Portal:Health care
Introduction
Health care, or healthcare, is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health professionals and allied health fields. Medicine, dentistry, pharmacy, midwifery, nursing, optometry, audiology, psychology, occupational therapy, physical therapy, athletic training, and other health professions all constitute health care. The term includes work done in providing primary care, secondary care, and tertiary care, as well as in public health.
Access to healthcare may vary across countries, communities, and individuals, influenced by social and economic conditions as well as health policies. Providing health care services means "the timely use of personal health services to achieve the best possible health outcomes". Factors to consider in terms of healthcare access include financial limitations (such as insurance coverage), geographical and logistical barriers (such as additional transportation costs and the ability to take paid time off work to use such services), sociocultural expectations, and personal limitations (lack of ability to communicate with health care providers, poor health literacy, low income). Limitations to health care services affect negatively the use of medical services, the efficacy of treatments, and overall outcome (well-being, mortality rates). (Full article...)
Selected general articles
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Schloendorff v. Society of New York Hospital, 105 N.E. 92 (N.Y. 1914), was a decision issued by the New York Court of Appeals in 1914 which established principles of respondeat superior in United States law. (Full article...) -
The Terri Schiavo case was a series of court and legislative actions in the United States from 1998 to 2005, regarding the care of Theresa Marie Schiavo (née Schindler) (/ˈʃaɪvoʊ/; December 3, 1963 – March 31, 2005), a woman in an irreversible persistent vegetative state. Schiavo's husband and legal guardian argued that Schiavo would not have wanted prolonged artificial life support without the prospect of recovery, and in 1998, he elected to remove her feeding tube. Schiavo's parents disputed her husband's assertions and challenged Schiavo's medical diagnosis, arguing in favor of continuing artificial nutrition and hydration. The highly publicized and prolonged series of legal challenges presented by her parents, which ultimately involved state and federal politicians up to the level of George W. Bush, the then U.S. president, caused a seven-year (1998 to 2005) delay before Schiavo's feeding tube was ultimately removed.
On February 25, 1990, at age 26, Schiavo went into cardiac arrest at her home in St. Petersburg, Florida. She was resuscitated, but had massive brain damage due to lack of oxygen to her brain and was left comatose. After two and a half months without improvement, her diagnosis was changed to that of a persistent vegetative state. For the next two years, doctors attempted occupational therapy, speech therapy, physical therapy and other experimental therapy, hoping to return her to a state of awareness, without success. In 1998, Schiavo's husband Michael Schiavo petitioned the Sixth Circuit Court of Florida to remove her feeding tube pursuant to Florida law. He was opposed by Terri's parents, Robert and Mary Schindler. The court determined that Schiavo would not have wished to continue life-prolonging measures, and on April 24, 2001, her feeding tube was removed for the first time, only to be reinserted several days later. On February 25, 2005, a Pinellas County judge again ordered the removal of Terri Schiavo's feeding tube. Several appeals and federal government intervention followed, which included Bush returning to Washington, D.C., to sign legislation moving the case to the federal courts. After appeals through the federal court system that upheld the original decision to remove the feeding tube, staff at the Pinellas Park hospice facility disconnected the feeding tube on March 18, 2005, and Schiavo died on March 31, 2005. (Full article...) -
Health spending per capita, in $US PPP-adjusted, with the US and Canada compared amongst other first world nations. For later data see List of countries by total health expenditure per capita.
A comparison of the healthcare systems in Canada and the United States is often made by government, public health and public policy analysts. The two countries had similar healthcare systems before Canada changed its system in the 1960s and 1970s. The United States spends much more money on healthcare than Canada, on both a per-capita basis and as a percentage of GDP. In 2006, per-capita spending for health care in Canada was US$3,678; in the U.S., US$6,714. The U.S. spent 15.3% of GDP on healthcare in that year; Canada spent 10.0%. In 2006, 70% of healthcare spending in Canada was financed by government, versus 46% in the United States. Total government spending per capita in the U.S. on healthcare was 23% higher than Canadian government spending. U.S. government expenditure on healthcare was just under 83% of total Canadian spending (public and private).
Studies have come to different conclusions about the result of this disparity in spending. A 2007 review of all studies comparing health outcomes in Canada and the US in a Canadian peer-reviewed medical journal found that "health outcomes may be superior in patients cared for in Canada versus the United States, but differences are not consistent." Some of the noted differences were a higher life expectancy in Canada, as well as a lower infant mortality rate than the United States. (Full article...) -
Willowbrook State School was a state-supported institution for children with intellectual disabilities in the Willowbrook neighborhood of Staten Island in New York City, which operated from 1947 until 1987.
The school was designed for 4,000, but by 1965 it had a population of 6,000. At the time, it was the biggest state-run institution for people with mental disabilities in the United States. Conditions and questionable medical practices and experiments prompted US Senator Robert F. Kennedy to call it a "snake pit". The institution gained national infamy in 1972, when Geraldo Rivera did an exposé on the conditions there. Public outcry led to its closure in 1987, and to federal civil rights legislation protecting people with disabilities. A February 2020 New York Times investigation found that the alumni of Willowbrook continue to be abused in smaller group homes. (Full article...) -
Social care in the United Kingdom is a devolved matter, so England, Northern Ireland, Scotland and Wales each have their own separate systems of private and publicly funded social care. Each country has differing policies, priorities and funding levels which has resulted in a variety of differences existing between the systems.
According to the Organisation for Economic Co-operation and Development the UK had one of the lowest government expenditures in Western Europe per head of the population at £695 in 2018 as compared with £1,530 in Norway, £1,451 in the Netherlands, £1,222 in Sweden or £1,033 in Switzerland, though higher than Spain or Portugal with £218 and £208 per head, respectively. (Full article...) -
End-of-life care (EOLC) is health care provided in the time leading up to a person's death. End-of-life care can be provided in the hours, days, or months before a person dies and encompasses care and support for a person's mental and emotional needs, physical comfort, spiritual needs, and practical tasks.
EoLC is most commonly provided at home, in the hospital, or in a long-term care facility with care being provided by family members, nurses, social workers, physicians, and other support staff. Facilities may also have palliative or hospice care teams that will provide end-of-life care services. Decisions about end-of-life care are often informed by medical, financial and ethical considerations. (Full article...) -
Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions of the mouth, most commonly focused on dentition (the development and arrangement of teeth) as well as the oral mucosa. Dentistry may also encompass other aspects of the craniofacial complex including the temporomandibular joint. The practitioner is called a dentist.
The history of dentistry is almost as ancient as the history of humanity and civilization, with the earliest evidence dating from 7000 BC to 5500 BC. Dentistry is thought to have been the first specialization in medicine which has gone on to develop its own accredited degree with its own specializations. Dentistry is often also understood to subsume the now largely defunct medical specialty of stomatology (the study of the mouth and its disorders and diseases) for which reason the two terms are used interchangeably in certain regions. However, some specialties such as oral and maxillofacial surgery (facial reconstruction) may require both medical and dental degrees to accomplish. In European history, dentistry is considered to have stemmed from the trade of barber surgeons. (Full article...) -
Health services research (HSR) became a burgeoning field in North America in the 1960s, when scientific information and policy deliberation began to coalesce. Sometimes also referred to as health systems research or health policy and systems research (HPSR), HSR is a multidisciplinary scientific field that examines how people get access to health care practitioners and health care services, how much care costs, and what happens to patients as a result of this care. HSR utilizes all qualitative and quantitative methods across the board to ask questions of the healthcare system. It focuses on performance, quality, effectiveness and efficiency of health care services as they relate to health problems of individuals and populations, as well as health care systems and addresses wide-ranging topics of structure, processes, and organization of health care services; their use and people's access to services; efficiency and effectiveness of health care services; the quality of healthcare services and its relationship to health status, and; the uses of medical knowledge.
Studies in HSR investigate how social factors, health policy, financing systems, organizational structures and processes, medical technology, and personal behaviors affect access to health care, the quality and cost of health care, and quantity and quality of life. Compared with medical research, HSR is a relatively young science that developed through the bringing together of social science perspectives with the contributions of individuals and institutions engaged in delivering health services. (Full article...) -
Commonwealth v. Twitchell, 416 Mass. 114, 617 N.E.2d 609 (1993), was the most prominent of a series of criminal cases, in the late 1980s and early 1990s, in which parents who were members of the Christian Science church were prosecuted for the deaths of children whose medical conditions had been treated only by Christian Science prayer. (Full article...)
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Caregiver syndrome or caregiver stress is a condition that strongly manifests exhaustion, anger, rage, or guilt resulting from unrelieved caring for a chronically ill patient. This condition is not listed in the United States' Diagnostic and Statistical Manual of Mental Disorders, although the term is often used by many healthcare professionals in that country. The equivalent used in many other countries, the ICD-11, does include the condition.
Over 1 in 5 Americans are providing care to those who are ill, aged, and/or disabled. Over 13 million caregivers provide care for their own children as well. Caregiver syndrome is acute when caring for an individual with behavioral difficulties, such as: fecal incontinence, memory issues, sleep problems, wandering, impulse control problems
, executive dysfunction, and/or aggression. Typical symptoms of the caregiver syndrome include fatigue, insomnia and stomach complaints with the most common symptom being depression. (Full article...) -
Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately.
In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care. However evidence of the effectiveness of FFS in improving health care quality is mixed, without conclusive proof that these programs either succeed or fail. Similarly, when patients are shielded from paying (cost-sharing) by health insurance coverage, they are incentivized to welcome any medical service that might do some good. Fee-for-services raises costs, and discourages the efficiencies of integrated care. A variety of reform efforts have been attempted, recommended, or initiated to reduce its influence (such as moving towards bundled payments and capitation). In capitation, physicians are not incentivized to perform procedures, including necessary ones, because they are not paid anything extra for performing them. (Full article...) -
The Health Threat Unit of the Directorate-General for Health and Consumer Protection (European Commission), is responsible for terrorism surveillance and early warning of biological, chemical, and radiological threats within the European Union. The Health Threat Unit runs the Rapid Alert System, which conducts surveillance on communicable diseases and diseases caused by acts of bioterrorism. The surveillance data are coordinated and evaluated by the Health Emergency Operations Facility. Health threat information and warnings are sent to the member states by the Communication and Crisis Center (BICHAT) and the Security Office in Brussels, Belgium.[citation needed] (Full article...)
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Moore v. Regents of the University of California was a landmark Supreme Court of California decision. Filed on July 9, 1990, it dealt with the issue of property rights to one's own cells taken in samples by doctors or researchers.
In 1976, John Moore was treated for hairy cell leukemia by physician David Golde, a cancer researcher at the UCLA Medical Center. Moore's cancer cells were later developed into a cell line that was commercialized by Golde and UCLA. The California Supreme Court ruled that a hospital patient's discarded blood and tissue samples are not his personal property and that individuals do not have rights to a share in the profits earned from commercial products or research derived from their cells. Following this decision, most U.S. courts have ruled against family members who sue researchers and universities over the "improper commercialization" of their dead family member's body parts. (Full article...) -
Occupational therapy (OT) is a healthcare profession that involves the use of assessment and intervention to develop, recover, or maintain the meaningful activities, or occupations, of individuals, groups, or communities. The field of OT consists of health care practitioners trained and educated to improve mental and physical performance. Occupational therapists specialize in teaching, educating, and supporting participation in any activity that occupies an individual's time. It is an independent health profession sometimes categorized as an allied health profession and consists of occupational therapists (OTs) and occupational therapy assistants (OTAs). While OTs and OTAs have different roles, they both work with people who want to improve their mental and or physical health, disabilities, injuries, or impairments.
The American Occupational Therapy Association defines an occupational therapist as someone who "helps people across their lifespan participate in the things they want and/or need to do through the therapeutic use of everyday activities (occupations)". Definitions by other professional occupational therapy organizations are similar. (Full article...) -
Clinical audit is a process that has been defined as a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change
The key component of clinical audit is that performance is reviewed (or audited), to ensure that what should be being done is being done, and if not, it provides a framework to enable improvements to be made. It had been formally incorporated in the healthcare systems of a number of countries, for instance in 1993 into the United Kingdom's National Health Service (NHS), and within the NHS there is a clinical audit guidance group in the Clinical audit comes under the clinical governance umbrella and forms part of the system for improving the standard of clinical practice. (Full article...) -
The Baby Doe Law or Baby Doe Amendment is an amendment to the Child Abuse Prevention and Treatment Act of 1974, passed in 1984, that sets forth specific criteria and guidelines for the treatment of disabled newborns in the United States, regardless of the wishes of the parents. (Full article...)
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Clinical peer review, also known as medical peer review is the process by which health care professionals, including those in nursing and pharmacy, evaluate each other's clinical performance. A discipline-specific process may be referenced accordingly (e.g., physician peer review, nursing peer review).
Today, clinical peer review is most commonly done in hospitals, but may also occur in other practice settings including surgical centers and large group practices. The primary purpose of peer review is to improve the quality and safety of care. Secondarily, it serves to reduce the organization's vicarious malpractice liability and meet regulatory requirements. In the US, these include accreditation, licensure and Medicare participation. Peer review also supports the other processes that healthcare organizations have in place to assure that physicians are competent and practice within the boundaries of professionally accepted norms. (Full article...) -
Archie Battersbee, a British boy, was the subject of several court hearings between April and August 2022, regarding whether or not to withdraw his life support, after he was found unconscious and subsequently considered to have suffered brainstem death. The courts ruled in favour of Barts Health NHS Trust, and against his parents, and allowed his life support to be withdrawn. (Full article...) -
The Federal Service for the Oversight of Consumer Protection and Welfare (Russian: Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человека; also Rospotrebnadzor; Russian: Роспотребнадзор) is the federal service responsible for the supervision of consumer rights protection and human wellbeing in Russia. This service was founded in 2004, and was included in the structure of the Ministry of Health Care of Russia until 2012. In May 2012 Rospotrebnadzor was removed from the supervision of the Ministry of Health and now reports directly to the Russian Government. It functions on the authority of the Act of Federal Service on the base of the Administrative Regulation. (Full article...) -
Henrietta Lacks (born Loretta Pleasant; August 1, 1920 – October 4, 1951) was an African-American woman whose cancer cells are the source of the HeLa cell line, the first immortalized human cell line and one of the most important cell lines in medical research. An immortalized cell line reproduces indefinitely under specific conditions, and the HeLa cell line continues to be a source of invaluable medical data to the present day.
Lacks was the unwitting source of these cells from a tumor biopsied during treatment for cervical cancer at Johns Hopkins Hospital in Baltimore, Maryland, in 1951. These cells were then cultured by George Otto Gey, who created the cell line known as HeLa, which is still used for medical research. As was then the practice, no consent was required to culture the cells obtained from Lacks's treatment. Neither she nor her family were compensated for the extraction or use of the HeLa cells. (Full article...) -
The Directorate of Health (Icelandic: Embætti landlæknis) is an Icelandic government agency which principal role is to promote high-quality and safe health care for the people of Iceland, health promotion, and effective disease prevention measures. (Full article...)
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Sciensano is a research institute and the national public health institute of Belgium. It is a so-called federal scientific institution that operates under the authority of the federal minister of Public Health and the federal minister of Agriculture of Belgium. Sciensano's core business is scientific research in the fields of public health, animal health and food safety. Sciensano arose in 2018 from the merger of the former Veterinary and Agrochemical Research Centre (in Dutch: Centrum voor Onderzoek in Diergeneeskunde en Agrochemie, in French: Centre d’Étude et de Recherches Vétérinaires et Agrochimiques, often shortened to CODA-CERVA) and the former Scientific Institute of Public Health (in Dutch: Wetenschappelijk Instituut Volksgezondheid, in French: Institut Scientifique de Santé Publique, often shortened to WIV-ISP). Both institutions were merged because of their complementary activities and to be able to provide a comprehensive answer to the health challenges of the future. More particularly, the merger was based on the One Health principle that states that the areas of human health, animal health and the environment are inherently connected with each other. The merger became official on April 1, 2018. (Full article...) -
The Treatment Trap - How the Overuse of Medical Care is Wrecking your Health and what you can do to Prevent it is a 2010 book by Rosemary Gibson and Janardan Prasad Singh. (Full article...)
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Sue Rodriguez (August 2, 1950 – February 12, 1994) was a Canadian right-to-die activist. In August 1991, she was diagnosed with amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease) and was given two to five years to live. She ultimately made the decision to end her life and she sought the assistance of a doctor to that end, leading to a legal battle. She lost her case in front of the Supreme Court of Canada, but took her own life with the help of an anonymous doctor on February 12, 1994. She is cited as an important figure in the eventual legalization of medical assistance in dying in Canada. (Full article...)
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Jackson Memorial Hospital in Miami, the primary teaching hospital of the University of Miami's Leonard M. Miller School of Medicine and the largest hospital in the United States with 1,547 beds (from Health care) -
The emergency room is often a frontline venue for the delivery of primary medical care. (from Health care) -
Health spending by country. Percent of GDP (Gross domestic product). For example: 11.2% for Canada in 2022. 16.6% for the United States in 2022. (from Health care) -
Life expectancy vs healthcare spending of rich OECD countries. US average of $10,447 in 2018. (from Health care) -
![Image 5Global concentrations of health care resources, as depicted by the number of physicians per 10,000 individuals, by country. Data is sourced from a World Health Statistics 2010, a WHO report.[needs update] (from Health care)](//upload.wikimedia.org/wikipedia/commons/thumb/1/1f/Global_physician_density_map_-_WHO_2010.png/120px-Global_physician_density_map_-_WHO_2010.png)
Global concentrations of health care resources, as depicted by the number of physicians per 10,000 individuals, by country. Data is sourced from a World Health Statistics 2010, a WHO report.[needs update] (from Health care) -
Primary care may be provided in community health centers. (from Health care) -
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Total healthcare cost per person. Public and private spending. US dollars PPP. For example: $6,319 for Canada in 2022. $12,555 for the US in 2022. (from Health care) -
National Hospital for Neurology and Neurosurgery in London, United Kingdom is a specialist neurological hospital. (from Health care)
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