Evolution of Health Care Delivery PDF

LESSON 1: EVOLUTION OF HEALTH CARE DELIVERY  WILLIAM HARVEY: Discovered the continuous circulation of blood in the body system. 1. PREHISTORIC AND...

LESSON 1: EVOLUTION OF HEALTH CARE DELIVERY  WILLIAM HARVEY: Discovered the continuous circulation of blood in the body system. 1. PREHISTORIC AND ANCIENT MEDICINE  CHRISTIAN HUYGENS: Developed the centigrade system for measuring  Prehistoric People: Used basic methods like immersion in water, temperature. applying mud, sucking stings, licking wounds, and exerting pressure to  GABRIEL DANIEL FAHRENHEIT: Developed the system of measuring stop bleeding. temperature.  Ancient Hebrews: Believed disease was a divine punishment or a mark  MARCELLO MALPPIGHI & ANTON VAN LEEWENHOEK : Forerunners in of sin. the invention of the microscope.  4th Century Hebrews: Believed disease was caused by an imbalance of  QUININE : Discovered as a treatment for malaria. the four humors: phlegm, blood, yellow bile, and black bile.  LEONARDO DA VINCI: Explored human anatomy through dissections. 2. ANCIENT EGYPT 10. 18th CENTURY  Deities: Associated with health, illness, and death.  ALBRECHT VON HALLER - In-depth studies of the nervous system;  Isis: Healing goddess. discovered the relationship of the brain cortex to  Hathor: Mistress of heaven and protector of women during childbirth. peripheral nerves, and became founder of modern  Keket: Fertility goddess. physiologic theory  Practices: Embalming,  LAZZARO SPALLANZANI - Pioneer of experimental fertilization  linked anatomy and physiology with theology,  STEPHEN HALES - Demonstrated blood circulation, stressed  used pills, cake suppositories, importance of the capillary system, and became the first  enemas, person to record blood pressure with manometer  ointments,  GIOVANNI BATTISTA MORGAGNI - Father of pathology; Correlated  drops, gargles, anatomy with pathology  fumigation, and baths.  EDWARD JENNER - Smallpox vaccination  Drugs were made from vegetable, mineral, and animal substances, and  WILLIAM HUNTER - Specialist in obstetrics, founded the Great Windmill imported materials like saffron, cinnamon, perfumes, spices, Street School of Anatomy, the first medical school in sandalwood, gums, and antimony. London  JOHN HUNTER - Experimental surgeon; Method of closing off 3. ANCIENT INDIA aneurysm; Pioneer in comparative anatomy  Life Cycle: Believed life was an eternal cycle of creation, preservation,  PHILIPPE PINEL - Humane regimen be instilled at Asylum de Bicetre and destruction. near Paris (care and treatment for mentally ill patients)  Diagnosed diabetes by the sweetness of urine.  Treated snakebites by applying tourniquets. 11. 19TH CENTURY  Performed surgery on the nose, earlobes, harelips, hernias, and  Autopsies were the major focus of medicine cesarean sections.  CARL ROKITANSKY - Most outstanding morphologic pathologist of his time 4. ANCIENT CHINA  RUDOLF VIRCHOW - All cells come from other cells  Harmony was the balance of yin and yang, Tao was considered the way.  CLAUDE BERNARD  Confucius: Forbade dissections.  Founder of experimental physiology  Nei Ching: A classic text of Chinese medicine.”Oldest Medical Book”  Discovered the principle of homeostasis, clarified the  Five Methods of Treatment: ✓Cure the spirit, multiple functions of the liver  nourish the body,  Studied digestive activities of the pancreas, and was the  give medications, first to link pancreas with diabetes.  treat the whole body,  He pioneered and established the specialty of internal  acupuncture and moxibustion. medicine.  Treatment: Exercise, physical therapy, massage, and administering  RENE-THEOPHILE HYACINTHE LAENNEC medicinal herbs, trees, insects, stones, and grains.  Pathologic and clinical understanding of chest diseases  11th Century – developed an inoculation against smallpox including emphysema, bronchiectasis and tuberculosis.   He was also a pioneer in the invention and use of the 5. ANCIENT GREECE stethoscope.  Healing Temples: Built healing temples of Asclepios in Thessaly.  EPHRAIM MCDOWELL - Performed the first successful abdominal  Tholos: A round building encircled a pool or sacred spring of water for surgery to remove a huge cyst from an ovary purification.  J. MARION SIMS  Abaton: A building for incubation where cures took place.  Laid foundation for gynecology and founded the Women’s  Healing Rituals: Healing rituals began after sundown and often Hospital of the State of New York involved fasting or abstinence from certain food or wine.  He invented the Sims position and later the speculum and catheter 6. PRE-HIPPOCRATIC MEDICINE  1831 - Nitrous oxide gas and chloroform had been  Thales: Believed the basic element in all animal and plant life was discovered but not yet put into practice water, from which came the earth and air.  JOSEPH PRIESTLY - Discovered nitrous oxide gas. HUMPHRY DAVY  Anaximander: Believed living creatures originated in water. suggested its use in surgery but was ignored.  Anaximenes: Believed air was necessary for life.  CRAWFORD W. LONG - Used sulfuric ether during surgery in 1842  Heraclitus: Believed fire was the principal element of life.  JOSEPH LISTER  6th Century BC: Believed earth, air, fire, and water were the basic  Discovered that bacteria were often the origin of disease components of life.  Safe surgical procedure  LOUIS PASTEUR - Germ theory of disease and explained the 7. HIPPOCRATES effectiveness of asepsis and antisepsis  Father of Medicine: Revolutionized medicine from the ancient past and  ROBERT KOCH - Extensive research into microorganisms and founded began turning it into objective science. bacteriology  People practicing medicine should be pure and holy.  BENJAMIN RUSH - First American Psychiatrist  Taught that one should observe all, study the patient rather than the  WILLIAM BEAUMONT - First prominent American Physiologist disease, evaluate honestly, and assist nature.  GREGOR MENDEL - Foundation of modern genetics - Experiments of  Mental Illness: Addressed mental illness, anxiety, and depression. heredity of plants  WILHELM CONRAD ROENTGEN - November 8, 1895 – discovered xrays 8. CHRISTIANITY  PIERRE AND MARIE CURIE - Discovered radium and provided  Healing Message of Christ foundation for the use of radioactivity in the treatment  Healing was not differentiated into physical, mental, or spiritual. of disease  Luke the Physician: A physician mentioned in the Bible.  Christian Faith: Emphasized compassion, forgiveness, and concern for 12. 20TH CENTURY the unfortunate and the dispossessed.  MAJOR WALTER REED - Eradicated yellow fever  Roman Emperor Constantine: Founded a hospital in the fourth century.  PAUL EHRLICH - Father of chemotherapy  Christian Community: Established hospitals in Caesarea, Edessa, and  PAVLOV - Extensive research of the process of digestion Bethlehem.  ABEL, ROWNTREE, AND TURNER - Invented the first artificial kidney  Crusades: Led to the distribution of diseases like leprosy, typhus, and that led to dialysis smallpox.  WILLEM EINTHOVEN - Made the first electrocardiogram  1347: The bubonic plague occurred.  HANS BURGER - Invented electroencephalogram  LIND, EIJKMAN, HOPKINS, SZENT-GYORGI, AND FUNK 9. THE RENAISSANCE  Defined and isolated vitamins and described their role in  PARACELSUS : Father of pharmacology. life processes.  JEAN FERNEL : - Made physiology, pathology, and therapeutics  Surgical techniques were refined. standard disciplines of medicine.  Electron microscope was invented in 1930. - First suggested that gonorrhea and syphilis are  SALK VACCINE - Virtually eliminated the scourge of poliomyelitis separate diseases.  WATSON AND CRICK - Accurately described deoxyribonucleic acid  AMBROISE PARE : Forerunner of clinical surgery. (DNA) molecule in 1962  ANDREAS VERSALIUS: Father of anatomy.  CHRISTIAAN BARNARD - Performed first successful human heart  LATROCHEMISTRY : A combination of alchemy, medicine, and chemistry. transplant  JAN BAPTIST VAN HELMONT : First measurement of the relative ⚬ Computers and imaging equipment ⚬ Laparoscopic surgery weight of urine. ⚬ Major transplants ⚬ Lithotripsy & Use of lasers  GALILIEO: Presented laws of motion in a mathematical manner. ⚬ Coronary bypass surgery ⚬ Artificial hips and knees  ISAAC NEWTON: Discovered gravity. ⚬ Arthroscopic surgery ⚬ Plastic surgery  HISTORICAL OUTLINE OF HOSPITAL 13. 21ST CENTURY ⚬ Rapid expansion of technology and information 331 AD : ⚬ Roman Emperor Constantine I (Constantine the Great) ⚬ Research into genetics has greatly expanded our knowledge about heredity established the modern concept of a hospital. ⚬ Biotechnology ⚬ The Christian tradition emphasized the close relationship of ⚬ Robotic surgery the sufferer to the members of the community. ⚬ Less blood loss 370 AD : ⚬ St. Basil the Great established a religious foundation in ⚬ Faster recovery of patients Cappadocia that included a hospital and an isolation unit for ⚬ Fewer overall complications those suffering from leprosy. ⚬ Electrical conduction system of the heart has been mapped 6TH CENTURY: ⚬ St. Benedict of Nursia at Montecassino founded a hospital where the care of the sick was placed above and before every HEALTH : WHO defines health as “state of complete physical, mental, and social other Christian duty well-being, and not merely the absence of disease or infirmity.” ⚬ The Christian tradition emphasized the close relationship of DISEASE - A condition of the living animal or plant body or of one of its parts the sufferer to the members of the community. that impairs normal functioning and is typically manifested by 1099: ⚬ Hospitallers of the Order of St. John established a hospital distinguishing signs and symptoms that could cater to 2,000 patients in the Holy Land, later MORTALITY - Death rate known as St. John Ambulance. MORNIDITY - Occurrence of disease or condition 1145: ⚬ The Hospital of the Holy Ghost was founded at Montpellier, Health care is affected by social forces, ethical issues, and economic forces. France, becoming one of the most important centers in Europe for training doctors. RISK FACTORS AND PRIMARY CAUSES OF DEATH ⚬ The Middle Ages also saw the beginnings of support for HEART DISEASE hospital-like institutions by secular authorities. ⚬ Sedentary lifestyle 11TH CENTURY: ⚬ Pestilence and disease killed crusaders. ⚬ Cigarette smoking 12TH CENTURY: ⚬ Arab hospitals in Baghdad, Damascus, and Cordoba in Spain ⚬ Hypertension admitted patients regardless of religious belief, race, or social ⚬ Obesity order. ⚬ Diabetes 1524: ⚬ The first hospital in North America (Hospital de Jesus ⚬ High cholesterol Nazareno) was built in Mexico City by Hernan Cortes. CANCER 1540: ⚬ Henry VIII stopped building hospitals in England, and ⚬ Cigarette smoking voluntary hospitals were established. ⚬ Positive stool occult blood 1565: ⚬ The first hospital was erected by the Spaniards in Cebu and ⚬ Failure to perform breast self-examination was later transferred to Manila for the purpose of treating ⚬ Failure to have Papanicolaou tests (Pap smears) sick and wounded military personnel. CEREBROVASCULAR DISEASE ( STROKE) ⚬ The Spanish government and missionaries established ⚬ Cigarette smoking hospitals in the Philippines. ⚬ Hypertension 1578: ⚬ San Lazaro Hospital was established. ⚬ High cholesterol 1751: ⚬ The first incorporated hospital in America was the ACCIDENTS Pennsylvania Hospital in Philadelphia, which obtained a ⚬ Failure to use seat belts charter from the crown. ⚬ High alcohol use ⚬ Early hospitals in the Philippines were established by the CHRONIC LOWER RESPIRATORY DISEASE Franciscans, Brotherhood of the Misericordia, Brotherhood of ⚬ Cigarette smoking San Juan de Dios, and the Dominicans. THE HEALTH CARE ENVIRONMENT CLASSIFICATION OF HOSPITALS IN THE PHILIPPINES HEALTH - The state of being free from illnesses DOH Administrative Order No. 2012 – 0012 - someone or something is thriving or doing well  Subject: Rules and Regulations Governing the new Classification of CARE - maintenance, and protection of someone or something Hospitals and Other Health Facilities in the Institution - attention applied to avoid damage or risk ENVIRONMENT - the surroundings or conditions in which a person, animal, or TYPES OF HOSPITAL: plant lives or operates 1. PUBLIC/GOVERNMENT HOSPITAL - provide conditions for development and growth as well as of danger - Owned by a government and receives government funding. and damage - Provides medical care free of charge, the cost of which is covered by the funding the hospital receives HEALTH CARE - efforts made to maintain well-being especially by 2. PRIVATE HOSPITALS trained and licensed professionals - owned by a for-profit company or a non profit organization and - the act of taking preventive medical procedures to improve a privately funded through patient payments person’s well-being 3. DISTRICT/ CENTRAL HEALTH CARE - an organized way of medical care concerned with the - have a large capacity for intensive care and long-term care maintenance of the health of the whole body - Specialized centers for surgery, plastic surgery, obstetrics, and - mainly influenced by the social, economic conditions & health laboratories will also be available policies of the place and varies across different countries, 4. SPECIALIZED individuals, groups etc - These specialty hospitals are typically part of a large hospital often TYPES OF HEALTHCARE : located on the hospital campus or nearby - EXAMPLES: trauma centers, rehabilitation hospitals, children‟s PRIMARY SECONDARY TERTIARY hospitals, geriatric hospitals, psychiatric hospitals. 5. TEACHING  Focuses on health  provided by the  specialized - combines assistance to patients with teaching to medical students and equity producing medical specialists consultative nurses and often is linked to a medical school or university social policy beyond and other health healthcare - unique in that they employ physician residents who are in training and the traditional professionals who  For inpatients and work hand in hand with local medical schools. healthcare. do not have direct on referral from 6. CLINIC  PREVENTICE CARE contact with a primary and - outpatient care only and are smaller than a typical hospital.  Aim is to provide patient secondary - operated by a government health agency or a partnership of private local care to a  EX: urologists, healthcare for physicians and/or surgeons patient because dermatologists, advanced medical professionals cardiologists investigation and FUNCTION OF HOSPITALS: 1. PATIENT CARE 4. EMPLOYMENT related to primary treatment 2. TEACHING 5. SOCIETAL care are normal  EX: plastic surgery, 3. RESEARCH 6. HEALTH SYSTEM generalists, burn treatment, SUPPORT  EX; common colds, cardiac surgery, check-ups, minor cancer treatment MENTAL HEALTH FACILITY: injuries. Psychiatric hospitals, also known as mental hospitals, mental health units, mental asylums, or asylums, specialize in treating serious mental disorders such as clinical depression, schizophrenia, and bipolar disorder. HEALTH CARE ENVIRONMENT: the healthful atmosphere and healthcare setting in which a patient is These hospitals vary in size and grading, with some focusing on short-term or undergoing a treatment outpatient therapy for low-risk patients. HOSPITAL: ○ Health care institutions that have an organized professional staff and Others provide temporary or permanent care for residents who require routine inpatients facilities and deliver services 24/7. assistance, treatment, or a controlled environment due to psychological ○ Supplying specialized staff and equipment to meet the health care needs disorders. of the surrounding population. ○ Doesn’t have overnight patients are usually referred to as ‘clinics LONG-TERM/RESIDENTIAL CARE FACILITY: TELEMEDICINE: → When support from family, friends, and local programs is insufficient, people  remote delivery of healthcare services through telecommunication needing full-time help  enables to evaluate, diagnose, and treat patients without needing an → Facilities may offer housing and housekeeping, with many also providing in-person visit. personal care and medical services. HISTORY OF TELEMEDICINE → Facility-based long-term care includes: ○ used in military contexts during the Civil War for medical consultations and ⚬ Board and care homes ordering supplies ⚬ Assisted living facilities ○ 1948 - Pennsylvania : first electronic medical record transfer, images were ⚬ Nursing homes sent 24 miles between two townships via telephone line. ⚬ Continuing care retirement communities (CCRCs) ○ 1950s - Montreal: Canadian radiologists created a teleradiology system ○ 1959 - University of Nebraska: Clinicians transmitted neurological 1. Board and Care Homes: examinations across campus using two-way interactive television. → Small private facilities (usually with 20 or fewer residents) offering personal ○ 1967 - University of Miami : Physicians transmitted electrocardiographic care and meals. rhythms over voice radio channels from fire rescue units to Jackson → Nursing and medical care are typically not provided on-site. Memorial Hospital in Miami 2. Assisted Living: TYPES OF TELEMEDICINE → Provides help with daily care but less intensive than nursing homes. 1. Remote Patient Monitoring: → Residents live in apartments/rooms with services such as meals, personal Also known as telemonitoring, this allows patients with chronic care, and 24-hour supervision. diseases to be monitored at home using mobile medical devices that 3. Nursing Homes: collect vital data. Caregivers can review this data instantly. → Provides extensive medical care and personal services. 2. Store-and-Forward: → Includes nursing care, 24-hour supervision, rehabilitation services, and Also known as asynchronous telemedicine, it enables providers to assistance with daily activities. share patient information, such as lab results, with physicians at → Residents may stay temporarily (post-hospitalization) or permanently due to different locations. ongoing conditions. 4. Continuing Care Retirement Communities (CCRCs): 3. Interactive Telemedicine: → Offers multiple levels of care (independent living, assisted living, skilled This facilitates real-time communication between physicians and nursing) in one location. patients, conducted via telephone or video conferencing that complies → Services include healthcare and recreational programs. Residents transition with Health Insurance Portability and Accountability Act regulations. based on care needs. ADVANTAGES OF TELEMEDICINE  CONVENIENCE HOSPICE  INCREASED ACCES  Originating in Western society since the 11th century  REDIUCED CANCELLATIONS OR NO SHOWS  Traditionally places of hospitality for the sick, wounded, or dying. The  ENCOURAGEMENT OF HEALTHY CHOICES modern concept includes palliative care for the incurably ill, whether in DISADVANTAGES OF TELEMEDICINE hospitals, nursing homes, or the patient's own home.  INABILITY TO PRESCRIBE MEDICATIONS  Cicely Saunders in 1967 : The first modern hospice  TECHNICAL TRAINING AND EQUIPMENT COSTS  Specialized care for those facing life-limiting illnesses, focusing on well  LICENSING ISSUES being needs of both patients and their families.  Hospice is not a place: A Service through written agreements with professionals offer support where patients reside. OUT-PATIENT/AMBULATORY CARE  Medical care provided on an outpatient basis  Includes diagnosis, observation, consultation, treatment, intervention, and rehabilitation services, utilizing advanced medical technology and procedures outside of hospitals.  Refers to any same-day medical procedure : meaning services that DON’T REQUIRE MEDICAL ADMISSION 1) Wellness: This includes preventive and basic medical care, such as primary care clinics and counseling centers. 2) Diagnosis: These services may stand alone or be part of a wellness or treatment program and include X-rays, lab tests etc 3) Treatment: Same-day surgery centers, substance abuse clinics, chemotherapy, and other therapeutic forms. 4) Rehabilitation: Post-operative therapies, occupational and physical therapy, and rehabilitation for substance abuse.  TELEMEDICINE - Newer ambulatory care: It allows healthcare professionals to interact with patients through email, phone, and video chatting.  Ambulatory care employs many of the same healthcare professionals found in inpatient care settings. PREVENTIVE HEALTH CARE  Preventive medicine or prophylaxis, involves measures taken to prevent diseases rather than treat them. ▬ Primal and Primordial Prevention: Aims to prevent the development of risk factors early in life. ▬ Primary Prevention Prevent disease occurrence by eliminating disease agents or enhancing resistance. ▬ Secondary Prevention: detect and address diseases before symptoms appear. ▬ Tertiary Prevention reducing the impact of symptomatic diseases through rehabilitation and treatment. ▬ Quaternary Prevention Mitigate or prevent unnecessary or excessive health interventions. HOME HEALTH CARE  Health care services provided in a patient’s home for illness or injury. This type of care is typically less expensive, more convenient.  Ex. Wound care, nutrition therapy, injections, monitoring health ▬ Goals to help patient get better and and improve condition ▬ It requires doctor referral to asses patients and must communicate regularly on patients progress ▬ EX TASK: Measure blood pressure, temperature, heart rate, and breathing Ensure correct medication administration