Area of Study 2 Flashcards
Old Public Health
- Late 1800s - Early 1900s.
- Main cause of death = communicable disease.
- Focus on changing the physical environment.
Old Public Health - Practices and Policies
- Providing safe water.
- Sanitation
- Sewage disposal.
- Improved housing conditions.
- Better working conditions.
Old Public Health - Effectiveness
- Pretty successful
- Diseases like TB and smallpox were pretty much eradicated.
- After a certain point communicable diseases weren’t the primary health issue anymore.
- Main health issues now had to do with lifestyle
- Approach to health had to change.
New Public Health
- An organised response by society to protect and promote health and to prevent injury, illness and disability.
- Demonstrates an understanding of how lifestyle and living conditions influence health status.
- Aims to improve quality of life.
- Involves direct funds towards implementing polocies and programs, providing services that protect and promote health and equity.
Biomedical Model
- Focuses on the physical or biological aspects disease and illness.
- Practised by doctors.
- diagnosis, cure and treatment (also known as ‘fix-it’ or ‘band-aid’ approach)
- Works to treat diseases once they are present.
Biomedical Model - Advantages
- Enables many common conditions, illnesses and injuries to be quickly and effectively treated.
- Many causes of death that were common are able to be quickly diagnosed and effectively treated and cured =↑ life expectancy.
- Improves quality of life as many chronic conditions can be managed with medication and surgery = ↓ pain and suffering.
Biomedical Model - Disadvantages
- Relies on health professionals and tech which can be costly.
- Smaller, rural based health clinics may not be able to afford medical tech and resources.
- Dosen’t focus on the causes of ill-health
- Doesn’t encourage people to be responsible for their health, meaning that more people may get sick.
Biomedical Model - Improvements in Medical Tech
- Diagnostic Tools and Equipment - MRI scanning, CT scanning, Genetic screening for disease.
- Pharmaceuticals - Statins (reduce cholesterol), SSRI (antidepressants), Advances in vacines.
- Medical Procedures - Organ transplants, hip and knee replacements, Reproductive technology (IVF)
Social Model
- Conceptual framework.
- Improvements in health and wellbeing are achieved by directing effort towards addressing the social, economic and environemental determinants of health.
- Based on the understanding that in order for health gains to occur social, economic and environmental determinants must be addressed.
Social Model - Guiding Principles (A.R.E.A.S)
- Addresses the Broader Determinants of Health.
- Acts to Reduce Social Inequites.
- Empowers Individuals and Communities.
- Acts to Enable Access to Healthcare.
- Involves Inter-sectorial Collaboration.
Social Model - ADDRESSES the broader determinants of health
- By taking the focus off the behaviours of an individual, society is able to share responsibility for health among the most vulnerable.
- Implementing policies and changes to the environment that promote their health.
Social Model - Acts to REDUCE social inequalities
- Reducing social inequalities means addressing _____ and providing extra support to those who need it.
Factors
- Income
- Age
- Race
- Gender
- Location
Social Model - EMPOWERS individuals and communities
Community
- Providing information and resources
- Enable individuals to work collectively to address the determinants that impact health.
- Benefit the broader community group.
Individual
- Empowering them with knowledge, confidence, skills and resources.
- Enable them to make decisions and take action to promote their own health.
Social Model - Acts to enable ACCESS to healthcare
- Services and information should be readily available.
- Based on need, affordability, appropriateness and accessibility to all.
- Should also address the barriers to access such as:
- Location
- Culture
- Language
- Transport
- Discrimination
- Accessibility of Buildings
- Cost
- Knowledge
Social Model - Involver inter-SECTORIAL collaboration
Embraces the need for integrated action between:
- Government Departments (Including employment, education, social welfare and transport)
- Private Sector (Including manufacturers and service providers)
- Health Sector
Social Model - Advantages
- Doesn’t just focus on the disease once symptoms are present.
- Encourages people to make better choices and take care of their health to prevent the onset of disease.
- Education can be passed on from generation to generation.
- Less expensive than the biomedical model
- Focuses on the vulnerable population groups
- Aims to reduce social inequities
- Responsibility of health is shared
Social Model - Disadvantages
- Not every condition can be prevented (eg. genetic conditions)
- Health promotion messages may be ignored
- Doesn’t address the current health concerns of individuals (ie. those who are already ill)
- Doesn’t promote the development of technology and medical knowledge
Biomedical Model - Example - CVD
- Prescription of antihypertensive drugs to treat high blood pressure.
- Open bypass surgery to treat heart attack and blockage
- Defibrillators are used to induce shock to treat a cardiac arrest patient.
Social Model - Example - CVD
- Promoting education regarding healthy eating in schools
- Investment in increasing cycling paths or subsidised gym memberships to encourage physical activity
- Introducing legislation such as no GST on fresh fruits and vegetables.
Ottawa Charter - Building Blocks - Enable
To support people with the information, opportunities, resources and skills that they need to make choices that support good health.
Ottawa Charter - Building Blocks - Mediate
- Optimal health cannot be ensured by the health sector alone.
- Health promotion required coordinated action by all levels of government, the health sector, NGOs, industry and the media.
Ottawa Charter - Building Blocks - Advocate
About promoting and supporting initiatives that promote health on behalf of the whole community and protecting health as a resource.
Ottawa Charter - Action Areas - Build Healthy Public Policy
- Relates to decisions made by the government and organisations in relation to laws and policies relating to or affecting health.
-Aim - to put health on the agenda of policymakers
Ottawa Charter - Action Areas - Create Supportive Environments
- Making it easier for people to make healthy choices by providing a physical and social environment that promotes health gains.
- Aim - Take care of and support each other by encouraging people to make healthy lifestyle choices.
Ottawa Charter - Action Areas - Strengthen Community Action
- Encouraging people from all parts of the community to work together to achieve better health outcomes.
- Aim - Build links between individuals, communities, key stakeholders, and community centres to develop a shared health strategy in order to achieve a common health-related goal.
Ottawa Charter - Action Areas - Develop Personal Skills
- Educate and equip people with new life skills for managing and making informed decisions about their health.
Ottawa Charter - Action Areas - Reorient Health Services
- Involves individuals, community groups and health professionals and the government working together to achieve a healthcare system that promotes health.
Medicare
- Australia’s universal healthcare system
- All people have access to healthcare without facing any barriers.
- Access to healthcare at no out-of-pocket cost.
Services Covered by Medicare
- Doctors (GP)
- Specialist consultants at public hospitals
- Public hospitals (including surgery and follow-up procedures)
- X-rays and pathology tests (blood tests)
- Eye tests.
Services Not Covered by Medicare
- Treatment in private hospitals
- Dental services
- Allied Health services
- Elective treatments (eg. cosmetic surgery)
- Home nursing and treatment
- Ambulances
- Health aids (eg. glasses, hearing aids, prosthetics)
How is Medicare Funded
- Medicare Levy (2% tax to all Australian taxpayers)
- Medicare Levy Surcharge (1%-1.5% additional tax to high-earning individuals who don’t take out PHI)
- General Tax (Taking from the tax pool that all Australian taxpayers pay)
How Does Medicare Work?
Medicare covers anything that is deemed ‘medically necessary’ or ‘clinically essential’
Schedule Fee
- Almost like a ‘recommended price’ for services
- Set by the government for different services
- Doctors and health professionals can choose whether they want to follow the scheduled fee.
- If they want to charge more or less for their service.
GAP
- Medicare only pays a portion of the scheduled fee.
- The remainder of the scheduled fee is called the GAP which the patient has to pay.
- Out-of-hospital - 85% of the fee
- In-hospital service - 75% of the fee
Out-of-pocket Expenses
- Any extra money the patient has to pay for a service.
- Including both the GAP and any extras the doctor may wish to charge.
Bulk-billing
- Services are more financially accessible for patients.
- The doctor has only chosen to charge 85% of the scheduled fee.
- No GAP or out-of-pocket expenses.
Medicare Safety Net
- Extra financial support for those who incur significant GAP costs.
- Scheduled fee is usually covered for the remainder of the year.
- Only covers the GAP and not any extras the doctor may wish to charge.