intro to healthcare
,Medical Coding Notes
1-1: Introduction to Healthcare
● Rising U.S. healthcare costs led to strict medical necessity rules for
hospitalization.
● Admission review ensures care is appropriate, effective, and high quality.
● Patients usually complete pre-admission testing (PAT) as outpatients.
● Technological advances increased outpatient testing and surgeries.
● Healthcare consumers are more informed, demanding high-quality,
cost-effective, preventive, and primary care.
1-2: History of Medicine
Prehistoric Medicine
● Illness believed to be caused by angry gods or evil spirits.
● Tribal priests attempted to drive spirits out.
● Trephining (skull drilling) used to release spirits.
● Plants like willow bark were used for pain relief (salicin → basis of aspirin).
Ancient Medicine
● Imhotep (2650 BC): First known physician; authored medical texts.
● Hippocrates (460–370 BC): "Father of Medicine"; separated medicine from
religion; Hippocratic Oath.
● Galen (129–200 AD): Roman physician; advanced surgery and tumor excision.
● Antyllos: Innovated aneurysm and cataract surgery.
● Ancient Israelites: Promoted preventive health and isolation of contagious
patients.
● Chinese Medicine: Used acupuncture to balance yin/yang.
● Indian Ayurveda: Focused on prevention; included amputations and plastic
surgery.
,Medieval Medicine (Middle Ages)
● Limited education (except among nobility).
● Hospitals were built, often run by monks/nuns; care was charity-based.
● Rhazes (864–930): First accurate descriptions of measles and smallpox.
● Avicenna (980–1037): Canon of Medicine; described meningitis, tetanus, and
other diseases.
● Epidemics: leprosy → plague (Black Death, 1347), killing 25% of Europe.
● First hospitals in Baghdad, Cairo, Damascus.
● Medical schools established in Salerno, Bologna, Oxford, Paris.
Renaissance Medicine (1300–1600 AD)
● Renewed interest in science and anatomy.
● Ambroise Paré: Advanced surgical techniques (ligatures, wound care).
● Vesalius: Published De Humani Corporis Fabrica (anatomy revolution).
● Leonardo da Vinci, Michelangelo: Performed dissections.
● Fracastoro: Proposed infection spread by invisible germs.
● Syphilis epidemic spread by armies.
Modern Medicine
● William Harvey: Circulation of blood.
● Leeuwenhoek: Discovered bacteria with microscope.
● Jenner: Smallpox vaccine.
● Pasteur & Koch: Germ theory of disease.
● Lister: Antiseptics in surgery.
● Roentgen: X-rays.
● Curie family: Radium for cancer treatment.
● Fleming: Penicillin.
● Ehrlich: Chemotherapy.
● Domagk: Sulfa drugs.
● Advances: vaccines, anesthesia, surgery, medical imaging, HIV/AIDS
identification, eradication of smallpox (1977).
, 1-3: Healthcare Delivery in the U.S.
Key Milestones (Table 1-5):
● 1751: First U.S. hospital founded (Pennsylvania Hospital).
● 1765: First U.S. medical school (University of Pennsylvania).
● 1847: American Medical Association (AMA) founded.
● 1862: Dept. of Agriculture precursor to FDA.
● 1887: Federal disease lab → NIH.
● 1895: National Medical Association (African American physicians).
● 1906: First Food & Drug Act.
● 1910: Flexner Report exposed poor medical schools.
● 1929: First Blue Cross plan; 1939 Blue Shield launched.
● 1946: CDC established; Hill-Burton Act funded hospitals.
● 1965: Medicare & Medicaid created (SSA amendments).
● 1970s–80s: Rising costs, HMO Act, HIPAA privacy protections.
● 1990s: SCHIP created; major public health programs expanded.
● 2010: Affordable Care Act (ACA/Obamacare) passed → expanded coverage,
insurance reform.
● 2015: MACRA introduced value-based Medicare payments.
1-4: Continuum of Care
● Definition: A coordinated range of services across different levels of care.
Levels of Care:
Primary Care (first contact):
● Provided by general/family doctors or nurse practitioners.
● Services: checkups, immunizations, family planning, health education, early
disease detection.
Secondary Care (specialist referrals):
● Specialists/hospital staff.
,Medical Coding Notes
1-1: Introduction to Healthcare
● Rising U.S. healthcare costs led to strict medical necessity rules for
hospitalization.
● Admission review ensures care is appropriate, effective, and high quality.
● Patients usually complete pre-admission testing (PAT) as outpatients.
● Technological advances increased outpatient testing and surgeries.
● Healthcare consumers are more informed, demanding high-quality,
cost-effective, preventive, and primary care.
1-2: History of Medicine
Prehistoric Medicine
● Illness believed to be caused by angry gods or evil spirits.
● Tribal priests attempted to drive spirits out.
● Trephining (skull drilling) used to release spirits.
● Plants like willow bark were used for pain relief (salicin → basis of aspirin).
Ancient Medicine
● Imhotep (2650 BC): First known physician; authored medical texts.
● Hippocrates (460–370 BC): "Father of Medicine"; separated medicine from
religion; Hippocratic Oath.
● Galen (129–200 AD): Roman physician; advanced surgery and tumor excision.
● Antyllos: Innovated aneurysm and cataract surgery.
● Ancient Israelites: Promoted preventive health and isolation of contagious
patients.
● Chinese Medicine: Used acupuncture to balance yin/yang.
● Indian Ayurveda: Focused on prevention; included amputations and plastic
surgery.
,Medieval Medicine (Middle Ages)
● Limited education (except among nobility).
● Hospitals were built, often run by monks/nuns; care was charity-based.
● Rhazes (864–930): First accurate descriptions of measles and smallpox.
● Avicenna (980–1037): Canon of Medicine; described meningitis, tetanus, and
other diseases.
● Epidemics: leprosy → plague (Black Death, 1347), killing 25% of Europe.
● First hospitals in Baghdad, Cairo, Damascus.
● Medical schools established in Salerno, Bologna, Oxford, Paris.
Renaissance Medicine (1300–1600 AD)
● Renewed interest in science and anatomy.
● Ambroise Paré: Advanced surgical techniques (ligatures, wound care).
● Vesalius: Published De Humani Corporis Fabrica (anatomy revolution).
● Leonardo da Vinci, Michelangelo: Performed dissections.
● Fracastoro: Proposed infection spread by invisible germs.
● Syphilis epidemic spread by armies.
Modern Medicine
● William Harvey: Circulation of blood.
● Leeuwenhoek: Discovered bacteria with microscope.
● Jenner: Smallpox vaccine.
● Pasteur & Koch: Germ theory of disease.
● Lister: Antiseptics in surgery.
● Roentgen: X-rays.
● Curie family: Radium for cancer treatment.
● Fleming: Penicillin.
● Ehrlich: Chemotherapy.
● Domagk: Sulfa drugs.
● Advances: vaccines, anesthesia, surgery, medical imaging, HIV/AIDS
identification, eradication of smallpox (1977).
, 1-3: Healthcare Delivery in the U.S.
Key Milestones (Table 1-5):
● 1751: First U.S. hospital founded (Pennsylvania Hospital).
● 1765: First U.S. medical school (University of Pennsylvania).
● 1847: American Medical Association (AMA) founded.
● 1862: Dept. of Agriculture precursor to FDA.
● 1887: Federal disease lab → NIH.
● 1895: National Medical Association (African American physicians).
● 1906: First Food & Drug Act.
● 1910: Flexner Report exposed poor medical schools.
● 1929: First Blue Cross plan; 1939 Blue Shield launched.
● 1946: CDC established; Hill-Burton Act funded hospitals.
● 1965: Medicare & Medicaid created (SSA amendments).
● 1970s–80s: Rising costs, HMO Act, HIPAA privacy protections.
● 1990s: SCHIP created; major public health programs expanded.
● 2010: Affordable Care Act (ACA/Obamacare) passed → expanded coverage,
insurance reform.
● 2015: MACRA introduced value-based Medicare payments.
1-4: Continuum of Care
● Definition: A coordinated range of services across different levels of care.
Levels of Care:
Primary Care (first contact):
● Provided by general/family doctors or nurse practitioners.
● Services: checkups, immunizations, family planning, health education, early
disease detection.
Secondary Care (specialist referrals):
● Specialists/hospital staff.
