Historical events that changed healthcare

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Founded by healthcare architect Wayne Ruga , the Symposium was a result of his realization that the introduction of diagnostic related groups DRGs in the U. Wayne thought that hospital environments could be designed so that patients would heal faster. And so did many others. Which is why the Symposium fostered a community of healthcare and design professionals who are passionate about creating environments that support health and well-being for everyone who works, stays, or visits a hospital or healthcare facility.

Wayne and his Symposium board of advisors went on to establish the nonprofit Center for Health Design CHD in because they wanted to be able to fund research in the emerging evidence-based design field.

Now, more than 25 years later, The Center is still fulfilling that mission. Although this first literature review only found 48 credible studies linking elements of the physical environment to outcomes, it is historically significant because it put science behind the theory.

Seven years later, there were 1, credible studies. There hasn't been a comprehensive literature review since , but it's estimated that there are now more than 2, credible studies. Perhaps more significant, this first literature review sparked the evidence-based design movement, which led to the establishment of the EDAC certification program, launch of a peer-reviewed journal, awards program, and much more research.

The formation of this nonprofit organization to manage the development of the Guidelines for Design and Construction of Hospitals and Health Care Facilities was a pivotal moment in the history of the Guidelines. Originally part of implementing regulations for the Hill-Burton Act, guidelines revisions were funded by the U. Without the efforts of J. They were the ones to convince the federal government after to fund more revisions cycles of the guidelines and were instrumental in founding FGI.

And while not a regulatory document, many U. Their influence on facility design and construction has been substantial. Today, the Guidelines are developed by a multi-disciplinary group of engineering, design, facility, and construction professionals, as well as state regulators, researchers, and others from the private sector.

To make them truly a consensus-based document, public input is also solicited. There are many technological advances that have changed how healthcare facilities are designed and constructed. However, the introduction of this smart phone by Steve Jobs at the Macworld conference in San Francisco ushered in a new era of digitization that has impacted millions of people around the world.

Today there are more than 97, health and fitness apps for smart phones and tablets that help people monitor chronic conditions and lead healthy lifestyles.

Digitization has also disrupted the retail, transportation, banking, and hospitality industries. Healthcare may be next. While it's primary goal was to reduce the number of uninsured Americans through things like coverage of preventative services, individual mandates, health insurance exchanges, and medicaid expansion, it also included many provisions that impacted how and where care is being delivered.

As a result, the healthcare industry shifted to building more ambulatory care buildings, retail clinics, urgent care clinics, and micro hospitals.

Big-box hospitals aren't going away just yet though, but the number of inpatient beds is decreasing -- which continues to impact facility design and construction.

And despite all the changes to the ACA enacted or proposed by the current administration, it doesn't seem like that is going to impact the changes in how and where healthcare is delivered. Go to my recent blog post to find out why. Do you agree that these are the most important historically significant events that have affected healthcare facility design and construction? What else would you add?

Please do me a favor -- if you liked this post and like this blog, please share it with others by sending them the link or posting it on your Twitter, LinkedIn, or Facebook. Also, don't forget to subscribe, so you'll get emails when new content is posted. Photo Credit: Moses H. Cone Memorial Hospital, Greensboro, N. Surprised not to see the California state seismic mandate here. The mother of all unfounded mandates single handedly forced so much new hospital work in calif which influences so much more.

Good catch, Kevin! The seismic mandate update established five structural and five non-structural classifications of hospital building seismic safety levels, as well as deadlines for some classification upgrades.

Actually, as a result of the Sylmar earthquake, which significantly damaged a recently-completed hospital, California passed the Alfred Alquist Hospital Seismic Safety Act establishing seismic standards for all new hospital construction.

Sb Senate Bill added more details following he '94 Northridge "event. That's a good one, too, Saif, although I'm not sure how influential it was on hospital and healthcare facility design and construction -- more impact on operations and maintenance, and product innovations.

But preventing infections was the main impetus for FGI's recommendation for single-bed patient rooms in the Guidelines.

As the first serious study to link design to clinical outcomes, it launched today's strong movement towards an evidence-based design process. You're right, Kirk! Department of Health and Human Services HHS is the nation's principal agency for protecting the health of all Americans and providing essential human services.

The Affordable Care Act was signed into law, putting in place comprehensive U. The Medicare Prescription Drug Improvement and Modernization Act of was enacted - the most significant expansion of Medicare since its enactment.

It included a prescription drug benefit. The Office of Public Health Emergency Preparedness now the Office of the Assistant Secretary for Preparedness and Response was created to coordinate efforts against bioterrorism and other emergency health threats.

HHS responds to the nation's first bioterrorism attack - delivery of anthrax through the mail. The Ticket to Work and Work Incentives Improvement Act of was signed, making it possible for millions of Americans with disabilities to join the workforce without fear of losing their Medicaid and Medicare coverage.

It also modernized the employment services system for people with disabilities. Vaccines for Children Program was established, providing free immunizations to all children in low-income families. In , a blood test to detect HIV was licensed.

Medicare and Medicaid programs were created, making comprehensive health care available to millions of Americans. In , the Department of Education Organization Act was signed into law, providing for a separate Department of Education.

The Federal Security Agency was created, bringing together related federal activities in the fields of health, education, and social insurance. President Theodore Roosevelt's first White House Conference urged creation of the Children's Bureau to combat exploitation of children.

The Pure Food and Drugs Act was passed, authorizing the government to monitor the purity of foods and the safety of medicines, now a responsibility of the FDA. Conversion of the Marine Hospital Service into the Public Health and Marine Hospital Service in recognition of its expanding activities in the field of public health. In , the name was shortened to the Public Health Service. Immigration legislation was passed, assigning the Marine Hospital Service the responsibility for medical examination of arriving immigrants.

The federal government opened a one-room laboratory on Staten Island for research on disease, a very early precursor to the National Institutes of Health. The National Quarantine Act was passed, beginning the transfer of quarantine functions from the states to the federal Marine Hospital Service.

Appointment of the first Supervising Surgeon later called the Surgeon General for the Marine Hospital Service, which had been organized the prior year. President Lincoln appointed a chemist, Charles M. Wetherill, to serve in the new Department of Agriculture. Passage of an act for the relief of sick and disabled seamen, which established a federal network of hospitals for the care of merchant seamen, forerunner of today's U. Public Health Service. The Secretary is a member of the President's Cabinet.

Nominations to the office of Secretary are referred to the U. Senate Committee on Finance. Confirmation is last considered by the U. Thomas E.

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Jeffersonian ideas of democracy and republicanism continue to be read and studied. The lasting influence of the American Revolution gives credence to the idea of it being one of the most influential events in our history. The printing press is perhaps the most important invention of the last 2, years. His invention was one of the major driving forces behind the Renaissance. Before the Gutenberg press, books were copied by hand and were very expensive. Monks, scribes, and the educated labored for many hours by oil lamp to make copies of literature, religious texts, official documents, etc.

In some cases, the process could take years. After Gutenberg made his printing press, books could be printed in a tiny fraction of the time. It is hard to overestimate the implications of this: suddenly, people could have their own copies of books and read them for themselves.

Education was no longer limited to a select few. Books were not just for the rich and affluent; as their price dropped, they could be sold to the lower classes as well. Political pamphlets could be printed up by the thousands and influence social movements like never before. One of the most culturally and architecturally rich periods of world history, it marked the final transition from the Middle Ages to the modern period.

The Renaissance triggered the rebirth of civilization after the Black Death, pushing ignorance aside and giving birth to the development of mathematics and astronomy.

Books were printed for the first time, giving the common man the ability to read at will previously the domain of priests and monks. Science, art, and literature advanced to new heights. World maps were drawn up and new civilizations discovered, as we finally rejected the idea that the earth was the center of the universe. The Renaissance was a time of great minds questioning tradition and standing beliefs.

The most distinctive features of Renaissance culture were its anti-feudal, secular, humanistic character and worldview. It was an awakening to the world and the beginning of the modern era.

The historical effects of the colonial period stretch across centuries, and across all the continents of the world. From the 16th century onward, several European powers set up colonies in Africa, Asia, and the Americas. The Spanish and Portuguese were first global empires, followed closely by the British, French, Dutch, and Russian empires, and eventually by Belgium, Germany, and Italy.

The age of colonialism resulted in the division of the world between them and the exploitation of countries in the third world. Anti-colonialist movements picked up steam after the two world wars, and many of these countries would gain their independence. The worldwide conflict where the Allies defeated the Axis powers involved almost every nation on earth and became the deadliest war in human history, with an estimated 50 to 80 million deaths.

There were fronts in Europe, Africa, and Asia, and it ripped apart every race, religion, culture, and nation. Men, women, and children were killed or exterminated by the millions, including in the Holocaust, in which 11 million people were murdered. But whichever stage is considered the beginning, World War II changed the face of the earth forever, led to the end of the era of European empires, the creation of the United Nations, and the beginning of the Cold War.

After the socialist Red Army beat the monarchist and capitalist White Army, they established the government of what would become the U. The October Revolution changed the course of World War I, set the stage for World War II, the rise and decline of Fascism, the spread and eventual fall of Communism, the Cold War, and decolonization, and became the inspiration for many more uprisings for years to come, such as the communist revolutions in Germany, Hungary, Mongolia. Cuba, Vietnam, China, and many other countries.

Historians now say that all roads in the twentieth century lead to World War I , which was caused by the assassination of Archduke Franz Ferdinand, heir to the Austrian throne, by Yugoslav nationalist Gavrilo Princip in June, By August of that year, Austria-Hungary declared war on Serbia, Germany declared war on France and Russia, and Britain declared war on Germany, starting a chain reaction of events that eventually involved all the great powers of the time.

The Great War was the first time modern lethal weapons were used in conventional warfare, including chemical weapons and tanks. Over 9 million people were killed and whole empires, like that of Russia, Germany, the Ottomans, and Austria, were dismantled. No one could imagine anything worse until the world had to face WWII a few decades later. It is not possible to overstate the importance of the French Revolution to world history. Not only did it shape the entire modern world as we know it and pave the way for capitalism to conquer feudalism, it set the stage for revolutionary uprisings and changes in all parts of the globe.

The period of radical social and political upheaval during the French Revolution and the Napoleonic Wars that followed had a lasting impact not just on France or Europe, but the entire planet. It will always be remembered as the event that ended feudalism and whose shockwaves led to a total transformation of social structures in every country.

After the French treasury was drained exacerbated by bankrolling and supplying the American Revolution , it created much misery and hunger, which led to anger against the monarchy. Images of the revolution, such as the Storming of the Bastille, the guillotine, and the gigantic personality of Robespierre, are now iconic. The French Revolution introduced the concept of the republic to the world, and Revolutionary France soon had to fight for its life in wars against all of Europe.

By its mere existence and the worldwide historical and social transformations it caused, the French Revolution can easily be considered the most monumental historical event of the modern era, and more than any other, the defining historical event that changed the world forever.

Writer, editor, dreamer, media fanatic, total geek and future corpse. A morally ambiguous protagonist with an awesome beard. By Andrew Galbreath Published Oct 01, Share Share Tweet Email Comment. Via quantamagazine. Via wikimedia. Via rf. Via marxists.

Via wikipedia. Via umwblogs. Via reference. Via blog. Via fillthewell. Via lidenz. Via wikpedia. Related Topics Most Influential. Andrew Galbreath 31 Articles Published Writer, editor, dreamer, media fanatic, total geek and future corpse. The Tax Equity and Fiscal Responsibility Act of had given Medicare beneficiaries the option of enrolling in Medicare through private plans rather than through the traditional fee-for-service Medicare plan. Under Part C, the federal government paid the private plans for each beneficiary accepted, amounting to 95 percent of the Medicare average cost per enrollee.

The insurance plans were not allowed to choose which individuals could enroll, but they could choose which geographic areas to serve. They were required to offer all traditional Medicare benefits but could also offer additional benefits beyond traditional Medicare, such as vision and dental benefits. By , about 15 million Medicare beneficiaries—30 percent of all Medicare beneficiaries—were enrolled in Medicare Advantage plans.

Studies have shown that Medicare Advantage HMOs but not other types of Medicare Advantage plans tended to perform better than traditional Medicare in providing preventive services and controlling overall costs; however, beneficiaries perceived traditional Medicare more favorably. Because of these perceptions, older and less healthy recipients tended to enroll in traditional Medicare, so the private Medicare Advantage plans may have actually received higher payments than they needed for their relatively healthy enrollees.

While Medicare Part A covered hospitalization costs, and Medicare Part B covered doctors' visits, Medicare had not originally covered any prescription drug costs. When President George W. Bush was elected in , he promised to provide prescription drug coverage to seniors.

President Bush signed the bill on December 8, and it took effect on January 1, The law, sometimes known as Medicare Part D, established four tiers of coverage. Enrollment in the coverage was voluntary.

Medicare beneficiaries who chose to enroll could do so in three ways: by purchasing separate drug coverage, if they were already enrolled in the government plan for Parts A or B; by enrolling in a private Medicare plan; or through their former employer's retirement benefits program.

Beneficiaries paid premiums to enroll in the program, which were higher for those with higher income. But by , the Congressional Budget Office concluded that Medicare Part D spending had proved lower than either estimate. By , about 37 million Medicare beneficiaries were enrolled in the prescription drug program. The law also granted both Medicare and non-Medicare recipients a tax exemption for health savings accounts HSAs , which allow people to save money for out-of-pocket medical expenses.

The aim of the law was to provide an expansion of health insurance coverage to more Americans through both individual health insurance exchanges as well as through employer-provided plans. Minimum requirements of coverage were established and both individual and employer mandates, enforced by tax penalties, were established over a period of years in order to achieve the goal of expanded coverage.

Subsidies and tax credits were provided to individual consumers based on income level and dependents, and the law provided for an expansion of Medicaid to cover low-income childless adults. Small businesses were given tax credits based on the level of insurance offered to employees, as well. The law also specified ten essential benefits that plans created after the law's passage need to include. Existing plans were grandfathered in, but by , few of the grandfathered plans remained due to frequent changes to health insurance policies.

The ten essential benefits outlined by the Affordable Care Act included the following: [39] [40]. Most of the law's major provisions were implemented in Between and , the number of uninsured individuals nationwide declined by Meanwhile, annual Medicaid enrollment increased by 9. Nearly 10 million individuals purchased insurance through the new exchanges as of November , about 35 percent of the total number of estimated potential enrollees. Numerous studies have been conducted to assess changes in insurance premiums since the passage of the ACA; some have found large increases while others have found little or no change.

Throughout the twentieth century, Progressive groups repeatedly called for national health insurance in the United States. The Progressive Party , also known informally as the Bull Moose Party , was formed in and nominated former President Theodore Roosevelt as its candidate for the presidential election. Its platform called for a National Health Service and public insurance for the elderly, unemployed, and disabled.

The proposal for government health insurance was controversial and was opposed by influential organizations such as the American Federation of Labor, the American Medical Association , and fraternal organizations. Roosevelt finished second in the election, losing to Democratic candidate Woodrow Wilson. The Progressive Party performed poorly in the congressional elections and was dissolved in ; however, its idea of social insurance continued to influence reformers such as President Franklin Roosevelt.

By , 16 European countries had adopted public health insurance. In contrast, the United States rejected the European models and instead developed a system of private health insurance in which many employers provided plans to employees and their families.

This system emerged in the late s when hospitals began offering health plans to public school teachers. In , the Dallas public schools entered into a contract with Baylor Hospital. Under the agreement, teachers would pay a monthly fee in exchange for guaranteed care at Baylor. The plan proved a success and was imitated by administrators around the country. The creator of one such plan illustrated his advertising posters with a picture of a blue cross.

The American Hospital Association then adopted the blue cross as an insignia for plans they approved, while the American Medical Association adopted a blue shield for their approved plans. According to one historian, "Blue Cross paid whatever the hospital charged.

Blue Cross was not designed to monitor hospital costs. In the s, an industrialist named Henry Kaiser employed 5, workers on an aqueduct project in Southern California, with only one hospital nearby. Kaiser agreed to pay the hospital a fixed rate for each worker, and in exchange the hospital would provide all medical care for the workers' occupational injuries.

The arrangement gave rise to the Kaiser Permanente Health Plan, a health insurance plan that operates its own hospitals and physicians' groups. The Kaiser system created managed care, which is the model for today's health maintenance organizations HMOs and preferred provider organizations PPOs. Under the model of managed care, the insurance company involves itself more directly in medical care, often by owning hospitals, paying salaries to doctors, controlling referrals, or limiting the treatments covered.

The employer-sponsored model of health insurance spread during World War II, when a labor shortage prompted the federal government to institute wage controls with the intent of preventing inflation. In , the War Labor Board ruled that wage controls did not apply to fringe benefits offered by employers, such as health insurance. In response, employers began offering greater health benefits rather than higher salaries in order to attract workers.

The model grew more popular after the war when payments by employers toward employee health insurance were made tax-exempt. By , 77 percent of Americans had hospitalization coverage, and over 50 percent also had coverage for routine medical expenses.

In the s, the RAND Corporation conducted a randomized study assigning people to different types of private health insurance, fee-for-service or managed care. The managed care organization in the study proved better at controlling costs, leading to public policies encouraging this type of private insurance. In the early years of the United States, healthcare was provided by wives and mothers in the home, with occasional home visits by doctors.

Medical colleges were established starting in the late s, providing formal scientific training and licensing to physicians. The role of doctors became more authoritative and pronounced with further advancements in science and the growth of cities, which presented health hazards due to overcrowding, poor sanitation and attendant disease.

In a group of physicians formed the American Medical Association AMA with the early mission—and achievement—of state regulation of pharmaceuticals. As medicine grew more professionalized, private health insurance pools were established, and employers and unions began offering some medical benefits to workers. Though once housing primarily very poor and terminally ill patients, hospitals evolved to more closely resemble the institutions they are today, in two ways. First, the development of antiseptics allowed for more sanitary treatment conditions and better education of physicians.

Second, hospitals began offering health plans for public school teachers, which allowed the teachers to go to hospitals more often for routine care and sparked the development of the employer-sponsored insurance model. Ballotpedia features , encyclopedic articles written and curated by our professional staff of editors, writers, and researchers. Click here to contact our editorial staff, and click here to report an error. Click here to contact us for media inquiries, and please donate here to support our continued expansion.

Share this page Follow Ballotpedia. Subscribe Donate. Subscribe Subscribe. What's on your ballot? Jump to: navigation , search. Healthcare policy affects not only the cost citizens must pay for care, but also their access to care and the quality of care received, which can influence their overall health. A top concern for policymakers is the rising cost of healthcare, which has placed an increasing strain on the disposable income of consumers as well as on state budgets.

Healthcare policy in the U. Children's Health Insurance Program.

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What's more, it's likely that the innovations that came from all this design and construction activity also set the standards for hospitals around the world. Angie Thieriot's experiences as a patient, mother of a patient, and daughter of a patient in the s convinced her that there was a more humane way to deliver care.

So, she founded Planetree in San Francisco, Calif. Her goal? The ripples of Planetree's work still influence healthcare facility design today, especially in this era of consumerism where the focus is on improving the patient experience. And while Planetree has grown and become more "corporate" than perhaps Angie envisioned, it is still helping healthcare organizations around the world achieve person-centered care excellence.

The of us who attended the first Symposium in Carlsbad, Calif. Because it was the first time that architects, interior designers, facility managers, administrators, and clinicians came together to share their ideas on how the design of the physical environment impacts patient outcomes.

Founded by healthcare architect Wayne Ruga , the Symposium was a result of his realization that the introduction of diagnostic related groups DRGs in the U. Wayne thought that hospital environments could be designed so that patients would heal faster. And so did many others. Which is why the Symposium fostered a community of healthcare and design professionals who are passionate about creating environments that support health and well-being for everyone who works, stays, or visits a hospital or healthcare facility.

Wayne and his Symposium board of advisors went on to establish the nonprofit Center for Health Design CHD in because they wanted to be able to fund research in the emerging evidence-based design field. Now, more than 25 years later, The Center is still fulfilling that mission.

Although this first literature review only found 48 credible studies linking elements of the physical environment to outcomes, it is historically significant because it put science behind the theory. Seven years later, there were 1, credible studies. There hasn't been a comprehensive literature review since , but it's estimated that there are now more than 2, credible studies. Perhaps more significant, this first literature review sparked the evidence-based design movement, which led to the establishment of the EDAC certification program, launch of a peer-reviewed journal, awards program, and much more research.

The formation of this nonprofit organization to manage the development of the Guidelines for Design and Construction of Hospitals and Health Care Facilities was a pivotal moment in the history of the Guidelines. Originally part of implementing regulations for the Hill-Burton Act, guidelines revisions were funded by the U. Without the efforts of J. They were the ones to convince the federal government after to fund more revisions cycles of the guidelines and were instrumental in founding FGI.

And while not a regulatory document, many U. Their influence on facility design and construction has been substantial. Today, the Guidelines are developed by a multi-disciplinary group of engineering, design, facility, and construction professionals, as well as state regulators, researchers, and others from the private sector.

To make them truly a consensus-based document, public input is also solicited. There are many technological advances that have changed how healthcare facilities are designed and constructed. However, the introduction of this smart phone by Steve Jobs at the Macworld conference in San Francisco ushered in a new era of digitization that has impacted millions of people around the world. Today there are more than 97, health and fitness apps for smart phones and tablets that help people monitor chronic conditions and lead healthy lifestyles.

Digitization has also disrupted the retail, transportation, banking, and hospitality industries. Healthcare may be next. While it's primary goal was to reduce the number of uninsured Americans through things like coverage of preventative services, individual mandates, health insurance exchanges, and medicaid expansion, it also included many provisions that impacted how and where care is being delivered.

As a result, the healthcare industry shifted to building more ambulatory care buildings, retail clinics, urgent care clinics, and micro hospitals. Big-box hospitals aren't going away just yet though, but the number of inpatient beds is decreasing -- which continues to impact facility design and construction.

And despite all the changes to the ACA enacted or proposed by the current administration, it doesn't seem like that is going to impact the changes in how and where healthcare is delivered. Go to my recent blog post to find out why. Do you agree that these are the most important historically significant events that have affected healthcare facility design and construction? What else would you add? Please do me a favor -- if you liked this post and like this blog, please share it with others by sending them the link or posting it on your Twitter, LinkedIn, or Facebook.

Also, don't forget to subscribe, so you'll get emails when new content is posted. Photo Credit: Moses H. Cone Memorial Hospital, Greensboro, N. Surprised not to see the California state seismic mandate here. The mother of all unfounded mandates single handedly forced so much new hospital work in calif which influences so much more.

It seems that the medial profession is on the brink of significant change. You can feel it. People are looking more and more to the internet to solve their medical dilemmas. Nurse practitioners are pushing to expand their roles. The complexities and often injustices of medical payment systems are being exposed. These changes strike fear in many providers — no one likes change.

I really wanted to create some sort of amazing, artistic info-graphic for this post, sort of a pictorial of the history of health care in the U. Unfortunately, I am illiterate in graphic art and my meager attempts at a crash course in various graphic art softwares failed miserably. This is how the U. Organized medicine begins.

Physicians band together to create the American Medical Association becoming a powerful influence over health care legislation. Theodore Roosevelt campaigns on the issue of mandatory health insurance, supported by many progressive groups. Their efforts are set aside with the beginning of World War I. The cost of health care increases relative to other sectors and medical attention becomes increasingly more difficult for the middle class to afford.

Politically, no changes are made to health care law however some companies such as General Hospital and Baylor University begin to offer health insurance to their employees. The Great Depression brings emphasis on offering government based benefits to Americans. However, in the passing of the Social Security Act health insurance is omitted. Despite resistance, Blue Cross begins offering insurance for hospital care in some states. During World War II, employers begin to offer health insurance coverage to compensate for wage controls placed on employers.

This is the beginning of the employer-based system we have today. Few legislative changes are made to health care as attention is diverted to Korea. Tax incentives are given to employers offering health insurance plans further propogating the employer-based health system we have today.

Medicine continues to advance with more medications developed. The first successful organ transplant is performed. The price of hospital care doubles.