Health Care System in the UK

Health Care System in the UK

1. When was the National Health Service created and what kinds of service does it provide to the UK citizens?

The National Health Service was created in 1948. It provides the majority of healthcare in England, including primary care, in – patient care, long- term healthcare, ophthalmology and dentistry.

2. What way is the NHS funded and managed?

NHS funded by the taxpayer and managed by a government, the Department of Health, which sets overall policy on health issues.

3. Speak on the social protection of patients before the creation of NHS if it existed.

Before the NHS was created a patient were generally required to pay for their health care. Free treatment had been sometimes available from teaching hospitals and charity hospitals.

4. What kinds of health care are charged for? Is any kind of service free or charge? Analyze the drug expenses coverage?

Ambulance services, metal health, and ancillary services such as physical and occupation therapy, in-home and in-clinic nursing, and certain care for the sick elderly in nursing homes are financed from the NHS budget.

Prescribe contraception is also issued free or charge.

Patients in England of working age pay fixed price for each drug prescribed regardless of the amount of drug prescribed or the cost to the pharmacy. The pharmacy invoices the cost of the drugs to the NHS.

5. What are the components of the NHS? Describe the functioning and responsibilities of each component.

The core of service is the General Practitioners (or family doctors) why are responsible for the care of patients registered with them. GPs are mostly private doctors that choose to contract with the NHS to provide services to patients.

Health Care System in the USA

6. How do people pay for health care in the USA? What are Medicare and Medicaid?

Most employers and their families now pay more than 50 per cent of the cost of health insurance.

Madicare was providing free or discounted medical care for ager Americans over 65.

Medicaid was providing free medical care for the poor and ager, for the blind and dependent children.

7. What are the agencies of the Public Health Service and what functions do they perform?

The agencies of the Public Health Service are

The Health Administration - regulates health care to people.

The Food and Drug Administration - certifies the safety of food, effectiveness of drugs and medical products.

The Centers for Disease Control and Prevention - prevent diseases, premature death and disability.

The Agency for Healthcare Research and Quality and the Agency of Toxic Substances and Disease Registry – regulates hazardous spills of toxic substances.

8. What are the problems of health care system in the USA? What are the emerging health problems of the American population?
The most expensive health care system in the world. The annual rate of increase of health care expenditures seriously challenges the financial capability of the USA. Access to and quality of care for large segments of population remain. Great difficulties adapting to emerging health problems such as AIDS, medical care of mental patients.

9. What are the challenges confronting the healthcare?
At least 5 major challenges confront health care system in the USA. The most fundamental is how to shift from providing health care to producing health. The next challenges is to focus on providing cost-effective information system which can monitor the costs and effectiveness of health services. The third is to control health care expenditures. The fourth is to cope with resistance to fundamental changed from within the health care sector. The US are also challenged to transfer the resources liberated from health care to other sectors that can contribute to health.

Hospitals

10. The most family health care institution is the hospitals. Other institutions provide health care in addition to hospital. Nursing (or convalescent) homes. There are also prenatal clinics for pregnant woman, well-baby clinics for new mothers and their babies, and mental health clines for those who need periodic psychiatric attention, among others.

11. The general hospital patients of all ages with all kinds of illness, patients with acute problems stay there only a short term, 7 days. These hospitals provide a variety of services, including therapy, cardiology, gastroenterology, urology, neurology…

In specialty hospitals treat patients with chronic illness, such as tuberculosis, oncology, surgery, cardio-vascular problems, requiring long-term care, or patients of one age group. Specialty hospitals include Rehabilitation, Children’s and Psychiatric hospitals.

12. Hospitals can also be categorized by their means of financial support. Most hospitals financed by the government of their country – this is government hospitals, other hospitals are private – invested-owned, and non-profit institution, know as voluntary hospitals.

13.

· Dieticians – they evaluate diets, assess nutritional status and plan diets for people with specific conditions.

· Speech therapists – they help people with speech problems to speak more clearly.

· Physiotherapists – they help people disabled by an illness or injury to learn skills, and, when possible, to resume work.

· Hospitals porters – they more equipment or patients on trolleys and in wheelchairs.

· Pharmacists – they prepare and dispense medicines.

· Social workers – they help the patients with problems of everyday life at home.

· Radiographers – they work in the X-ray department.

· Medical laboratory scientists– they carry out tests for illnesses, like blood tests.

· Midwives – they are trained to assist women in childbirth.

· Nurses – they care for patients, especially in a hospitals.

14. There are some many medical specialties.

· Cardiologists – treats heart diseases.

· Dermatologists – treats infections, growths, and injuries related to the skin.

· Emergency Medicine – work specifically in emergency departments where they treats acute illnesses and emergency situations, e.g. trauma.

· Gynecologists – involved in the health care and maintenance of the reproductive system of women.

· Ophthalmologists – treats diseases and injuries of the eye.

· Surgeons – perform many different types of surgery, usually of relatively low degree of difficulty.

· Radiologists – perform diagnosis and treatment by the use of X-rays and radioactive materials.

Taking a history

15. The history – taking process is a well-established and commonly used sequence:

1) History of presenting complaint. The main symptoms should be clearly defined as soon as possible, to find out the cause of admission or seeking medical advice. The onset, severity, progression, associated features or symptoms are all important.

2) History of present illness. The patient is requested to give an account of recent events in their own words.

3) Systemic enquiry. The history is taken of the main symptoms of the major bodily systems.

4) Past medical history. Patients are asked about their previous medical/surgical diseases.

5) Drug history and allergies. Information is obtained on any medication prescribed self-administered drugs.

6) Family history provides information about any predisposition to disease, and relevant information on relatives.

7) Social history. Information is collected about the patients occupational, social, personal factors, such as habits, employment, housing, interests, sports…

16. There are such systems in over body.

GVS: chest pain, palpitations: ischemia, myocardial infarction, gupotention.

RS: shortness of breath, cough, sputum, wheeze, hemoptysis: tuberculosis, asthma, pneumonia.

GS: nausea, vomiting, indigestion, abdominal pain, heartburn, change in bowel habit: gastritis, pancreatites, ulser.

GUS: nocturia, frequency, incontinence, change in color/smell of urine: cicitis, calcure, kidnes faigure.

CNS: headaches, weakness, dizziness, fits, faints, vertigo: apelepsia, sclerosis, alsgeemeria deseases.

17. To accomplish the purpose a set of the following practical tips has been developed:

· Show the patient your attention

· Start by eliciting the presenting complaint

· Let the patient tell story in their own words

· Try not to interrupt

· Use the language which the patients understands

· Summarize the story for the patient to check, correct and add more relevant details

· Obtain the patients history also from other sources of information.

Surgery

18. Surgery is one of the most important fields of HS. Traditionally, it has been described as a branch of medicine which treats diseases, injuries, deformities, malformations.

The main controlling factors in surgery are anaesthesia and asepsis. Anaesthesia is used to avoid shock in a patient and to make him insensitive to pain. Asepsis is a complex of measures used to prevent introduction of microorganism into the wound from without.

19. Corrective surgery or plastic surgery is used to correct some congenital and acquired defects such as: clubfoot, harelip, cleft palate, bowlegs and defects caused by accident or disease.

Curative surgery is used in the cure of diseases such as cancers, blood clots, appendicitis and other life-threatening diseases which need surgical operations.

20. Depending on the type of operation and procedures used, there are such types of anesthesia:

· General anesthesia refers to the suppression of activity in the central nervous system.

· Local anesthesia blocks pain in regions of the body without affecting other functions of the body.

· Regional anesthesia is loss of pain sensation with muscle relaxation in certain regions of the body.

· Spinal anesthesia refers to a regional block resulting from a small volume of local anesthetics being injected into the spinal canal.

· Epidural anesthesia is a regional block resulting from an injection of a large volume of local anesthetic into the epidural space.

21. Nurses prepare surgical instruments sterilizing them in specially constructed machines – sterilizers and autoclaves.

The methods of sterilization include boiling, low (or high) pressure steam sterilization, cold sterilization by strong antisepsis, chemical sterilization and radiation sterilization.

22. Prepare the patient for the operation:

· he/she shouldn’t eat or drink anything for 12 hours before the operation

· given an enema to empty the colon from wastes the area to be operated is thoroughly cleaned, shaved and pained with the solution of iodine

· the patient is put on a operation table, covered with a sterilized cloth and administered narcosis.

Afterwards the patient is under special care and attention; his wound is frequently carefully bandaged. The surgeon prescribes the patient proper post-operative treatment. When surgeon are due for removal – this is usually done a week after the operation – the patient is discharged.

23. Surgical instruments prepare the apparatuses for blood transfusion, check up the presence and state or blood substituting solutions and preserved blood.

Surgery requires a large variety of specialized equipment. In addition to the special operating table, there are high-intensity lights and the anaesthesia machine. The main instruments table is covered with a large collection of scalpels, forceps, suture needles, retractors and other instruments.

Medical emergencies

24. There such medical emergencies: when the person has stopped breathing (it may be result of asphyxiation, electrocution, heart attack or other type of accident), severy bleeding, shock (when the victims bodily tissue do not receive an adequate supply of oxygen-containing blood) and poisoning (when the poisonous substance is swallowed).

25. The primary aim of the first aid may be summarized in three key points: to preserve life, to prevent further harm and to promote recovery. The ABC of the first aid refers to the assessment of persons airway, breathing and circulation.

26. Different nature and man-made disasters and such as flood, earthquakes, hurricanes, crowds, traffic accidents, gas or nuclear explosions, fire and others result in emergencies.

27. The ABC of the first aid refers to the assessment of persons airway, breathing and circulation. CPR is the cardiopulmonary resuscitation of victim. It has two aspects. The first is getting oxygen into the blood by blowing air into the lungs. The second is heart massage-application of chest pressure to compress the heart and squeeze blood out of it into the circulatory system.

28. Shock is the condition when the victims bodily tissues do not receive an adequate supply of oxygen-containing blood. Symptoms and signs include tachycardia/tachypnoea, hypotension, loss of consciousness, nausea, vomiting or diarrhea.

The victim should be put supine with feet raised. No food or drink should be given. Bleeding should be controlled and the victim should be kept warm and comfortable until professional assistance arrives.

29. It is to have the necessary equipment and medications readily available in a first aid kit. It should contain sterile cotton wool, gauze pad and saline solution for cleaning wounds; antiseptic wipes or sprays to reduce the risk of infection in the wound; some medications such as aspirin, painkillers, activated charcoal, tranquilizers and others; antiseptic ointment, iodine, brilliant green, burn spray and others.

30. In a case of poisoning the victim should be given the antidote, should be forced to vomit or even gastric lavage in hospital may be needed. Bleeding can be stopped with direct pressure above the place of bleeding (when artery bleeds). If a vein bleeds, the extremity must be elevated.

Injuries

31. Trauma can be described as “a physical wound or injury, such as a fracture or blow”. Major trauma can result in secondary complications such as circulatory shock, respiratory failure and death.

32. Severe injuries to the head rank among the most serious injuries that can occur. If the skull is fractured or a victim suffers: a concussion from a heavy blow, the brain can be irreparably damaged. No sedatives, alcohol, or pain medications should be given. Food and fluids should be kept at a minimum.

Neck and back injuries are equally serious. A broken back can result in paralysis if the spinal cord is damaged. A victim with such an injury should thus be moved as little as possible, although urgent first aid to restore breathing or stop bleeding should nonetheless be undertaken.

33. A fairly common emergency, though not usually a serious one, is a broken bone. A bone may be broken, or fractured, in a variety of ways. In a simple or closed fracture, the bone fragments do not pierce the skin. If the bone ends come through the skin, the break is known as a compound or open fracture. Comminuted fracture is an injury in which the bone has broken into a number of pieces.

34. If a fracture is suspected, it is best not to test it by pressing or moving, but to put a temporary splint until medical attention is available. Anything which will keep the area stiff, such as a wooden stick or rolled newspapers can be used for a splint. Pain management and immobilization of the damaged area or the whole victim are also recommended. A doctor will ultimately realign the bones and put the limb in a plaster cast until it heals, but a splint will protect in until then.

A strain is an injury to a muscle or tendon in which the muscle fibres tear as a result of overstretching.

A sprain is a more serious injury of a joint caused by a forcible twisting, with damage to the surrounding blood vessels, nerves and mainly ligaments.

35. There are such kinds of soft tissue injuries are bruises and wound such as abrasions and lacerations.

A bruise is usually the result of contusion that causes blood vessels to break with the resulting bleeding into tissues beneath the skin which remains unbroken.

An abrasion is the scraping of the skin surface. Most abrasions heal on their own without treatment.

Lacerations are cuts or tears in tissue in which the skin is opened. Deep lacerations can damage nerves and large blood vessels.

Administration of drugs

36.

· Oral administration. The route of administration is by mouth.

· Sublingual administration. In this route of administration, drugs are not swallowed but are placed under the tongue and allowed to dissolve in the saliva.

· Rectal administration. Suppositories and water solutions are inserted into the rectum.

· Parenteral administration. This type of administration is accomplished by injection through a ryringe under the skin, into a muscle, into a vein, or into a body cavity.

· Inhalation. In this method of administration, vapours, or gases, are taken into the nose or mouth and are absorbed into the blood stream through the thin walls of the air sacs in the lungs.

· Topical application. This is the local external application of drugs on the skin or mucous membranes of the mouth or other surface.

37. There are several types of parenteral injections:

· Subcutaneous injection. This injection is sometimes called a hypodermic injection, and is given just under the several layers of the skin.

· Intradermal injection. This shallow injection is made into the upper layers of the skin.

· Intramuscular injection. This injection is given into the muscle, usually into the buttocks.

· Intravenous injection. This injection is given directly into the veins.

· Intrathecal injection. This injection is made into the sheath of membranes which surround the spinal cord and brain.

· Intracavitary injection. This injection is made into a body cavity, as, for example, into the peritoneal or pleural cavity.

38. Chemists shop is an institution of health service which supplies the population with medicines and medical things. It is a place where a wide variety of articles is sold, where prescription can be made; drugs are composed, dispensed, stored and sold.

At the chemists department one can buy drugs ready to use, different things for medical care (hot water bottles, medicine droppers, mustard plasters, cupping glasses, thermometers and soon) and medical herbs.

39. The pharmacist should instruct the patient about the dangers of overdosage; the problems resulting from an inadequate dosage; the expected side effects of the drug; the proper storage of the drug.

The pharmacist should also advise the patient about the dangers of taking drugs for longer periods unless he is under care of a physician.

40. A complete prescription is made up of six essential parts: the patient’s name, the superscription, the inscription, the subscription, the signature and the prescriber’s name. The inscription is the body of the prescription. The inscription may consist of three parts: medication, adjuvant and vehicle. The signature consists of the directions to be given to the patient. This information is intended to be placed on the label of the container in which the medication is dispensed. The prescribes name is the part of the prescription that guarantees its authenticity.

Дата добавления: 2015-11-04