402 EXAM 1 Flashcards
1
Q
used interchangeably with population; a collection of individuals who share one or more personal or environmental characteristics
A
Aggregate
2
Q
systemically collecting data on the population, monitoring of the population’s health status, and making available information about the health of the community
A
Assessment
3
Q
the role of public health in making sure that essential community-wide health services are available, which may include providing essential personal health services for those who would otherwise not receive them. also refers to ensuring that a competent public health and personal health care workforce is available
A
assurance
4
Q
a payment arrangement in which insurers agree to pat providers a fixed sum for each person per month or per year, independent of the costs actually incurred
A
capitation
5
Q
a setting- specific practice whereby care is provided for clients and families where they live, work, and attend school. The emphasis is acute and chronic care and the provision of comprehensive, coordinated, and continuous services. Nurses who deliver community- based care are generalists or specialists in maternal/infant, pediatric, adult, or psychiatric/ mental health nursing.
A
Community-based nursing-
6
Q
method for improving the health of the population on a community- wide basis. The method brings together key elements of the public health and personal health care systems in one framework.
A
Community health improvement process (CHIP
7
Q
- nurses providing secondary or tertiary care in a home setting, school nurses, and nurses in clinical settings; any nurse who does not practice in an institutional setting
A
Community health nurses
8
Q
small business
A
Cottage industry
9
Q
- the development of partnerships, alliances, and other linkages across settings to provide a broad range of services for the population served
A
Integrated systems
10
Q
- the need to provide leadership in developing policies that support the health of the population; it involves using scientific knowledge in making decisions about policy
A
policy development
11
Q
used interchangeably with aggregate; a collection of individuals who share one or more personal or environmental characteristics
A
population
12
Q
problems are defined (by assessments or diagnoses), and solutions (interventions), such as policy development or providing a particular preventive service, are implemented for or with a defined population or subpopulation
A
Population- focused practice
13
Q
- what we, as society, do collectively to ensure the conditions in which people can be healthy
A
public health
14
Q
to clarify the government’s role in fulfilling the mission, 3 core functions are implemented at all levels of government: assessment, policy development, and assurance…..
A
Public health core functions
15
Q
a specialty because it has a distinct focus, and scope of practice, and it requires a special knowledge base.
A
public health nursing
16
Q
- a coalition of public health nursing organizations that develop levels of skills to be attained by public health nurses for each of the competencies.
A
Quad Council
17
Q
eople who are within a larger population, such as high-risk infants under the age of 1 year, unmarried pregnant adolescents, or individuals exposed to a particular event such as a chemical spill
A
subpopulation
18
Q
there has been a shift in community health nursing to ?
A
protect and improve health of americans
19
Q
o National prevention, health promotion, and public health council
o Prevention & public health fund
A
• Patient protection and Affordable Care Act
20
Q
• Dramatic increase in life expectancy since _____.
A
1900s
21
Q
vision for public health in america
A
healthy people in healthy communities
22
Q
mission of public health in america
A
o Promote physical and mental health
o Prevent disease, injury, and disability
23
Q
• Essential PH services:
A
o Assessment
o Policy development
o Assurance
24
Q
what society sees and does to verify that the conditions people live in can be healthy
A
• Public health—
25
3 parts of public health core functions
assessment
policy development
assurance
26
systematically collecting data on population; monitoring the health status of the population, and making information available re: community’s health.
assessment
27
providing leadership via development of policies which support the health of the population
o Policy development—
28
ensuring that essential community oriented health services are available; making certain there is a competent public health and personal health workforce is available.
o Assurance—
29
levels of prevention
primary
secondary
tertiary
30
examples of primary
hand washing, smoking cessation, health promotion, immunizations, & exercise
31
examples of secondary
screenings (mammograms)
32
examples of tertiary
problem has already happened & you’re trying to prevent worsening of the condition or reoccurrence. (prevention of complications).
33
what does population
| based mean?
at a certain place (school based nurses)
34
what does population oriented mean?
cover's a larger place (calcasieu parish school board nurses)
35
• Set the bar for the level of performance necessary to delivery essential public health services.
National Public Health Performance Standard Program
36
• Four principles that guided the development of the National Public Health Performance Standard Program
o Developed around the 10 essential public health services
o Focus on the overall public health system rather than on single organizations.
o Describe an optimal level of performance
o Support a process of quality improvement.
37
• Defined as the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences.
public health nursing (PHN)
38
public health nursing is _______-focused practice that emphasizes the promotion of health, the prevention of disease and disability, and the creation of conditions in which all people can be
population
39
• Characteristics of PHN specialty
o Population-focused
o Community-oriented
o Health and preventative focus
o Interventions are made at the community or population level
o There is a concern for the health of all members of the population/community, particularly vulnerable subpopulations.
40
Essential areas of the preparation of PHN Specialist
* Epidemiology
* Biostatistics
* Nursing theory
* Management theory
* Change theory
* Economics
* Politics
* History of public health
* Issues in public health
* Public health administration
* Community assessment
* Program planning and evaluation
* Interventions at the aggregate level
* Research
41
current education for PHN
o BSN graduate has basic preparation to function as a staff PHN
o Master’s degree required for specialization in PHN
♣ Then eligible to sit for certification exam
42
future education for PHN
o BSN graduate has basic preparation to function as staff PHN.
o Doctor of nursing practice (DNP) will likely be required for specialization in PHN
♣ Then eligible to sit for certification exam.
43
• A collection of individuals who have one or more personal or environmental characteristics in common
Population or Aggregate
44
members of a population can be defined in terms of
geography and
special interest or circumstance
45
example of geography
o (country, group of countries, or state)
46
example of special interest or circumstance
children attending a particular school
47
• Group within the larger population
Subpopulation
48
• Diagnoses, interventions, and treatments are carried out for population or subpopulation.
population focused practice
49
population focused practice is concerned with more than one ____.
subpopulation
50
• Diagnoses, interventions, and treatments are carried out at individual client level.
Individual-focused practice:
51
o Community-oriented, population-focused strategies
| o Community-based combination of population-focused, community oriented strategies and direct-care clinical strategies
public health nursing
52
o The provision or assurance of personal illness care to individuals and families in the community.
community-based nursing
53
roles in PHN
* Public health nursing administrators
* Staff nurses
* Curriculum plan to prepare staff nurse or generalist
* Identification of skills and necessary knowledge.
54
• Barriers to specializing in PHN
o Changing mindset that nursing is only at bedside
o Work structure and role socialization
o Few nurses receive graduate-level preparation in PHN concepts and strategies
55
- states that health is a human right and that the health of its people should be the primary goal of every government.
Declaration of Alma-Ata
56
the ability of individuals or communities to adapt and self-manage when facing physical, mental or social challenges
health
57
the process of enabling people to increase control over, and to improve, their health
health promotion
58
activities designed to protect patients or other members of the public from actual or potential health threats and their harmful consequences.
disease prevention
59
)- often primary care providers and are at the forefront of providing preventative care to the public
advanced practice nursing (APN)
60
an electronic version of a patient’s medical history, that is maintained by the provider over time, and may include all of the key administrative clinical data relevant to that persons care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports
Electronic health records (EHR)-
61
- Obamacare
Affordable Care Act
62
the first level of the private health care system, delivered in a variety of community settings, such as physicians’ offices, urgent care centers, in-store clinics, community health centers, and community nursing centers
primary care
63
a system in which care is delivered by a specific network of providers who agree to comply with the care approaches established through a case management approach.
managed care
64
mandated through laws that are developed at the national, state, or local level.
Public health
65
- the agency most heavily involved with the health and welfare concerns of U.S. citizens. Regulates health care and oversees the health status of Americans.
U.S. Department of Health and Human Services
66
the goal of the integration of public health and primary care, includes a comprehensive range of services including public health and preventative, diagnostic, therapeutic, and rehab services. Composed of public health agencies, community-based agencies and primary care clinics, and health care providers.
Primary health care (PHC)-
67
individuals within the community help in defining health problems and in developing approaches to address the problems.
Community participation
68
• Indicators that continue to cause disparities in the US’s health care systems:
o Cost
o Access
o Quality
69
o Weakening of national and global economy
o Loss of 7 million jobs in the US
o ?????????National health spending expected to grow 6.1% per year, reaching $4.5 trillion by 2019
♣ Per capita spending increasing from $8046 in 2009 to $13,387 in 2018
o Increases in public spending
o Decreases in private spending
o By 2012, expect public payment for health care services will account for more than 50% of total health care purchases in the U.S.
• 2008 “Great Recession”
70
• The Aging baby boomer population will increase _____ ______.
medicare expenditures
71
• Medicaid recipients can be expected to decline as?
jobs are added to the economy.
72
• Groups who face greatest barriers to access to healthcare
o Poor
o Minority group members
o Non-english speakers’
73
how many people in the US lack adequate access to primary health care (2007)?
o 56 million
74
how many deaths a year attributed to preventable medical errors
o 98,000
75
______ of which are due to preventable medication errors
♣ 7,000
76
Trends Affecting the Health Care System
* Demographics
* Technology
* Global influences
77
Demographics
aging baby boomer generation
rise in foreign-bAQZUJN -P0 orn population
lack of diversity in health care workforce
78
• Examples of technology
o Telehealth
o Electronic medical records
o Personal Health record (PHR)
o Health Information Exchanges (HIEs)
79
Benefits of technology
cost-effective
improved care
reduce medical errors
80
pitfalls of technology
concerns about privacy and security
unclear reimbursement for services provided
81
Global Influences
globalization
infectious disease outbreaks
world health organization (WHO)
82
W.H.O. defined ___ ____ _____ as: having evolved and reflect from the economic condition and sociocultural and political characteristics of the country and its communities; based on application of social, biomedical, and health services research and public health experience.
primary health care
83
Organization of Health Care System
* Primary health care system
* Primary care
* Public health system
* The federal system
* The state system
* The local system
84
o Care provided by health care professional
| o Care provided at the individual level
primary care
85
o Broad range of services
o Emphasis is on prevention
o Care provided at community level (public health and office of public health)
• Primary Health Care (PHC)—
86
• Multidisciplinary team of health care providers
PHC workforce
87
• Tem members of the PHC workforce include:
```
o Primary care generalists and public health physicians
o Nurses
o Dentists
o Pharmacists
o Optometrists
o Nutritionists
o Community outreach workers
```
88
o Goal of attaining a level of health that permitted all citizens of the world to live socially and economically productive lives
• Declaration of Alma Ata (1978)
89
* First level of the private health care system
* Delivered in a variety of community settings
* Americans access it through insurance programs
* Managed care
primary care
90
• Primary care developed in the ____ because there was a need to reexamine the role of general practitioner
1960s
91
• Primary care generalists include:
o Family physicians
o General internists
o General pediatricians
o NPs
o Clinical Nurse Specialists (CNSs)
o Pas
o Certified nurse-midwives (CNMs)
o Doctorate in Nursing practice (DNP)
92
* Mandated through laws that are developed at the national, state, or local level
* Organized into many levels in the federal, state, and local systems
* At the local level, health departments
public health system
93
* Stand ready for disaster prevention of response
* Health care financing and administration
* Direct assistance to local health departments
* Board of examiners of nurses
state health department
94
* Direct responsibility to the citizens in its community or jurisdictions
* Variety of services and programs offered depending on the state and local health codes that must be followed
* Needs of the community, and available funding and other resources
* Office of public health
local health department
95
four strategies for action to ensure that scientific, economic, social, and political sustainability; laid the foundations for the Healthy People agendas of Healthy People 2020
health for all in the 21st century (HFA21)
96
refers to those countries with a stable economy and a wide range of industrial and technological development, low child mortality, high gross national income, and a high human asset index
developed country
97
a country that does not meet the criteria for a developed
less developed country
98
developed to relieve poor health conditions around the world and to establish positive steps to improve living conditions by the year 2015
UN Millennium Development Goals (MDGs
99
the health outcomes of a group of individuals, including the distribution of such outcomes within the group, and policies and interventions that link these two; an approach and perspective that focuses on the broad range of factors and conditions that have a strong influence on the health of populations (environment, genetics, ethnicity, pollution, and physical and mental stressors affecting a community)
population health
100
the factors and conditions that are important considerations in population health; may include income and social factors, social support networks, education, employment, working and living conditions, physical environments, social environments, biology and genetic endowment, personal health practices, coping skills, health child development, health services, sex, and culture
determinants
101
A basic level of health care that includes programs directed at the promotion of health, early diagnosis of disease or disability, and prevention of disease. Primary health care is provided in an ambulatory facility to limited numbers of people, often those living in a particular geographic area. It includes continuing health care, as provided by a family nurse practitioner; ultimate goal is to achieve better health for all
primary health care (PHC)
102
those that receive funding from multiple government and nongovernment sources
multilateral organizations
103
a single government agency that provides aid to less developed countries, such as the US Agency for International Development (USAID); influenced by political and historical agendas that determine which countries receive aid
bilaterial organization
104
include the most outspoken advocates of human rights, the environment, social programs, women’s rights
nongovernmental organizations (NGOs)
105
professional and trade organizations that are found mostly in the more developed and industrialized countries
private voluntary organizations
106
separate, autonomous organization that, by special agreement, works with the UN through its Economic and Social Council; was created as an outgrowth of the League of Nations and the UN charter that provided for the formation of a special health agency to address the wide scope and nature of the world’s health problems; the principal work of the WHO is to direct and coordinate international health activities and to provide technical medical assistance to countries in need
12. World Health Organization (WHO)
107
multilateral agency; formed after WWII to assist children in the war-ravaged countries of Europe, it is a subsidiary agency to the UN Economic and Social Council; After WWII, many social agencies realized that the world’s children needed medical and other kinds of support so programs were developed to control yaws, leprosy, and TB in children; Since then the UNICEF has worked closely with the WHO as an advocate for the health needs of women and children under the age of 5; there have been multinational programs aimed at safe drinking water, sanitation, education, and maternal and child health
United Nations Children’s Fund (UNICEF)
108
serves as a regional field office for the WHO in Latin America, with a focused effort to improve the health and living standards of the Latin American countries; distributes epidemiologic information, provides technical assistance over a wide range of health and environmental issues, supports health care fellowships, and promotes health and environmentally related research, along with professional education
Pan American Health Organization (PAHO)
109
another multilateral agency that is related to the UN; major aim is to lend money to the less developed countries so that they might use it to improve the health status of their people; also has collaborated with the field offices of the WHO for various health-related projects such as the control and eradication of the tropical disease onchocerciasis in West Africa, as well as programs aimed at provided safe drinking water and affordable housing, developing sanitation systems, and encouraging family planning and childhood immunizations
WORLD BANK
110
receive funding from private endowment funds.
17. Philanthropic Organizations
111
Commodification is an intense marketing that involves turning health care into a business with clients as consumers and health care professionals from altruistic healers to business technicians. Breast cancer awareness is the best known of this practice in the United States
Health commodification
112
A paradigm shift that refers to multilevel and multifactor negotiation process involving environment, health, emerging diseases, and human safety. To solve global health problems one must build capacity for global health diplomacy by training public health professionals and diplomats to prevent the imbalances that emerged between foreign policy and public health experts and imbalances existing with negotiating power and capacity between developed and developing nations.
global health diplomacy
113
Since mortality statistics have do not adequately describe the outlook of health in the world, the WHO has developed this indicator, in which it combines losses from premature death and losses of healthy life that result from disability.
global burden of disease (GBD)
114
Is a critical indicator to the well being of people around the globe. For example, many major health risks relate to interactions between people and their environment. This is shown in developing nations, community drinking water sources can be contaminated by agriculture runoffs containing toxic pesticides and fertilizers or natural occurring elements in the earth such as arsenic and fluoride.
environmental sanitation
115
are events that continue to impact people lives and even cause deaths world wide. Also causing countries billions of dollars and economic losses each year. Such disasters are: earth quakes, hurricanes, floods, drought, tsunamis, volcanic eruptions and so on. The most serious consequence of natural disasters are related to the mass production displacements, unsanitary conditions, lack of clean water, lack of nutritious foods, lack of safe housing, and the increased risk of diseases prevalent in crowded housing and unsanitary living conditions: typhoid fever, cholera, dysentery, TB, and infectious respiratory conditions.
natural disasters
116
may include bioterrorism, chemical agents, pandemics and epidemics, radiation and terrorism. The five worst man made disasters in history are: India Bhopal gas tragedy, Gulf of Mexico Deep-water horizon oil spill, Ukraine Chernobyl Meltdown, Japan Fukushima Meltdown, Global warming.
man-made disasters
117
One of the many man made disasters, this is an attack and the deliberate release of viruses, bacteria, and other germ agents used to cause illness or death of people, animals, or plants, which may lead to pandemics and epidemics (anthrax, Ebola virus, cholera, Lassa fever, plague, and small pox)
bioterrorism
118
occurs when a hazardous chemical has been released and the release has the potential to harms peoples health. Can be unintentional (industrial accident) or intentional (terrorists attack)
chemiical emergency
119
occurring when an excess amount of radiation is released to harm people’s health can be intentional or unintentional
radiation poisoning
120
This term was defined by the united nations in 1948 to mean any of the following acts committed with intent to destroy, in whole or part, a national, ethnic, racial, or religious group including killing members of the group causing serious bodily or mental harm to members of the group, deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part imposing measures intended to prevent births within the group and forcibly transferring children of the group to another group.
genocide
121
the culturally diverse groups are more?
vulnerable,
have less access to health care
receive a poorer quality of health care
have higher rates of chronic illnesses
shorter life expectancies
122
is a set of beliefs, values, and assumptions about life that are widely held among a group of people and is transmitted intergenerationally
culture
123
concepts of ____ and ethnicity within american society play a strong role in understanding human behavior and health. in everyday language, these 2 concepts are often used interchangeably.
race
124
is a biological variation within population groups based on physical markers derived from genetic ancestry such as skin color, physical features, and hair texture
race
125
you can be the same race but different _____.
culture
126
in contrast to race, is the shared feeling of peoplehood among a group of individuals and relates to cultural factors such as nationality, geographic region, culture, ancestry, language, beliefs, and traditions
ethnicity
127
are the physical, biological, and physiological characteristics that exist between racial groups and distinguish one race from another.
biological variations
128
biological variations occur in?
areas of growth and development
skin color
enzymatic differences
susceptibility to disease
lab tests findings
129
1. the physical distance maintained between individuals during an interaction
personal space
130
4 zones of interpersonal space
intimate space
personal space
social distance
public distance
131
intimate space
direct contact - 1.5 feet
132
personal space
1.5-4 feet
133
social distance
4-12 feet
134
public distance
greater than 12 feet
135
refers to past, present, and future time as well as to the duration of and period between events.
perception of time
136
some cultures assign greater or lesser value to events that occur in the past, present, or future
*fact*
137
person’s relationship with nature and efforts to plan and direct factors in the environmental that affect them
environmental control
138
• 3 views of nature and the role of environment in everyday life:
- nature controls the environment
- nature and the environment work in harmony to promote health and wellness
- the environment has master over nature
139
refers to the way in which families are structured to carry out role functions
social organization
140
the _____ should have knowledge of the client's culture and medical terminology.
interpreter.
141
______ should be trained, qualified, and hired to ensure that they have met minimum standard to provide accurate and safe interpretation.
interpreters
142
socioeconomic status is reflected in?
life expectancy
infant death rates
low birth rates
143
members of ____ ____ may be marginalized, preventing them from enjoying the same opportunities and resources for education, occupation, income earning, and property ownership that the dominant group has, thus relegating them to the fringe of society.
minority groups
144
1. a combination of culturally congruent behaviors, practice attitudes, and policies that allow nurses to use interpersonal communication, relationship skills, and behavioral flexibility to work effectively in cross-cultural situations
cultural competence
145
• Principles of Cultural Competent Nursing Care:
- Care must be client centered/specific
- Care must be based on the uniqueness of the client’s culture and incorporate the cultural norms and values of the client in the management of the care plan
- Self-empowerment strategies of the client are identified and viewed as strengths to facilitate client decision making and self-care management in health and illness situations
146
• 3 Stages to Developing Cultural Competence (pg. 153 Table 7-4)
- culturally incompetent
- culturally sensitive
- culturally competent
147
• Each stage has 3 dimensions that have an overall effect on nursing outcomes
- cognitive (thinking)
- affective (feelings)
- psychomotor (doing)
148
self-examination and in-depth exploration of one’s own biases, stereotypes, and prejudices as they influence behavior toward other cultural groups
cultural awareness
149
• Culturally aware nurses
- are conscious of culture as an influencing factor of differences between themselves and others
- understand the basis for their own behavior
- recognize that health is expressed differently
150
1. process of searching for and obtaining a sound educational understanding about culturally diverse groups
cultural knowledge
151
cultural knowledge's emphasis is on?
learning about the client’s worldview from an emic (native) perspective as it pertains to health beliefs and practices, cultural values, and disease incidence and prevalence
152
1. ability of nurses to effectively integrate cultural awareness and cultural knowledge when conducting a cultural assessment as well as a culturally based physical assessment and to use the data to meet the specific client’s needs
cultural skill
153
is ascribing certain beliefs and behaviors about a given racial and ethnic group to an individual without assessing for individual differences.
sterotyping
154
blocks the willingness of a person to be open and to learn about specific individuals or groups
stereotyping
155
stereotyping can be ____ or ____.
positive or negative
156
is the emotional manifestation of deeply held beliefs about a group
prejudice
157
is not based on reason or experience but rather on negative or favorable preconceived feelings
prejudice
158
is a form of prejudice that occurs through the exercise of power by individuals and institutions against people who are judged to be inferior
racism
159
1. the belief that one’s own cultural group determines the standards by which another group=s behavior is judged
ethnocentrism
160
ethnocentrism AKA
cultural prejudice
161
there is an inability to recognize the difference between one’s own cultural beliefs, values, and practices and those of another culture
cultural blindness
162
1. belief in one’s own superiority, or ethnocentrism, and is the act of imposing one’s cultural beliefs, values, and practices on individuals from another culture
cultural impositioin
163
1. nurses recognize that clients have different approaches to health, and that each culture should be judged on its won merit not on the nurse’s personal beliefs
Cultural relativism
164
1. a perceived threat that may arise from a misunderstanding of expectations when nurses are unable to respond appropriately to another individual’s cultural practice because of unfamiliarity with the practice
Cultural conflict
165
the feeling of helplessness, discomfort, and disorientation experienced by an individual attempting to understand or effectively adapt to a cultural group whose beliefs and values are radically different from the individual’s culture
culture shock
166
culture shock is brought on by?
anxiety that results from losing familiar signs and symbols of social interaction
167
1. assistive, supportive, facilitative, or enabling nurse actions and decisions that help clients of a particular culture accept nursing strategies, or negotiate with nurses to achieve satisfying health care outcomes
Cultural accommodation
168
is advocating, mediating, negotiating, and intervening between the client's culture and the biomedical health care culture on behalf of clients.
culture brokering
169
1. a systematic identification and documentation of the culture care beliefs, meanings, values, symbols, and practices of individuals or groups within a holistic perspective, which includes the worldview, life experiences, environmental context, ethno history, langue, and diverse social structure influences
Cultural nursing assessment
170
1. mapping of this was a strategic inflection point in the history of health care that created a massive shift in how all health professionals provide care and how public health is approached
genome
171
1. the study of the function and effect of single genes that are inherited by children from their parents.
genetics
172
1. study of all of a person’s genes, including their interaction with one another as well as the interaction of a person’s genes with the environment.
genomics
173
1. an international research project funded by the U.S. Congress in 1988 and completed in 2003, has mapped all of the approximately 25,000genes in human DNA.
Human genome project
174
1. a nucleic acid that contains the genetic instructions used in the development and functioning of all known living organisms and some viruses.
DNA
175
1. are comprised of specific sequences of the 4 bases (adenine, guanine, cytosine, and thymine).
genes
176
1. alterations in the usual sequence of bases that form a gene or change in DNA or chromosomal structures.
mutations
177
tests are now available to evaluate more than _____ `genetic disorders ranging from single-gene disorders such as CF, to more complex disorders like diabetes.
1600
178
DNA testing was first used in the late _____s
1970s
179
on november 21, 2009, the _______ took effect through an act of the U.S. Congress. it was designed to prohibit the improper use of genetic information in health insurance and employment
genetic information nondiscrimination act (GINA)
180
according to the DCD, a public health worker should be able to perform the following:
demonstrate basic knowledge of the role genomics plays in the development of disease
identify limits of his/her genomic expertise
make appropriate referrals to those with more genomic expertise
181
1. is a drawing of a family tree used by medical professionals and genetic counselors to assess families and try to spot patterns or indications that may be helpful in diagnosing or managing an individual’s health.
pedigree
182
1. refers to heritable changes in gene expression that do not involve changes to the underlying DNA sequence: a change in phenotype without a change in genotype.
epigenetics
183
ex of multifactorial diseases
cancer
pain
cardiovascular disease
184
the amount of money available to an individual or organization to spend on a particular good or service
budget limits
185
similar to prospective reimbursement for health care organizations; Specifically, 3rd party payers determine the amount that practitioners will be paid for a unit of care, such as a client visit, before the delivery of the service, thereby placing the limit on the amount of reimbursement received per patient; A payment method for health care services.
capitation
186
considered the best method; involves the listing of all costs & benefits that are expected to occur from an intervention during a prescribed time; costs & benefits are adjusted for time and inflation; CBA requires that all costs & benefits be known and quantifiable in dollars (the major problem w/its use)
cost-benefit analysis (CBA)
187
expresses the net direct and indirect costs & cost savings in terms of a defined health outcome; does not require the dollar value be put on the outcome; best used when comparing 2 or more strategies or interventions that have the same health outcome in the population; objective commonly used when CAE is performed in health care is improvement in quality of adjusted life-years for clients
cost-effectiveness analysis (CAE)
188
the people wanting/needing the supply
cost-utility analysis
189
the basis for prospective reimbursement; A group of patients classified for measuring a medical facility's delivery of care. The classifications, used to determine Medicare payments for inpatient care, are based on primary and secondary diagnosis, primary and secondary procedures, age, and length of hospitalization
diagnosis-related groups
190
the point at which a prescription D recipient has met the limit that the health insurance policy will pay for prescriptions in a given year and the requirement that the recipient will then be responsible for paying full price for all medicines until the end of the year covered by the health insurance
donut-hole
191
—reflects an increase in the output of a nation
Economic growth
192
—the science concerned with the use of resources, including the production, distribution, and consumption of goods & services
Economics
193
refers to the extent to which a health care service meets a stated goal or objective, or how well a program or service achieves what is intended
Effectiveness—
194
refers to producing maximal output, such as a good or service, using a given set of resources (or inputs), such as labor, time, and available money
Efficiency—
195
1. A charge made for a professional activity, such as a physical examination, the fitting of a contraceptive diaphragm, or the monitoring of a person's BP.
2. A system for the payment of professional services in which the practitioner is paid for the particular service rendered, rather than receiving a salary.
Fee-for-service—
196
the total market value of the output of labor and property located in the U.S.; reflects only the national U.S. output--Statistical measure used to compare health care spending among countries.
Gross domestic product (GDP)—
197
the total market value of all goods and services produced in an economy during a period of time (e.g., quarterly or annually); reflects national output plus income earned by U.S. businesses or citizens, whether within the United States or internationally
Gross national product (GNP)—
198
—Method to reduce health care costs by controlling the use of health care services and technologies.
Health care rationing
199
A social system that studies the supply and demand of health care resources and the effect of health services on a population.
Health economics—
200
a measure of macroeconomic theory; in this approach improving human qualities, such as health, are a focus for developing and spending money on goods and services because health is valued; it increases productivity, enhances the income-earning ability of people, and improves the economy. Therefore, there is a positive rate of return on the “investment in human capital.”
Human capital—
201
Sustained upward trend in the prices of goods and services.
Inflation—
202
the extent of use of technologies, supplies, and health care services by or for the client; includes and is a partial measure of the use of technology
Intensity—
203
focuses on the “bigger picture”—the total, or aggregate, of all individuals and organizations (e.g., behaviors such as growth, expansion, or decline of an aggregate); community
Macroeconomic theory—
204
simply means that clients make decisions and choose the health care services they want on the basis of the quality or reputation of the service
Managed competition—
205
—term used for a variety of health care arrangements that integrate the financing and the delivery of health care; offers an array of services to purchasers, such as employers, Medicaid, or Medicare, for a set fee. The concept of managed care is based on the notion that the use of costly care could be reduced if consumers had access to care & services that would prevent illness through consumer education and health maintenance; uses disease prevention, health promotion, wellness, & consumer education--A health care system in which there is administrative control over primary health care services in a medical group practice. The intention is to eliminate redundant facilities and services and to reduce costs. Health education and preventive medicine are emphasized. Patients may pay a flat fee for basic family care but may be charged additional fees for secondary care services.
Managed care
206
determining a lack of financial resources
Means testing—
207
—A U.S. federally funded state-operated program of medical assistance to people with low incomes, authorized by Title XIX of the Social Security Act. Under broad federal guidelines, the individual states determine benefits, eligibility, rates of payment, and methods of administration.
Medicaid
208
A federally funded national health insurance program in the United States for people over 65 years of age or who meet other criteria. Part A provides basic protection against costs of medical, surgical, and psychiatric hospital care. Part B is a voluntary medical insurance program financed in part from federal funds and in part from premiums contributed by enrollees. Medicare was authorized by Title XVIII of the Social Security Act of 1965.
Medicare—
209
—the set of techniques, drugs, equipment, and procedures used by health care professionals in delivering medical care to individuals; also includes information technology & the system within which such care is delivered
Medical technology
210
deals w/ the behaviors of individuals & organizations and the effects of those behaviors on prices, costs, and the allocating and distributing of resources; applied to health care looks at the behaviors of individuals & organizations that result form tradeoffs in the use of a service & budget limits
Microeconomic theory—
211
the purpose of the new hospital payment scheme was to shift the cost incentives away from the providing of more care & toward more efficient services; A payment mechanism for reimbursing hospitals for inpatient health care services in which a predetermined rate is set for treatment of specific illnesses. The system was originally developed by the U.S. federal government for use in treatment of Medicare recipients.
Prospective payment system (PPS)—
212
—focuses on the production, distribution, and consumption of goods and services as related to public health and where limited public resources might best be spent to save lives or best increase the quality of life
Public health economics
213
growing field of science and practice that involves the acquiring, managing, and using of monies to improves the health of populations through disease prevention and health promotion strategies; this field of study also focuses on evaluating the use of the money and the impact on the public health system
Public health finance—
214
the sum of years of life multiplied by the quality of life in each of those years; assigns a value, ranging between 0 (death) & 1 (perfect health), to reflect quality of life during a given period of years; the QALY is often used in malpractice suits to award money to clients who have been injured by health care
Quality of adjusted life-years—
215
the traditional reimbursement method, whereby fees for the delivery of health care services in an organization are set after services are delivered
Retrospective reimbursement—
216
those community providers that offer services to the uninsured and underinsured
Safety net providers—
217
Reimbursement made to health care providers by an agency other than the client for the care of the client (e.g., insurance companies, governments, employers).
Third-party payer—
