Chapter 13- The consumers of health care (Exam #2) Flashcards
1
Q
Describe the imperfect relationship between the need and the demand for healthcare.
A
- consumers who need health care services don’t use them
- consumers who don’t need them use them a lot
2
Q
What serves as intermediaries between health care consumer and the point of service?
A
third-parties
3
Q
Historically, who is the “gatekeeper”?
A
physicians
4
Q
____________ have begun taking a more active roll in decision making when it comes to health care consumption.
A
Third-party payers, government health care financing agencies and employers
5
Q
21st century health is defined as what 3 elements?
A
overall well-being, including physical, mental and social elements.
6
Q
T/F?
A customer or patron is described as a person who purchases a product or nonprofessional service such as groceries or a new suit?
A
true
7
Q
Client or Patient ?
Individuals served by health care providers?
A
patients
8
Q
____________ are defined as individuals awaiting or under medical care or treatment.
A
patients
9
Q
T/F?
Patrons are described as customers of professional services?
A
false
-clients
10
Q
What are RPh focusing there services on? (7)
A
- management of medication therapy and health
- the sale of health foods
- focus on supplements
- capitalizing on holistic approach
- selling candles or aromatherapy
- screening and immunizations
- referring to other services (hypnosis, PT, massage)
11
Q
What is the negative side effect the shift towards consumerism?
A
HCP can target audience and help who they want and avoid the ones that they don’t
12
Q
What do health care consumers ethically expect from professional practioner? (4)
A
- non-malfeasance
- beneficence
- justice
- veracity
13
Q
non-malfeasance
A
acting in a manner that places the patients welfare above self- interest; that will do no harm to the patient
14
Q
beneficence
A
help the patient meet his or her needs
15
Q
justice
A
to treat patients in a fair and equitable manner
16
Q
veracity
A
be truthful with patients in providing information about their health status
and treatment
17
Q
__________ was created when consumers were not willing to pay for health
care services for which the provider incurred cost
A
incongruities
18
Q
Where do consumers most often get their health
information? (2)
A
- Direct-to-consumer advertising
- Use of the Internet by health care consumers
19
Q
Why is money spent to advertise a product? (3)
A
- create demand
- convince the patient that they are suffering from a condition
- dispel myths
20
Q
What causes deterioration in the patient-provider relationship?
A
DTC advertising that convinces the patient that they are suffering from a condition….
21
Q
Cons to Internet Use by health care consumers?
A
the high probability that the information is incorrect, misleading, biased, medically, unproven, or even dangerous.
22
Q
Pros to internet use by providers? (2)
A
- remote access to databases
- telemedicine
23
Q
telemedicine
A
the use of electronic information and communications technologies to provide and support health
care when distance separates the participants
24
Q
Pros to internes use for pharmacist? (3)
A
- communicate w/ patients in an efficient manner
- receive prescriptions electronically
- access to up-to-date info on a mobile device
25
How is age impacting health care behavior (3)?
- chronological
- psychological
- social
26
Which "aging" refers to changes in the ability to function due to changes in cells and tissues?
chronological
27
Which "aging" refers to constant changes in cognition (the ability to think and reason, i.e., mental activities) and personality.
Psychological
28
Social aging refers to what? (2)
(1) changes in social relationships that define social
status within a society (e.g., married versus single) and (2) the various roles
people are expected to play at various stages in life
29
T/F?
| The three concepts of aging are independent of one another?
true
30
What can affect both psychological and social aging?
Chronological aging
31
T/F?
| Psychological aging can affect both chronological and social aging?
true
32
What has implications for chronological and psychological aging?
social aging
33
What are the 3 basic, generic models of the patient-provider relationship?
- expert
- social contract
- engineering
34
Name the model: practitioners makes decisions
Expert model
35
Name the model: Mutual participation in decision
| making
Social contract model
36
Name the model:Patient makes informed
| decisions as the MD offers knowledge
Engineering model
37
Thomas Szasz and Hollender (2)
Two of the early pioneers in conceptualizing the doctor–patient relationship.
-Fiduciary relationship behavioral model
38
Activity-passivity
MD:does something to the patient
Patient: doesn't respond
Prototype model: Parent-infant
i.e : anesthesia, acute trauma, coma, delirium
39
Guidance-cooperation
MD- tells the patient what to do
Patient- obeys/cooperates
Prototype model: Parent-child, parent-adolescent
i.e.: Acute infections, other acute illnesses
40
Mutual participation
MD-Helps the patient help him- or herself (uses expert
help)
Patient- Participant in partnership
Prototype model: Adult-adult
i.e.Most chronic illnesses, psychotherapy
41
Sick- role behavioral model- Talcott Parsons
a model based on the premise that illness is disruptive in a society.
42
Talcott Parsons says
a truly sick person should be temporarily relieved
| from some of his or her obligations and responsibilities while recovering from an illness.
43
What model is the most traditional and closely parallels the activity–passivity and guidance–cooperation models proposed by Szasz and Hollende?
The model of the sick role
44
Sick-role behavior
activity undertaken by individuals who
consider themselves to be ill, or who have been diagnosed by a health professional
as being ill, for the purpose of getting well.
45
Health behavior
any activity undertaken by an individual who believes him- or herself to be healthy, for the purpose of preventing illness or detecting disease in the asymptomatic stage.
46
Illness behavior
any activity undertaken by a person who believes he
or she may be ill for the purpose of defining his or her state of health and discovering a suitable treatment or remedy for the problem.
47
Patient's status: sick role- obligations (3)
- To be motivated to get well
- To seek technically competent help
- To trust the physician
48
Patient's status: sick role-Privileges (2)
- Exemption from performance of normal social role
obligations
-Exemption from responsibility for one's own state of
illness
49
Doctor's status: professional role- responsibility (5)
-To act for the welfare of the patient (orientation
toward the collective versus self )
-To be guided by the rules of professional
behavior (universalism versus particularism)
- To apply a high degree of achieved skill and
knowledge in solving problems of illness
-To be objective and emotionally detached
(affective neutrality)
-Professional self-regulation (to monitor
competence and ethical behavior)
50
Doctor's status: professional role- rights (3)
-Access to physical and personal intimacy
necessary for diagnosis and treatment
-Professional autonomy
-Professional dominance
51
Individual consumer behavior: a Five-stage model
- Need arousal
- Information gathering
- Decision evaluation
- Decision execution
- Post-decision assessment
52
Need arousal
What needs or wants are identified by the individual that
| may give rise to interest in searching for a product or service?
53
Information gathering:
How does the individual gather information relevant
| to determining what product or service to select?
54
Decision evaluation:
How does the individual evaluate the alternative
| under consideration?
55
Decision execution:
What action does the individual take after the best
| alternative is selected?
56
Post-decision assessment:
How does the individual’s post-purchase experience affect his or her subsequent attitude and behavior toward the product or service provider?
57
When do people consider themselves ill?
- interferes w/ normal activity/function
- Symptoms are clear and tolerance threshold is exceeded
- attach causes to symptoms due to pervious illness/ref group
- assumes prognosis of the illness is serious
58
What determines health? (4)
- genetics/biology
- physical environments
- social environment
- health care
59
What effects 85% of your health? (3)
- genetics/biology
- physical environment
- social environment
60
What effects 15% of your health care?
-health care
61
Prosperity is linked to _________?
health
62
10 Leading causes of death (2000)
```
Heart disease
Cancer
Major Cardiovascular disease
Chronic lower respiratory disease.
Accidents
Diabetes mellitus
Influenza/pneumonia
Alzheimer’s disease
Kidney disease
Septicemia
```
63
What has contributed to less deaths ? (3)
- Improvements in standard of living or lifestyle, including personal hygiene, diet, nutrition and housing
- Advances in public health
- Progress in medical practice
64
What contributed to death in now and in the future?
Diseases of affluence contribute to chronic illness
65
Things that contribute to diseases of affluence contribute to chronic illness? (4)
- Sedentary lifestyle
- Poor diet
- Smoking
- Alcohol abuse
66
T/F?
| As time goes on people are living longer?
true
67
Obesity contributes to _______ and _______?
-disease and health care cost
68
By the year 2030 _____% of adults age 20-74 will be obese.
50
69
T/F?
| Physician visits have increased over the years?
true
- 2.6% in 1928
- 5.8% in 1996
- 13% w/ 10 or more visits per year 2010
70
Patients are getting more involved in their healthcare and are now demanding what ? (3)
- better information
- better processes
- better insight into what they are paying for
71
What is driving consumerism? (3)
- Chronic diseases
- Information accessibility
- Healthcare market reforms
72
What is reforming in the healthcare market to drive consumerism? (3)
- Insurance
- Quality control regulations
- FDA role in direct-to-consumer advertisement
73
What are the 3 E's of Healthcare Consumerism?
- Empathy
- Empowerment
- Engagement
74
Szasz and Hollender's 3 Models of Care
- Activity-Passivity
- Guidance-Cooperation
- Mutual Participation
75
T/F?
| Mutual Participation is similar to Activity-passivity.
false
| -social contract
76
Patient- centered model vs. disease-centered?
MD's are more engaged with the patient overall not just concerned with disease.
77
Practitioners encouraged to view the illness through the patient’s eyes by considering what 4 key elements.
- Understand patient’s ideas of what is wrong.
- Elicit patient’s feelings about illness.
- Ask how the problem affects daily life.
- Know the patient’s expectations regarding treatment.
78
Bio-psychosocial model
Came about due to dissatisfaction with biomedical model
79
Bio-psychosocial model involves what 2 things?
- Physical and social context
| - Emotional and psychological state
80
______________ Deals with Poverty, place of residence, environmental pollution, diet, exercise
Physical and social context
81
_______ deals with stress.
Emotional and psychological state
82
Cultural sensitivity
is a set of skills that enables you to learn about and get to know people who are different from you, thereby coming to understand how to serve them better within own communities
83
Cultural competency
is the integration and transformation of knowledge about individuals and groups of people into specific standards, policies, practices, and attitudes used in appropriate cultural settings to increase the quality of services; thereby producing better outcomes
84
Health Practices (5)
- prayer
- rituals
- folk remedies
- herbs
- alternative health practioner
85
Family unit is important and influences health care decision making in what culture?
Latinos
86
Health beliefs regarding illness
| 2
- Causative factors of illness
| - Personal views regarding specific illnesses
87
Which culture believes in karma and rely on health providers /accepting of suggestions
Indian subcontinent and Middle Eastern population
88
Which culture is concerned about our HCS/ socialized medicine and views our system as bureaucratic
Eastern European
89
What culture subscribes to hot-cold disease explanatory model and tend to have a rapid response to therapy expectations
Asians
90
What culture is less trusting of physicians and more concerned about privacy and unsanctioned harmful exp.
African American and blacks
91
T/F?
| There is NOT racial discordance among some ethnic groups
-false
| IS
92
Who documents racial and ethnic disparities in healthcare based on social, economic and systematic bias?
Institute of Medicine (IOM)
93
_________ states the having a Diverse workforce of health professionals is an important part of eliminating disparities in the U.S.
American College of Physicians (2004)
94
___________ is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions
Health Literacy
95
How many American's lack necessary literacy skills to function in the health care system?
90 million (1/4) or 25%
96
What % of adults have the necessary health literacy skills to manage all aspects of their healthcare according to the 2007 National Healthcare Disparities Report?
12
97
What are the 4 Communication Strategies
- Communicate message at the 5th grade level or lower
- Use pictures and models
- Use the teach-back or show-me techniques to assess patient understanding
- Encourage patients to use “Ask me 3”
98
Encourage patients to use "Ask me 3"
- what is my main problem?
- What do I need to do? And
- Why is it important for me to do this?
99
What type of behavior describes a healthy person trying to maintain their health?
Health behavior
100
What type of behavior describes a possibly sick individual discussing with others (lay-referral system) or making appt.
Illness behavior
101
What type of behavior describes individuals who are taking medication after being diagnosed.
Sickness behavior
102
HBM- Health Belief Model (3)
1. Individual Perceptions
2. Modifying factors
3. Likelihood of Action
103
Which part of the HBM involves individuals perceived benefits of preventive action MINUS perceived barriers to preventive action
Likelihood of Action
104
Locus of Control (another behavioral change model) (2)
1. Internal
| 2. External
105
Locus of Control Internal
I control the consequences of my behavior
106
Locus of Control External
The consequences of my behavior are outside of my control
107
Social Cognitive Theory
"Self-Efficacy"
| believing oneself capable of successfully performing certain behaviors or reaching certain goals
108
What affects behavior? (4)
- attitude towards act/ behavior
- subjective norm
- behavioural intention
- behaviour
109
Trans-theoretical model of change was developed to ?
understand why attempts to change fail or succeed
110
Compliance
Patient following or “complying” with a health professional’s recommendations.
111
What implies a patient choice in making the decision to follow health professional’s
recommendations?
Adherence
112
What factors affect adherence? (5)
- Health system
- Social/economic
- Condition-related
- Patient-related
- Therapy-related
113
What Requires collaboration between patient and healthcare provider?
Motivational Interviewing
114
T/F?
| Motivational Interviewing is the patient-centered approach that focuses on patients ambivalence to change
true
115
Motivational Interviewing key principles
- Expressing empathy
- Developing discrepancy
- Rolling with resistance
- Avoiding argumentation and
- Supporting self-efficacy
116
T/F?
| The patient is more likely to be YOUNGER and MALE?
false
| -older and female
117
T/F?
| Patients are more likely to be Obese or overweight
true
