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2711 Midterm > 9: Healthcare > Flashcards

9: Healthcare Flashcards

1
Q

healthcare

A

Services provided to individuals or communities by agents of the health services or professions to promote, maintain, monitor, or restore health

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2
Q

Canadian healthcare system is a mix of the 3 models, what are they?

A
  1. The Medical Model
  2. The Social Model
  3. The Health Promotion Model
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3
Q

The Medical Model

A

Focuses on the TREATMENT of diseases and injuries
○ Favours surgery/drug therapy, and rehabilitation through
PHYSICAL therapies
○ Usually in the physician’s office, a hospital or other
healthcare institutions
○ Influenced by the payment system

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4
Q

The Social Model

A

Sees medical care as one part of a COMPLETE healthcare system
○ personal/family counselling, home care, adult daycare
programs as part of the healthcare system
○ Tries to keep older people in their own homes (aging in
place)
○ Includes Long Term Care: combines medical/nursing
care with social & community services

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5
Q

The Health Promotion

A

focuses on prevention and self-care
○ Aims to PREVENT disease through lifestyle change,
knowledge on healthy behaviour, environmental
improvement
○ programs that promote fitness and warn about the
risks of unhealthy behaviours (smoking, binge drinking )
○ Actions that most people do not associate directly with healthcare: workplace safety regulations, seatbelt legislation, pollution control

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6
Q

which model of healthcare uses a multidisciplinary approach, where clinicians still important contributors but not the only ones or @ the centre

A

The Social Model

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7
Q

which healthcare model is easily integratable into the social model

A

HP model

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8
Q

primary/ secondary care bs

A

??????? do i need to know this

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9
Q

main challenges with canadian healthcare system

A
  1. Wait time
  2. Issues with continuity of care and transition to long-term care
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10
Q

Canadian Health Act (1984)

A
  • Publicly funded Health Care insurance
  • National Standards for each Province & Territory
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11
Q

Canadian Health Act (1984)
+ 5 criteria that must be achieved (PCUPA)

A
  1. Public (non-profit) Administration
  2. Comprehensive services
  3. Universal coverage
  4. Portability
  5. Access to services
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12
Q

Older people accounted for ___% of all provincial and territorial government health spending

A

44%

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13
Q

T or F: Older people are more likely to be hospitalized and spend longer in hospital, but see specialists/ generalist practitioners less than younger people

A

F:
- see specialists and generalist practitioners more often than younger people
- MORE likely to be hospitalized and spend longer in hospital

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14
Q

T or F: the proportion of health system expenses spent on seniors has been stable over the last decade …… population aging adds slightly more than 1% to the growth in healthcare costs

A

F: less than 1%
health system expenses spent on seniors being stable over the last decade = true

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15
Q

T or F: Population aging is not the main reason for growth in healthcare expenses

A

T
· Expensive (new) medical interventions
○ Drug
○ Technology
○ More tests

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16
Q

T or F: medicare is sustainable and there is no real financial crisis coming

A

T

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17
Q

what causes Inequality in Access to healthcare

A
  1. Geography
  2. Socio-economic status (*intersection with aging)
  3. Cultural issues
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18
Q

which is NOT a way to address needs of older adults with continuity of care listed in the lecture:
1. More homecare
2. Transfer from acute care to chronic or long-term care
3. Increase funding allocated to informal care

A
  1. Increase funding allocated to informal care
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19
Q

T or F: The Canada Health Act includes all nursing home care costs in its definition of covered services

A

F: DOES NOT

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20
Q

T or F: there is a mismatch between required continuity of care and the Canadian system, lacking a proper plan for continuity of care

A

T - big issue

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21
Q

T or F: even the poorest older adults can be served by long-term care

A

F: Long-term care is not covered totally by OHIP (affects the poorest older adults)
- unaddressed vulnerabilities of older adults in long-term care facilities

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22
Q

what year did the Canadian government put in place a hospital insurance system that covered the entire population

A

1957

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23
Q

what year did government-insured physician services emerge

A

1968

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24
Q

what year did all provinces/territories belong to a national medical insurance program

A

1972

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25
Q

what year did the House of Commons support Canada Health Act

A

1984

26
Q

“Father of Medicare” - Tommy Douglas

A

1962 - enacted a provincial version of the Medicare system in Saskatchewan

1984 - Canadian federal gov. created a national medicare system based on his model

  • federal gov. agreed to pay 1/2 the cost of the system, leaving other 1/2 to provinces/territories
27
Q

Challenges to the Healthcare System Today

A
  1. care shifting from institutions -> communities
    - funding has not kept pace w this shift
  2. decreased institutionalization = more pressure on women/families/communities
  3. need for family support as the need for community-based and institution-based long-term care grows w aging population
  4. healthcare system does not fully insure long term care
  5. ongoing concerns with cost, quality of care, sustainability
28
Q

Wait Times Reduction Fund

A

(2004 - 2014), $5.5 billion
- reduce unnecessary procedures, set up specialty clinics for procedures, track patient needs electronically to respond quickly to emergencies
- 2019, 30% of patients didn’t receive treatment within established benchmark times

29
Q

T or F: as more seniors need surgery, availability of surgeons and facilities will increase to meet benchmarks

A

F: as more seniors need surgery, availability of surgeons and facilities influence system’s ability to meet benchmarks

30
Q

community supports and institutional care are connected…. what could help reduce wait list time

A

better community care services and support for caregivers

31
Q

Alternate Level of Care (ALC)

A

patients in acute care hospitals no longer in need of acute care

32
Q

(-) of ACL and solution

A

(-) put a strain on hospital resources
(- ) may experience functional decline while awaiting discharge to more appropriate setting (long-term, rehab .etc)

(+) better coordination between different agencies, informal caregivers, home care services, and acute and continuing care systems would reduce ALC patient #

33
Q

Indigenous seniors face a number of health risks that can exacerbate health problems, including …..

A
  • poverty
  • geographic location
  • personal isolation
  • food insecurity
  • weak social support networks

*face inequity due to lifelong low social status, low income, gender inequity (for women)

34
Q

Unique issues to Indigenous healthcare

A
  • living on reserves (far from care centres) makes getting consistent care a problem
  • seniors benefit from culturally-safe care and traditional medicines (not just Western)
  • lack of qualified staff to service
    • jobs = low-paying & in remote areas = burn out & high turnover
      *staff don’t speak Indigenous languages
35
Q

in 2019, Canada spent $_____ billion on healthcare (~____ per person)
= ____% of GDP

A

$264 billion on healthcare (~7,068 per person)
= 11.6% of GDP

36
Q

hospitals and other institutions accounted for ___% of healthcare spending in 2019

A

37.5%

37
Q

cost of care to the older population in the future will depend on:

A
  1. health of new cohorts of older people
  2. impact of HP and disease prevention
  3. cost of drugs and technology
  4. cost of running and managing healthcare personnel and institutions
38
Q

T or F: community-based long-term care and health promotion will allow the healthcare system to provide quality care, control costs, help keep people in their homes

A

T

39
Q

Adapting the healthcare system to an aging society can contain costs and provide the kind of care older people want and need, by integrating the _______model with _______

A

social model (home and community care) with institutional treatment (hospital care)

40
Q

T or F: the Canadian system has moved away from community-based healthcare services the past few years

A

F: moved towards

41
Q

the proportion of seniors living in an institution _____ with age (+ or -)

A

increases

42
Q

COVID nursing home crisis + provincial responses

A

(-) high death rates in first months
(-) frail seniors with underlying conditions = greatest risks in homes
(-) staff and equipment shortages, inability to quarantine residents

(+) increased testing, added staffing, mask requirements

43
Q

Many nursing homes and healthcare professionals support person-centered care … what is this?

A

tailors activities and services to each resident’s personal preferences and values
- honors choice, dignity, individuality
- “nothing about me, without me”

44
Q

what positive outcomes are associated with person-centered care?

A

improved QOL and relationships with staff

45
Q

the Simon K.Y. Lee Seniors Care Home in Vancouver serves Chinese community elders. his home adopted a philosophy in institutional care called “____ ________ ___________”

A

the Eden Alternative
= aims to de-institutionalize nursing homes and other long-term care institutions
= where elders live must be habitats for human beings, not sterile medical institutions

46
Q

T or F: the funding discrepancy between community/acute/institutional care causes older people to turn to social welfare system for help

A

T: when needing long-term care

47
Q

Many provinces intend to shift health services from institutions to community care - what problems does this bring up?

A
  • development of community care lags behind hospital bed closings
  • Community care demands more knowledge of medical practice as older people leave hospitals sooner
48
Q

Community care programs include …

A
  • hospitals
  • nursing homes
  • doctors’ services
  • community-based services (geriatric day hospitals, adult daycare, home care)
49
Q

community care programs form a __________ that range from institutional care to little or no institutional contact

A

continuum of care

50
Q

geriatric day hospitals

A

offer a full range of hospital services, assess an older person’s needs, and create rehabilitation and care programs
- may save the system money if they can keep people out of nursing homes and in the community

51
Q

adult daycare programs (ADCs)

A

provide in-community support for people who cannot stay in their homes without caregiving
- improve social and psychological measures of well-being
- delay institutionalization

52
Q

assisted living

A

housing that provides personal care services and other supports
- need more care than home-based health services can provide
- often require help with ADLs

53
Q

home care

A

blends medical and non-medical care, using social and medical services to help people live independently in the community

54
Q

long-term institutional care

A

live-in institutions that are not hospitals and offer medical care to chronically ill older people

55
Q

where do adult daycare and geriatric day hospitals fit on a continuum between

A
56
Q

where do adult daycare and geriatric day hospitals fit on a continuum between home care, assisted living, and long-term institutional care

A

.home care
= adult daycare
.assisted living
= geriatric day hospitals
.long-term institutional care

57
Q

in 1984, the Canada Health Act listed home care as an “extended service”, meaning ….

A

It was not included as an insured service covered by the Act

58
Q

the Romanow Report (2002)

A

proposed homecare become a funded program within the national healthcare system

59
Q

in 2017, the gov. of Canada pledged $6 billion for what?

A

for home care service expansion, including palliative home care, over the next 10 years

60
Q

issues for the future in healthcare

A
  1. availability: continuum of care and necessary supply of health professionals not available in all regions (especially rural)
  2. accessibility: lack of knowledge, transportation, cultural sensitivity = barriers
  3. coordination: need for complex care from multiple providers in several settings requires coordination and integration
61
Q

single point of entry model

A

provides flexibility, continuity, and quality of care for clients while controlling costs
- personalized help to each client by
a. addressing needs
b. coordinate services from multiple sources
c. monitors progress

2711 Midterm (11 decks)

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