Chapter 9 Health Care Delivery System

Chapter 9:
Health Care

Copyright © 2012 Cengage Learning, Brooks/Cole Publishing

Social Work: A Competency-
Oriented Education

 Council on Social Work Education (CSWE)
- Defines Educational Policy and Accreditation
Standards (EPAs)
- Developed 10 “Core Competencies” and 41
Related “Practice Behaviors”
 Every student should master the Practice
Behaviors and Core Competencies before
completing the program


Resources Aligned to EPAS 2008

 The Textbook –
- “Helping Hands” icons call attention to content that
relates to Practice Behaviors and Competencies

- “Competency Notes” at the end of the chapter
help put the Practice Behaviors and Competencies
in practical context

Resources Aligned to EPAS 2008 (cont’d)

 The Practice Behaviors Workbook developed
with the text provides assignable exercises that
assist in mastering the Practice Behavior and
Competencies

 Additional on-line resources can be found at:
www.cengage.com/socialwork


A Definition
Care provided to individuals to prevent or promote
recovery from illness or disease

EP 2.1.1a, 2.1.3a, 2.1.8a
.

Rising costs
• National expenses for health care have increased
from $73.2 billion in 1970 to $2.5 trillion in 2009
• The U.S. spends billions of dollars annually to
provide health services to uninsured persons
• Health Care expenditures are expected to increase
to $4.3 trillion by 2018

EP 2.1.1a, 2.1.3a, 2.1.8a

Moral and ethical issues
• How much of our country’s resources should be
spent on health care?
• How should those resources be allocated?

EP 2.1.2b, c
.

Ecological/systems approach
to health care
As early as the Greek and Roman eras of civilization,
it was observed that many health problems were
Associated with changes in the environment

EP 2.1.2b, c
c.

Environment and lifestyle play big roles
The greatest contributors to premature death in the
U.S. are not individual hereditary factors, but
environmental and lifestyle factors

EP 2.1.2b, c

Factors that affect health care
• Income
• Ethnicity
• Gender
• Age
• Disability
• Place of residence

EP 2.1.3a

Income
• Income and health status are positively related
• Even those who are employed have difficulty
affording health insurance and health care
• Almost 18% of children from low-income families
had no health insurance in 2007

EP 2.1.3a

Ethnicity
• Whites enjoy better health care than people of
color
• Life expectancy for groups of color is less than it is
for whites
• People of color are more at risk to develop and
suffer from chronic diseases than whites

EP 2.1.3a

Gender
• Average life expectancy for women is greater than
for men
• Women are more likely than men to spend their
last years in poverty, which places them at risk to
experience poor health

EP 2.1.3a

Age
• Our country’s oldest and youngest citizens are at
highest risk of poor health
• The U.S. has a higher infant mortality rate than any
Western country
• Major causes of death vary significantly by age

EP 2.1.3a
.

Disability
• Persons with temporary or permanent disability are
at greater risk to have serious health problems than
persons without disabilities
• Health problems are often compounded by the lack
of affordable, accessible, appropriate health care

EP 2.1.3a

Place of residence
• Living in a rural or urban area increases your
chances of health problems
• Over half of people who live in poverty live in rural
areas
• Individuals in rural areas are more likely to suffer
from emotional disorders than people in urban
areas

EP 2.1.3a

Applying an ecological/systems perspective

• Health Risk Factors
• Holistic Health

EP 2.1.8a, 2.1.9b

Evolution of health care in America
• Keeping people alive
• Control of communicable diseases, sanitation
measures, and public health education
• Control of chronic degenerative diseases

EP 2.1.9a

Critical issues in health care
• Funding and costs
• Health insurance and managed care
• Costs vs. outcomes
• Rapidly-growing elderly population
• Increased knowledge and technology
• Health care for the poor
• Malpractice suits

EP 2.1.9a

Current major health care problems
• HIV and AIDS
• Other illnesses
• Catastrophic illness
• Teen pregnancy
• Environmental factors
• Lack of prevention and wellness programs

EP 2.1.3a, 2.1.7b, 2.1.9a

Ethical dilemmas in health care:
Saving lives at what cost?
• Baby Doe cases
• Right-to-die cases
• Bioethics
• Alternative medicine

EP 2.1.2b, c

Health planning goals
• Eliminate problems in the cost of care
• Prevent duplication of care in some areas and gaps
in others
• Streamline the interface of public and private sector
delivery of care

EP 2.1.8b, 2.1.9b

Major health care programs
• Medicare
• Medicaid
• Maternal and Child Health
• Healthy Steps for Young Children
• CHIP and S-CHIP

EP 2.1.8b, 2.1.9b

Goals of health care reform
• Reduce long-term growth of health care costs for
business and government
• Protect families from bankruptcy or debt because
of health care costs
• Guarantee choice of doctors and health plans
• Invest in prevention and wellness
• Improve patient safety and quality care

EP 2.1.8b, 2.1.9b

Goals of health care reform (cont’d)
• Ensure affordable, high-quality health coverage for
all Americans
• Maintain coverage when you change or lose a job
• End barriers to coverage for people with
preexisting conditions

EP 2.1.8b, 2.1.9b

Affordable Care Act of 2009
Title Caption
I Quality, affordable health care for all Americans
II Role of public programs
III Improving the quality and efficiency of health care
IV Prevention of chronic disease and improving
public health
V Health care workforce

EP 2.1.8b, 2.1.9b

Affordable Care Act of 2009 (cont’d)
Title Caption
VI Transparency and program integrity
VII Improving access to innovative medical therapies
VIII Community assistance services and supports
IX Revenue provisions

EP 2.1.8b, 2.1.9b

Social work and health care
• Hospital settings
• Long-term care facilities and nursing homes
• Community-based programs
• Home health care
• State departments of health/health planning agencies
• Primary versus secondary settings

EP2.1.1a, c, 2.1.8b, 2.1.9b

Chapter 9 Health Care Delivery System

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