Chapter 2
Health Care Systems
Health Care
Science
Technology
Copyright © The McGraw-Hill Companies, Inc.
Objectives
Summarize significant historical
changes in health care.
 List the reasons for the importance
to health care of the scientific
method.
 Compare ancient and current
medical practices.

2
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Objectives (cont.)
Identify major trends in health
care.
 List the types of health care
facilities and the services
provided in each.

3
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Objectives (cont.)
List the ways in which health
care facilities, government
agencies, and nonprofit
volunteer agencies contribute to
the health of a community and
the world.
 Identify the clients served by
Medicare and Medicaid.

4
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Objectives (cont.)
Discuss the impact of the
uninsured on health care costs.
 Summarize the purpose of health
maintenance organizations
(HMOs).
 Define the purpose of workers’
compensation.

5
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
History of Health Care 2-1
Prehistory and the Ancient World
 The Middle Ages
 The Renaissance
 The Industrial Revolution
 Modern Times

6
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Prehistory and the Ancient World


7
Ancient healers used diet,
rest, plants, and herbs, and
performed surgery.
The caduceus, which is the
symbol of the physician,
may have evolved from the
symbol for Asclepius, the
Greek god of healing.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Prehistory and the Ancient World
(cont.)
The Hippocratic Oath is a code
of ethics developed by
Hippocrates around 400 B.C.
 This code promotes patient
confidentiality and forbids the
deliberate harming of a patient.

8
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Prehistory and the Ancient World
(cont.)

Galen was a Greek trained by the
Egyptians and appointed as
physician to the gladiators.
–
–
9
He is credited with performing tracheotomies
and documenting the importance of the spinal
cord in the movement of limbs.
His manuscripts were used to train physicians
until the Renaissance, which began in the 14th
century.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
The Middle Ages

500 A.D. – 1500 A.D.
–

Rhazes was a Persian doctor.
–
–
10
Reason began to replace belief in
spiritual or superstitious causes for
illness.
He wrote about the differences
between smallpox and measles.
He provided a clearer understanding of
the causes of disease.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
The Middle Ages (cont.)

The Barber-Surgeon
–
–
11
Barbers performed cataract
surgery, limb amputations, and
phlebotomy (bloodletting).
The red and white barber pole may
have begun as a pole to hang
bandages, or may have
symbolized blood, veins, and
bandages (red, blue, and white).
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
The Middle Ages (cont.)

The Beginning of Medical Care
Regulation
–
–
12
Physicians were licensed after
formal training with experienced
doctors.
Women were not allowed to
practice medicine.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
The Middle Ages (cont.)

Religion and Medicine
–
13
Religious principles led to the
founding of many Islamic
hospitals and Christian
monasteries where the sick
were treated.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
The Renaissance

14th – 17th Centuries
–
–
–
14
15th Century
 The invention of the printing press
allowed discoveries to be published.
16th Century
 The scientific method came into use
and the microscope was invented.
Age of Enlightenment (1700s)
 The study of anatomy was allowed by
the church.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
The Industrial Revolution

Late 18th and Early 19th Centuries
–
–
–
–
–
–
–
15
Stethoscope invented.
Vaccination began.
Marked the beginning of modern medicine.
Louis Pasteur’s experiments formed the basis of
microbiology.
Joseph Lister began disinfecting surgical
equipment and hand washing (medical asepsis).
Robert Koch found that pathogens are the source
of some diseases.
Ether used as an anesthesia.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Modern Times

20th Century
–
–
–
–
16
Antibiotics invented.
Radium discovered.
CAT scans, MRI, and
ultrasound are used.
Organ transplants
commonplace.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Section 2-1
Apply Your Knowledge
What did the invention of the
printing press allow?
Answer:
The printing press made it possible
to publish books about discoveries.
17
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Trends in Health Care 2-2
Technology
 Preventive Medicine and Wellness
 Aging Population
 Underinsured and Uninsured
 Ambulatory Care and Outpatient
Surgery
 Home Health Care

18
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Technology
Computer technology allows
noninvasive diagnosis of soft
tissue diseases and injuries.
 Ultrasound used to examine
body cavities.
 Field of radiology no longer
limited to X rays.

19
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Technology (cont.)



20
Miniaturization allows
cameras and instruments to
be inserted into the body for
surgical procedures.
Digital images can be
transmitted to a consulting
specialist.
Client’s records can be made
available anytime and
anywhere.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Preventive Medicine and Wellness


21
Wellness idea began about 20 years ago with
the introduction of fitness centers.
Wellness industry
growth spurred by
baby boomers,
physicians,
insurance
companies, and
fitness
professionals.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Preventive Medicine and Wellness (con

Hospital wellness centers offer services
such as:
–
–
–
–
–
–
22
Cardiac rehabilitation.
Pulmonary rehabilitation.
Occupational medicine.
Sports medicine.
Clinical weight management.
Physical therapy.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Preventive Medicine and Wellness
(cont.)

Most hospital wellness centers offer
wellness programs for clients with
chronic diseases such as:
–
–
–
–
23
Arthritis.
Diabetes.
Osteoporosis.
Neuromuscular disorders.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Preventive Medicine and Wellness
(cont.)

Many hospital wellness centers offer
complementary classes in:
–
–
–

Some hospital wellness centers provide
screening for diseases that include:
–
–
–
24
Yoga.
Nutrition.
Stress management.
Breast, cervical, and prostate cancer.
High blood pressure.
High cholesterol.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Preventive Medicine and Wellness
(cont.)

Factors relating to personal responsibility
for wellness include:
–
–
–
–
–
–
–
25
Fitness.
Preventive care.
Spiritual health.
Safety.
Nutrition.
Tobacco addiction.
Stress management.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Aging Population




26
Caused by fewer births and
fewer deaths.
Baby Boom, 1946-1964.
Population of 65 and older
expected to double between
the years 2000 and 2030,
from 35 million to 70 million.
As the population ages,
demands on the health care
services will increase.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Underinsured and Uninsured
16% of U.S. population (42
million) have no health
insurance.
 Some have health insurance,
but coverage is limited by a
large co-payment or deductible
in addition to the insurance
premium.

27
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Underinsured and Uninsured (cont.)
As new technology and products
emerge, costs increase.
 County hospitals, supported by
taxes, care for uninsured low
income people.
 Costs associated with the
uninsured are passed on to those
who are insured or can afford to
pay.

28
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Ambulatory Care and
Outpatient Surgery
Technology, research,
and new medications
make same-day
surgery possible.
 Costs can be reduced
when patients do not
remain overnight.

29
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Home Health Care




30
Became popular in the late 1980s.
Medicare began paying hospitals a
flat fee for diagnostic related groups
(DRGs).
Patients are released from the
hospital early and receive home visits
by a skilled professional.
Patient benefits by exposure to fewer
pathogens, lowered stress and
anxiety, and decreased cost.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Section 2-2
Apply Your Knowledge
What can be done to contain the
cost of health care?
Answers:
1. Home health care.
2. Ambulatory care.
3. Preventive care/wellness.
31
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Health Care Facilities 2-3








32

Hospitals
Long-Term Care
Practitioners’ Offices
Clinics
Laboratories
Emergency Medical Services
Home Health Care
Rehabilitation
Hospice
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Hospitals





33
Hospitals Run by Religious
Organizations
Private Hospitals
Nonprofit Hospitals
Hospitals Run by
Government Organizations
Specialized Hospitals
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Long-Term Care




34
Residents may be frail, elderly,
handicapped, or disabled.
Residents seen by the physician
monthly.
Assisted-living centers offer
separate living quarters, and
provide meals and housekeeping.
Some residents are able to perform
many of their own activities of daily
living (ADL).
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Practitioners’ Offices
Many offer testing
and minor surgery.
 Dentists and dental
hygienists are
included in this
group.
 May be an individual
or a group practice.

35
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Clinics



36
Practitioners have separate clients,
but share billing, reception, and
record-keeping staff.
Clinic may specialize or offer a
wide variety of services.
“Clinic” may refer to a type of care
provided on a specific day and may
move from location to location.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Laboratories
May perform tests on blood or
body tissues.
 Can be part of a clinic or
hospital.
 Some are supported by public
money.

37
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Emergency Medical Services




38
Developed to provide care to ill and
injured as quickly as possible.
May be part of the 911 phone
system.
Police officers, firefighters, and
ambulance staff may perform EMS.
In rural areas, volunteers, park
rangers, or ski patrol may provide
EMS.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Home Health Care
Can be considered another
type of health care facility.
 May be long term or short term.

39
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Rehabilitation
Designed to help clients regain
physical or mental abilities or to
help them live with disabilities.
 May be part of a hospital, clinic,
or privately owned.

40
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Hospice
Services are
provided to the
terminally ill.
 Includes treatment
from doctors,
nurses, therapists,
dieticians, social
workers, clergy,
and volunteers.

41
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Hospice (cont.)

Therapy is designed to:
–
–
–
–
42
Improve quality of life.
Use pain medications effectively.
Relieve symptoms.
Prepare the person and his or
her family for death.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Section 2-3
Apply Your Knowledge
What are four types of care that
may be provided in a long-term
care facility?
Answer:
1. Regular professional health care services
2. Therapy
3. Physical rehabilitation
4. Skilled nursing care
43
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Health Care Agencies 2-4
Government Agencies
 Volunteer and Nonprofit Health
Agencies

44
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Government Agencies

Local Health Departments
–
–
–
45
Provide immunizations, inspections,
and environmental protection.
Collect statistics about communicable
diseases.
May provide health education and
other health-related services to the
community.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Government Agencies (cont.)

U.S. Department of Health and
Human Services (DHHS)
–
–
National agency that deals with health
in the United States.
Important agencies under DHHS
include:



46
Centers for Disease Control (CDC).
Food and Drug Administration (FDA).
National Institute of Health (NIH).
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Government Agencies (cont.)

World Health Organization
(WHO)
–
–
–
–
47
International agency sponsored
by the United Nations.
Primary goal is to help all
people attain the highest
possible level of health.
Compiles statistics on disease.
Provides training for medical
personnel.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Volunteer and Nonprofit
Health Agencies
Can be on the state, local, or national
level.
 Supported by private contributions
and fund-raising.
 Usually focus on a single disease.
 Examples include:

–
–
48
–
American Lung Association (ALA).
March of Dimes.
American Heart Association (AHA).
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Section 2-4
Apply Your Knowledge
What are three ways volunteer and
nonprofit organizations have
contributed to health and health care?
Answer:
1. Influenced laws.
2. Created standards of care for infants.
3. Educated doctors and other health
professionals in new techniques.
49
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Health Insurance 2-5
Paying for Health Care
 Medicare and Medicaid
 Managed Care
 Workers’ Compensation
 Military Health Care

50
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Paying for Health Care
Insurance company decides what
medical services will be covered.
 Group insurance coverage is offered
to employees by many employers.

51
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Medicare and Medicaid
Programs are result of federal
legislation.
 Programs target people who lack
access to care.

52
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Medicare
Largest health insurance
program in the nation.
 Must be at least 65 years old or
disabled to qualify.
 Part A provides for hospital care,
limited skilled nursing facility
services, home health services,
and hospice care.

53
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Medicare (cont.)
Part B helps pay for the services
of physicians, outpatient
hospital services, and medical
equipment and supplies.
 The insured pays a premium for
Part B and may have to pay a
deductible or have other private
insurance.

54
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Medicaid
Government
insurance for
certain lowincome people.
 Dental coverage
may be available.
 No co-payment
or deductible.

55
INDIANA MEDICAID
AND OTHER MEDICAL ASSISTANCE PROGRAMS
100341842799
001
Danny L. Owens
07/19/62
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Managed Care


Health care plans specifically designed to
control costs.
Advantages
–
–
–
56
Most include preventive care, such as
annual physicals, mammograms, and wellbaby care.
Monthly premiums and out-of-pocket
expenses are usually lower than with
traditional insurance.
Reduced paperwork.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Managed Care (cont.)

Disadvantages
–
–
–
–
57
Limited choice of doctors and hospitals,
except for emergency treatment.
Must be referred to specialist by primary
care physician.
Usually more restrictive than ordinary
insurance.
Not all health expenses count toward
deductible.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Health Maintenance Organizations
Focus on prevention and
wellness.
 Businesses or individuals pay
premiums to the HMO instead of
an insurance company.
 HMOs focus on wellness care not
usually covered by insurance.
 Popular in the 1980s and 1990s.

58
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Workers’ Compensation
Insurance that covers accidents,
injuries, or diseases that occur
in the workplace.
 Federal law requires businesses
to purchase and maintain a
minimum amount of workers’
compensation insurance.

59
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Workers’ Compensation (cont.)

Types of services provided for
injuries occurring in the workplace:
–
–
–
–
60
–
Basic medical treatment for inpatient and
outpatient care.
Weekly payments to employees for
temporary disabilities.
Monthly payments to employees with
permanent disabilities.
Death benefits.
Rehabilitation costs.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Military Health Care


61
Provided to current military
personnel, retired military
personnel, and veterans
through CHAMPUS/TRICARE
program.
Public Health Service and
National Oceanic and
Atmospheric Administration
are also covered by this
benefit.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Section 2-5
Apply Your Knowledge
List 3 advantages to managed
care.
62
Answer:
1. Most policies include preventive care.
2. Monthly premiums and out-of-pocket
expenses are lower than with traditional
insurance.
3. Paperwork is reduced, and there are no
claim forms.
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2
Chapter 2 Credits
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Slide 20
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Slide 29
Slide 30
Slide 33
Slide 35
Slide 41
Slide 61
63
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Healthcare Medical Communication
Systems, Inc.
Daniel Miller/CORBIS
PhotoDisc
Doug Martin
KS Studios
Ron Chapple/Getty Images
Matt Meadows
CORBIS
David Kelly Crow
Copyright © The McGraw-Hill Companies, Inc.
Chapter 2