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Chapter 9 Health Care Delivery System

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This chapter gives an overview of our country’s current health-care system, the problems it faces, and the types of health-care policies and programs available. It traces the relevant legislation and discusses the roles that social workers play in making those policies and programs possible.

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Chapter 9 Health Care Delivery System

  1. 1. Chapter 9: Health CareCopyright © 2012 Cengage Learning, Brooks/Cole Publishing
  2. 2. Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  3. 3. 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 Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  4. 4. 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 Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  5. 5. 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 Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  6. 6. A DefinitionCare provided to individuals to prevent or promoterecovery from illness or diseaseEP 2.1.1a, 2.1.3a, 2.1.8a Copyright © 2012 Cengage Learning, Brooks/Cole Publishing.
  7. 7. 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 2018EP 2.1.1a, 2.1.3a, 2.1.8a Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  8. 8. 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 Copyright © 2012 Cengage Learning, Brooks/Cole Publishing .
  9. 9. Ecological/systems approach to health careAs early as the Greek and Roman eras of civilization,it was observed that many health problems wereAssociated with changes in the environmentEP 2.1.2b, c Copyright © 2012 Cengage Learning, Brooks/Cole Publishing c.
  10. 10. Environment and lifestyle play big rolesThe greatest contributors to premature death in theU.S. are not individual hereditary factors, butenvironmental and lifestyle factorsEP 2.1.2b, c Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  11. 11. Factors that affect health care• Income• Ethnicity• Gender• Age• Disability• Place of residenceEP 2.1.3a Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  12. 12. 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 2007EP 2.1.3a Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  13. 13. 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 whitesEP 2.1.3a Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  14. 14. 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 Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  15. 15. 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 Copyright © 2012 Cengage Learning, Brooks/Cole Publishing.
  16. 16. 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 Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  17. 17. 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 Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  18. 18. Applying an ecological/systems perspective• Health Risk Factors• Holistic Health EP 2.1.8a, 2.1.9b Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  19. 19. Evolution of health care in America• Keeping people alive• Control of communicable diseases, sanitation measures, and public health education• Control of chronic degenerative diseasesEP 2.1.9a Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  20. 20. 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 Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  21. 21. 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 Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  22. 22. 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 Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  23. 23. 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 careEP 2.1.8b, 2.1.9b Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  24. 24. Major health care programs• Medicare• Medicaid• Maternal and Child Health• Healthy Steps for Young Children• CHIP and S-CHIPEP 2.1.8b, 2.1.9b Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  25. 25. 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 Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  26. 26. 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 Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  27. 27. Affordable Care Act of 2009Title 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 workforceEP 2.1.8b, 2.1.9b Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  28. 28. Affordable Care Act of 2009 (cont’d)Title Caption VI Transparency and program integrityVII Improving access to innovative medical therapiesVIII Community assistance services and supports IX Revenue provisionsEP 2.1.8b, 2.1.9b Copyright © 2012 Cengage Learning, Brooks/Cole Publishing
  29. 29. 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 Copyright © 2012 Cengage Learning, Brooks/Cole Publishing

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