CHLH 101 CH. 13 (HEALTH CARE DELIVERY IN THE
US)
early history-mid 1800s - Answer --self care has been a category of health care
throughout history and today
-assumed self-care occurs before seeking professional help
-from colonial times through late 1800's, anyone trained or untrained could practice
medicine
-past medical education not nearly as rigorous 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,
unhygienic
almshouses - Answer -"poorhouse", run by local government, provided some care
pesthouses - Answer -place to isolate infectious disease
late 1800s- early 1900s - Answer --care moved from patient's home to physician's
office or hospital, building and staff better, designed for patient care, trained people and
medical supplies available
-science had a bigger role in medical education
-mortality decline due to improved PH measures, sanitation within hospital better than at
home
-new procedures available: X-ray, specialized surgery, chemotherapy, ECG
-doctors and nurses become more specialized
early 1902's: - Answer -chronic diseases passed communicable as leading causes of
death
two party system - Answer -patients and physicians: physicians collected own bills, set
and adjusted prices based on ability to pay
1940's and 1950's - Answer --WWII impact, wage restrictions in place, employers
created health insurance to lure workers
-huge technical strides
-improved procedures, equipment, facilities meant rise in cost of health care
-concept of health care as basic right vs. privilege
Hill-Burton Act - Answer -federal matching funds for hospital construction
1960s - Answer --increased interest in health care
, -third-party payment system became standard method of payment, insurer pays
physician, not patient
-cost of health care rose
-increased access at little expense for those with insurance, those w/o insurance unable
to afford care
1965 - Answer -Medicare and Medicaid developed
1980s - Answer --Reagan and Congress eliminated Health system agencies
-deregulation of health care delivery
-questions in medical ethics
-elaborate health insurance programs developed
-costs rising due to technology, more elders, AIDS, liability and lawsuits
American Health Security ACt of 1993 - Answer -attempt to lay out structure and
system for better health plan
1990s - Answer --managed care becomes more prevalent
-CHIP developed
Health care delivery today - Answer --health care costs outpacing inflation for past few
decades
-US at/near top on health care spending per capita but US health stats not at top
Affordable Care Act - Answer --extends coverage
-initiates improvements in quality of care
-sets base level of coverage/covered services
spectrum of health care delivery - Answer --population-based practice (public health)
-medical practice, primary, secondary, and tertiary
-long-term practice
-end of life care
population-based practice (public health) - Answer --interventions aimed at disease
prevention and health promotion
-health education & service provision
-found in governmental health agencies, non profits, FQHC, schools
-providers are doctors, nurses, health educators, sanitation workers, epidemiologists
primary medical care - Answer --routine and preventative care
-annual physicals, sore throat, pink eye, vaccines, basic common chronic disease
management
-found in outpatient facilities
-providers are physicians, nurses, health educators
secondary medical care - Answer --specialized care and management
US)
early history-mid 1800s - Answer --self care has been a category of health care
throughout history and today
-assumed self-care occurs before seeking professional help
-from colonial times through late 1800's, anyone trained or untrained could practice
medicine
-past medical education not nearly as rigorous 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,
unhygienic
almshouses - Answer -"poorhouse", run by local government, provided some care
pesthouses - Answer -place to isolate infectious disease
late 1800s- early 1900s - Answer --care moved from patient's home to physician's
office or hospital, building and staff better, designed for patient care, trained people and
medical supplies available
-science had a bigger role in medical education
-mortality decline due to improved PH measures, sanitation within hospital better than at
home
-new procedures available: X-ray, specialized surgery, chemotherapy, ECG
-doctors and nurses become more specialized
early 1902's: - Answer -chronic diseases passed communicable as leading causes of
death
two party system - Answer -patients and physicians: physicians collected own bills, set
and adjusted prices based on ability to pay
1940's and 1950's - Answer --WWII impact, wage restrictions in place, employers
created health insurance to lure workers
-huge technical strides
-improved procedures, equipment, facilities meant rise in cost of health care
-concept of health care as basic right vs. privilege
Hill-Burton Act - Answer -federal matching funds for hospital construction
1960s - Answer --increased interest in health care
, -third-party payment system became standard method of payment, insurer pays
physician, not patient
-cost of health care rose
-increased access at little expense for those with insurance, those w/o insurance unable
to afford care
1965 - Answer -Medicare and Medicaid developed
1980s - Answer --Reagan and Congress eliminated Health system agencies
-deregulation of health care delivery
-questions in medical ethics
-elaborate health insurance programs developed
-costs rising due to technology, more elders, AIDS, liability and lawsuits
American Health Security ACt of 1993 - Answer -attempt to lay out structure and
system for better health plan
1990s - Answer --managed care becomes more prevalent
-CHIP developed
Health care delivery today - Answer --health care costs outpacing inflation for past few
decades
-US at/near top on health care spending per capita but US health stats not at top
Affordable Care Act - Answer --extends coverage
-initiates improvements in quality of care
-sets base level of coverage/covered services
spectrum of health care delivery - Answer --population-based practice (public health)
-medical practice, primary, secondary, and tertiary
-long-term practice
-end of life care
population-based practice (public health) - Answer --interventions aimed at disease
prevention and health promotion
-health education & service provision
-found in governmental health agencies, non profits, FQHC, schools
-providers are doctors, nurses, health educators, sanitation workers, epidemiologists
primary medical care - Answer --routine and preventative care
-annual physicals, sore throat, pink eye, vaccines, basic common chronic disease
management
-found in outpatient facilities
-providers are physicians, nurses, health educators
secondary medical care - Answer --specialized care and management
