CHLH 101 Final Exam Study Guide PDF

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CHLH 101 Final Exam Study Guide Healthcare Delivery in the US  Brief history of healthcare in US Early History- Mid 1800s -

Self- care has been a category of health care throughout history and today  Assumed self-care occurs before seeking professional help - From colonial time through late 1800s, anyone trained or untrained could practice medicine - Past medical education not nearly as rigorous as today  Less about science, more about experience - Most care was provided in patients’ homes - Hospitals only in large cities and seaports  Functioned more in a social welfare manner  Problems with cleanliness and unhygienic practices  Washing hands/ antiseptic - Almshouses – “poorhouse”, run by local government provided some care - Pesthouses – place to isolate infectious diseases Late 1800s- Early 1900s - Care moved from patient’s home to physician’s office/ hospital o Building and staffing better o Designed for patient care o Trained people and medical supplies available - Science had a bigger role in medical education - Mortality declined due to improved PH measures o Sanitation within hospital better than at a home - Early 1920s: chronic diseases passed communicable as leading causes of death - New procedures available: x-ray, specialized surgery, chemotherapy, ECG - Training: doctors and nurses become more specialized - 1929: U.S. spent 3.9% GDP on health care - Two party system – Patients and Physicians o Physicians collected own bills, set and adjusted prices based on ability to pay 1940s- 1950s - WWII impact o Wage restrictions in place o Employers created health insurance to lure workers - Huge technical strides in 1940s and 1950s - Hill- Burton- Act- federal matching funds for hospital construction - Improved procedures, equipment, facilities meant rise in cost of healthcare - Concept of health care as basic right vs. privilege 1960s - Increased interest in health insurance - Third- party payment system became standard method of payment o Insurer pays physician, not patient - Cost of health care rose - Increased access at little expense for those with insurance o Those without insurance unable to afford care

- 1965 Medicare and Medicaid developed 1980s 1990s -

Today -

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Reagan and Congress eliminated Health System Agencies o Which previously looked at cost- efficiency and effectiveness Deregulation of health care delivery Questions in medical ethics Elaborate health insurance programs developed Costs rising – fancy new technology, more older adults, ADIS, liability/ lawsuits

American Health Security Act of 1993 o Attempt to lay out structure and system for better health plan Managed care become more prevalent (primary care  specialist) o Achieve efficient o Control utilization o Determine prices and payment CHIP developed 1996: U.S. spent $1 trillion on health care: ~ 14% GDP

2010: U.S. healthcare costs $2.6 trillion; 17+% GDP Healthcare costs outpacing inflation for past few decades o U.S. at/near top on healthcare spending per capita o But.. U.S. health stats generally not at top - 2010- Affordable Care Act o Extends coverage o Initiates improvements in quality of care o Sets base level of coverage/ covered service Types of healthcare practice- public health, medical practice, long-term care - Population- Based Practice (Public Health) o Interventions aimed at disease prevention and health promotion o Health education & service provision o Ex) Sanitation, vaccination, disaster response, promoting health behaviors o Found in: Governmental health agencies  Also occurs in a variety of other settings (non-profits, FQHCs, schools) o Providers: wide variety of skills and experiences - Long- term practice o Restorative Care  Provide after surgery or other treatment  Rehab care, therapy, home care  Found in: inpatient and outpatient units, nursing homes, personal homes, other settings  Providers: doctor, nurses, PT, OT, ST o Long- term care  Help with chronic illnesses and disabilities  Time intensive skilled care to basic daily tasks

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Found in: inpatient and outpatient units, nursing homes, personal homes, other settings  Providers: physicians, nurses, PT, OT, ST - End- of – care practice o Services provided shortly before death o Hospice care  Terminal diagnosis (typically...