biomedical or Western system --- Based on evaluating the physical signs and symptoms of a patient, determining the cause of disease, and treating the cause

--- A major trend is an increase in the use of complementary or alternative healthcare therapies --- Complementary therapies: methods of treatment used in conjunction with conventional medical therapies

Offered by many healthcare facilities --- Uses both mainstream medical treatments and CAM therapies to treat a patient --- Example: chronic pain is treated with both medications and CAM therapies that encourage stress reduction and relaxation

--- Chinese medicine practitioners, such as acupuncturists --- Chiropractors --- Homeopaths --- Hypnotists

--- Many states have laws to govern the use of various therapies (1) Establish standards for some therapies (2) Forbid the use of some therapies (3) Label specific therapies experimental (4) Require a license or certain educational requirements before a practitioner can administer a particular therapy

--- The high cost of healthcare and a large number of uninsured individuals has created a demand for a national healthcare plan --- Many different types of plans have been proposed --- One plan involves nationalized medicine --- Government would pay for all health services --- Levy taxes to pay for them

--- Another plan involves creation of healthcare cooperatives that allow consumers to purchase healthcare at lower costs --- A third plan is based on managed care and requires employers to provide coverage with the federal government subsidizing insurance for the poor

--- A fourth plan allows each state to establish its own healthcare plan paid for by employers, individuals, and/or government subsidies --- The main goal in healthcare reform is to ensure that all Americans can get health coverage

--- Cost of creating the program --- The fact that those with insurance may pay more to cover uninsured individuals --- The lack of free choice consumers will have in choosing their healthcare providers --- The regulations that will have to be created to establish a national healthcare system

What is the Affordable Care Act (Obamacare) and how does it work?? https://youtu.be/vju70i6qskk

--- Exists when the outbreak of a disease occurs over a wide geographic area and affects a high proportion of the population --- The major concern today is that worldwide pandemics will become more frequent --- Society is global with individuals traveling easily throughout the world --- Disease can spread more rapidly from individual to individual

--- Concerned about influenza pandemics --- History shows influenza pandemics have killed large numbers of people --- 1918 Spanish flu pandemic killed approx. 2.6 percent of individuals who contracted it, or about 40 million people

--- Avian (bird) flu viruses, called H5N1 viruses, which are present in Asia and some other countries are of major concern --- Viruses pass readily from birds to birds and have devastated bird flocks in more than 11 countries

--- Infection appears in humans, but most cases result from contact with infected poultry or contaminated surfaces --- Spread from one person to another has been reported only rarely --- The death rate for bird flu in humans is 50 to 60 percent -- A major concern is that H5N1 viruses will mutate and begin to spread from birds to humans

--- Other viruses can cause pandemics : spread by rodents rare but deadly viral infection that affects the lungs such as the virus and the that cause hemorrhagic fever

--- Viruses are prone to mutating and to exchanging genetic information which may lead to the creation of a new lethal virus estimates that between 2 million and 7 million people worldwide could die --- Many governments are creating and constantly updating pandemic influenza plans to protect their populations

information R/T the pandemic and ways to avoid its spread must be given to the entire population research must be directed to producing effective vaccines in large quantities in a short period of time

drugs currently available must be stockpiled ready for immediate use with more research to develop and produce effective antiviral drugs --- diagnosis must be rapid and accurate --- Infection control methods must be implemented to limit the spread of the virus

must be immunized so they can care for individuals --- must be used to control the spread of the disease --- countries must work with each other to create a plan that will limit the spread of lethal viruses and decrease the severity of a pandemic

--- effort will be directed to identifying and limiting the effect of any organism that could lead to a pandemic --- Healthcare workers must stay informed and be prepared to deal with the consequences of a pandemic

--- Polio vaccine --- Development of antibiotics --- Drugs for cancer

--- cure for AIDS --- prenatal prevention of genetic disorders --- even more use of computerized healthcare

--- Healthcare has changed and will continue to change --- Healthcare workers must be constantly aware of changes that occur and make every attempt to learn about changes and trends