Ch 2 - Foundations of U.S. Health Care Delivery Flashcards
Health
Absence of illness and disease
Optimum health exists when:
A person is free of symptoms.
A person does not require medical treatment.
“ A state of physical and mental well-being that facilitates the achievements of individual and societal goals.” —Society for Academic Medicine
WHO Health
“A complete state of physical, mental and social well being, not merely the absence of disease.” —WHO
Referred to as the biopsychosocial model of health
WHO defined a health care system as all the activities whose primary purpose is to promote, restore, or maintain health.
Illness vs Disease
Illness
Identified by a person’s perception and evaluation of how he/she is feeling
People are ill when they infer a diminished capacity to perform tasks and roles expected by society.
Disease
Based on a professional evaluation
Requires therapeutic intervention
Holistic Health
Treats the whole person
Incorporates alternative therapies
Has physical, mental, social, and spiritual aspects
Literature shows that:
Religious and spiritual belief has a positive impact on overall well-being.
It affects the incidence, experience, and outcomes of common medical problems.
Disease Classification
Acute
Relatively severe
Episodic (of short duration)
Often treatable (i.e., myocardial infarct, lack of kidney function)
Subacute
Some acute features
Postacute treatment after discharge (i.e., head trauma, ventilator)
Chronic
Less severe but long and continuous
Can be controlled but can lead to serious complications (i.e., asthma, diabetes, hypertension)
Quality of Life
Overall satisfaction with life during and following a person’s encounter with the health care delivery system
An indicator of how satisfied a person was with the experiences while receiving health care
Comfort, respect, privacy, security, autonomy
A person’s overall satisfaction with life and self-perceptions of health, especially after a medical intervention
Goal: To have a positive effect on an individual’s ability to function, meet obligations, feel self-worth
Determinants of Health
Environment- Physical, social, cultural, and economic factors
Behavior/Lifestyle -Diet and foods play a major role in most significant health problems.
Heredity -Predisposes individuals to certain diseases. Current lifestyles can impact future progeny.
Medical care - Access to adequate preventive and curative health care services
Healthy People 2020
10-year plans
Key national health objectives
Founded on the integration of medical care and prevention, health promotion, and education
Goals:
Attaining high-quality, longer lives free of preventable disease, injury, and premature death
Achieving health equity, eliminating disparities, and improving the health of all groups
Creating social and physical environments that promote good health for all
Promoting quality of life, healthy development, and health behaviors across all life stages
Social and Market Justice Approaches
The production, distribution, and consumption of health care must be perceived as equitable.
No society has a perfectly equitable method to distribute limited resources.
Any method of resource distribution leaves some inequalities.
A theory of justice is needed to resolve the allocation of health care.
Equitable access to health services is addressed by the theories of market and social justice.
These two contrasting theories govern the production and distribution of health care services.
Market Justice
“Economic Good”
Fair distribution of health care to the market forces in a free economy
Medical services distributed on the basis of people’s willingness and ability to pay
Health care is an economic good governed by free market forces.
Individuals are responsible for their own achievements.
People make rational choices in their decision to buy health care products and services
People consult with their physicians, who know what is best for them.
The market works best without interference from government.
The production of health care is determined by how much the consumers are willing and able to buy at the prevailing price.
Those not able to pay have barriers to health care: “Rationing by ability to pay.”
Focus on individual rather than a collective responsibility for health
Social Justice
“The Good Society”
Theory is at odds with capitalism and market justice.
The equitable distribution of health care is society’s responsibility.
Best when a central agency is responsible for the production and distribution of health care
Health care is a social good.
Should be collectively financed and available to every citizen
Health care should be based on need rather than cost.
There is a shared responsibility for health.
Factors outside a person’s control might have brought on the condition.
There is an obligation to the collective good. The well-being of the community is superior to that of the individual.
Government, rather than the market, can better decide, through planning, how much health care to provide and how to distribute among all citizens.
Planned rationing, supply-side rationing, or nonprice rationing is where government limits the supply of health care services, particularly those beyond the basic level of care.
Limitations of Market Justice
Fails to rectify human concerns, such as crime, illiteracy, and homelessness, which can significantly weaken the fabric of a society
Does not always protect the society
Individual health issues can have negative consequences for society
Does not work well in health care delivery
Focusing on Determinants
To improve the nation’s health and resolve To improve the nation’s health and resolve disparities, it is critical to address both the social and medical determinants of health.
Social Determinants of Health
The framework includes demographics, personal behaviors, and community-level inequalities and their defining influence on health.
Personal demographics (e.g., race/ethnicity or age) directly contribute to vulnerability levels.
Social and income inequalities have shown to contribute to disparities in health.
Medical Determinants of Health
The medical care system focuses primarily on treating illness or poor health.
This framework includes a broad spectrum of medical care services and interventions to improve health through preventive and primary care and through contributions to the general health status.
Others are more influential in end-of-life mortality (specialty and long-term care).
