Evolution of Health Care Flashcards
Time Periods of Health Care
-Colonial (pre-1850)
-Institutionalization (1850-1900)
-emergence of scientific method in HC (1900-1945)
-Logistics and Planning (WWII-1980)
-Cost Containment (70s-2000)
-HC rationing (now)
Pre-1850 medical models
-Galen’s four humors must be balanced
-Miasma theory (bad air)
-religous punishment
Colonial providers (pre-1850)
-loose collection of unrelated services
-most sucess went to good advertisers
-often had another job
-apprentice
-circuit rider (dr came to patient)
-bled many pt to death
First Pharmacy school
-formed in 1821
-2 yr degree
Emergence of New Technologies of Care in Colonial period
-1757 smallpox vax
-1846 ether anesthetic
-1847 chloroform
-1847 when to use ether vs chloroform
-1847 germ theory, keep tools clean
Institutionalization Period (1850-1900)
-1854 shutting off contaminated water pipe ended chloera epidemic = sanitization and public health
-1865 sterilize med equipment
-pastuerization
-1870s- causes of anthrax and septicemia
-surgery became theoretically possible with hygiene and anesthesia
Purdue Rx formed
1884
Hospitals during industrialization period
-established in urban areas
-place to die
-place for dr to share ideas and network
-first dispensaries of health care
Emergence of scientific method (1900-1930)
-1900 John Hopkins
-1909 anti-syphilitic activity of salvarsan
-1918 flu pandemic case study in epidemiology
-1928 fleming and penicillin
More technological breakthroughs
-science of disease
-medicine as science
-inc power of drs
European approach to health care
-PUBLIC health
-financed thru gov
US approach to health care
-PERSONAL health
-who paid
medicine worked diligently to eliminate competition until
only a real dr would do
Evolution of payment
-pre1850: ducks, grain
-1850-1900: success for a few prominent individuals
-1900-1945: development of the concept of health insurance
-1945-1970: vast expansion, hospitals subsidized by feds, medicare/medicaid
-medical industrial complex babey
Payment methods to lower costs and reduce MD power
-1970-1980s: health planning to ensure resources used efficiently, but still based on fee for service
-1990s: recognition of out of control costs- regulations written to cause fierce competition, hope for free market to lower costs
-2000s: growing public subsidy of the cost of health care along w greater control
slide 16 idk what that means
Private insurance
-almost unique to the US
-early versions started to keep income up for hospitals
-BLUE cross/shield were formed to ensure drs and hospitals were paid money for services provided
WWII
-key issue in evolution of US hc
-employer insurance
employer-purchased insurance
-WWII
-gov froze wages
-corps competed for employees w benefits bc they could not raise wages
-court said hc benefits were not taxable income so lowkey employer provides it for free to employee
Post WWII impact
-fed support for medical research
-concept of HC as a right
-gov responsible to monitor and organize HC for everyone (GI experience)
-hospital construction funded by gov
-medicare/medicaid in the 60s so employers were off the hook
-quality of care began to equate to quality of job
Health Planning Period (1970-1980)
-short-lived attempt of gov to control quality
-coordination of number and types of hosptitals/equipment
-health planning/public service ammendments = funds for health planning agencies but failed
-Health Planning and Resources Development act
-Health Maintenance Organization act 1973
Post HMO act
-health insurance way more inflation than economy
Cost Containment Period (1980-1990s)
-consumers would make best choices
-rolled back regulation
-competition for HC services would make them better
-for profit health care
-marketing
-limited resources and high costs
-pressure from gov and employers to keep it cheap
-substantial growth of managed care
HC rationing (NOW)
-federalization, cost-shifting, rationing HC
-inc involvement of fed gov in HV
-new strategies to spread costs (req enrollment in part D for elders)
-rationing/limiting access
-continued attempts to prevent HC system crash
-PPAAC as a law to reform insurance industry
Explain the major trends in development of HC for predominant health problems
1850-1900: epidemics of infections
-1900-WWII: events, trauma, infections of individuals
-WWII-1990s: chronic life-style disease (heart attack, stroke, cancer)
-present/future: chronic disease, depression, alzheimers
