Final Exam Flashcards
Covers Lessons 5-8
What is Health Equity?
Everyone has the opportunity to attain full health potential and no one is disadvantaged.
What are Health Disparities?
PREVENTABLE differences in the burden of disease, injury, violence, or opportunities to reach your best health.
What are the systemic causes of health inequities?
- Structural Racism
- Reduce Poverty
- Improve Income Equity
- Increase Educational Opportunity
- Fix laws and policies
What are Social Identity Groups?
- How we define ourselves based on the physical, social, and mental characteristics.
Define Culture.
Integrated pattern in human behavior
Significance of Culture Competence (CC)?
The lack of CC in healthcare a big proponent to health disparities.
Benefits of CC?
- Better Outcomes
- Patients adhere to instruction
- Patients are loyal to a specific provider
- Meet the demands of our evolving demographic.
How has APTA addressed CC?
- The APTA’s Strategic Plan on CC in 2007
What’s included in an organizational culture?
A collective’s
- Attitude
- Beliefs
- Experiences
What Core Values are Related to CC?
- Accountability
- Altruism
- Excellence
- Duty
- Social Responsibility
Define Gender Identity
A person’s deep internal understanding of their own gender
Define Ethnocentrism
The tendency to think that one’s way of thinking, acting & believing are the only ‘right’, proper and moral way to act.
Define Cultural Imposition
An intrusive projection of one’s values or behavior patterns onto others
Examples of Cultural Impostion
- Prescribing a special diet without regard to cultural beliefs with food.
- Restricting family contact, when patient believes family contact will encourage recovery.
Define Acculturation
The process of adopting culture or social patterns of another.
What is Cross’s CCC?
A linear progression from Cultural Destructiveness to Cultural Proficiency.
Define Cultural Destructiveness
Seeks to destroy minority culture.
Ex: Denying service, dehumanizing
Define Cultural Incapacity
- Superiority of the mainstream culture
- Do not seek to destroy minority culture
Ex: AAs are the best athletes
Define Cultural Blindness
Treating everyone the same regardless of culture, this reinforces the dominant culture.
Define Cultural Pre-Competence
To recognize cultural differences and seek education about racial differences
Define Cultural Competence
- Respects cultural differences
- Makes changes to accommodate
Define Cultural Proficiency
- Holds cultural differences in high regard
- Educates others
- Develops skills and partnerships with and for other cultures
What is the CLAS?
Method to reduce disparities in quality of care and improve healthcare
What is the Goal for CLAS?
Reduce overall cost of healthcare by decreasing errors or malpractice
- Secondary to cultural or linguistic misunderstandings
Benefits of the CLAS
- Increase market share of patients
- Improve patient and employee satisfaction
- Reduce health disparities
Name the CLAS Mandates
- Patient care in respect to their culture
- Promote diversity in staff
- Encourage ongoing education
Whats specifically a “Health-Care Disparity”?
- Differences in health care coverage
- Access and quality to health care
What are the reasons for Health Disparities?
- Economic/SES
- Limited minority providers
- Bias, prejudice, stereotypes
- Adherence issues
- Behavioral Risk Factors
What are the domains of the social determinants of health (SDOH)?
- Economic Stability
- Educational access and quality
- Health Care access and quality
- Neighborhood and built environment
- Social and Community Context
Examples of how the SDOH contributes to health disparities
- Limited to no access to groceries
- Only promoting healthy choices and not doing more
Life Expectancy vs. Health-Life Expectancy
Life Expectancy is the average time someone is expected to live.
Health-Life Expectancy: The amount of years a person is anticipated to live without any disease and have a good quality of life.
Who is responsible for listing the Core Health Indicators?
The World Health Organization
What are the CLAS’s Recommendation?
Healthcare organizations are encouraged to provide information to the public on implementation, progress and success in CLAS standards.
What are the goals for healthy people 2030?
- Thriving lives and well being
- Attain health-literacy
- Attain full health potential
- Promote healthy development and behavior
- Engage leadership and the public to take action to improve health.
Literacy Vs. Health Literacy?
Literacy: The ability to read, write, and speak
Health Literacy: The capacity to obtain, process, and understand basic health information to make health decisions.
What is the key takeaway from Bowen’s Article?
- The health care system needs to consider SES and demographic factors for the elderly-disabled population.
What is the aim for Public Health?
- Prevention and promotion
What is the CDC?
- Centers for Disease Control and Prevention
The role of healthcare
Intervention
- Scope is on individual’s health
Definition of Rehabilitation
Treatment for impairments caused by disease or injury
What is primary care and give an example
Diagnose and treat
- PCP (Primary Care Physician)
What is secondary care and give an example
Seeing a specialist for ongoing management of common and less frequently encountered medical conditions. As of now PTs ARE HERE.
What is tertiary care and give an example
- Specialized care requiring specific care, personnel and equipment
- Ex: Inpatient rehab
What is Primary Prevention?
- Reduce disease incidence
- Prevent disease and injury
What is Secondary Prevention?
- Aims to reduce the impact of a disease or injury.
- Reduce prevalence
- Ex: Regular exams and screening tests to detect early stages.
What is Tertiary Prevention
- Address long-term consequences
- Ex: Cardiac Rehab
- Limit the effect of an ongoing condition
Ex: Depression or Arthritis
When was the establishment of the first health care legislation?
1798; Created the Public Health Service (PHS)
When was the first nurse training program?
1872
When was the Sheppard-Towner Act on Maternity and Infancy
1921
When and Where was the first HMO Western Clinic?
1910 in Tacoma, WA
When was the FDA?
1931
When was the social security act?
1935
When was the CDC established ? (Same time as the Hill-Burton Construction Act)
1946
When was the Kerr-Mills Act?
1960; medical assistance for the elderly
When was Medicaid and Medicare enroll?
1965
When was the HMO Act?
1973; expands on funding
When was the HHS established?
1980
What is an indemnity plan?
- Premium payment to insurance and then a copay to the provider and that copay is given back to the patient as a reimbursement.
Types of Private insurance
- PPOs - Preferred Prov.
- EPOs - Exclusive Prov.
- HMOs - Maintenance
- POS - Point of Service
Perks of Indemnity plans/Fee for Service?
- Choose any medical provider
- Pay the bill upfront and send it in for reimbursement
Downside of Indemnity
- Fee is set by the provider and the insurer limits they amount they reimburse.
Characteristics of HMOs
- No deductible
- Physicians are hired
- No out of network, full restriction
- PCP first for referral
Characteristics of PPOs
- Physicians are contracted with plan
- Out of network allowed but won’t covered as much than in network
Characteristic of EPOs
- Same as PPO but no out of network care
Characteristics of POS
- Physicians are contracted
- Out of network ok
- PCP first is encouraged but not fully required
What is Capitation?
- Insurers provide health care providers with a set amount of funding per patient
Freedom of Choice based on plan
- Cash (most) (Least Delay)
- PPO
- POS
- EPO
- HMO (Least freedom)
Same for Least delay to most delay but swap POS and EPO
Balanced Budget Act
- 1997
- Greatest change to medicare and medicaid
- Cap on therapy
- Strengthened system for fraud and abuse
- Child health insurance
When was the Patient Protection and Affordable Care Act?
2010; reform for healthcare and reimbursement
Major Features of the New ACA?
-All citizens and legal residents insured
-Pre-existing conditions can receive insurance
-Cannot be dropped by insurance
- Dependents up to the age of 26, was 23
How do nurses and therapists determine effectiveness of care?
-MDS: Minimum Data Set
- OASIS: Outcome and Assessment Information Set
- FIM: Functional Independence Measure
- Connect
- Optimal
What is CONNECT?
- Computer Software for PTs that comprises a national outcomes database for determining effectiveness of PT practice.
What is OPTIMAL?
- Outpatient Physical Therapy Improvement in Movement Assessment Log
- Includes a difficulty and confidence scale
- 1 is easy and very confident
- 5 is unable to do and not confident
Anything revolving around medicare and medicaid is which government agency?
- CMS
What is the NIH involved with?
- Aging
- Arthritis, musculoskeletal and skin disease
- Child health and development
- Neurological disease and stroke
What is the CDC responsible for?
- Birth defects and developmental disabilities
- Chronic disease prevention
- Injury prevention
- OSHA
What is the ACL and what does it focus on?
- Administration for Community Living
- Aging, Intellectual and developmental disabilities
Define Advocacy
The act of pleading or arguing in favor of something, such as a cause, idea, or policy; active support.
Types of Pro-Bono
- In a Clinical Setting
- In a Community
- In a different state
- In disaster relief
Steps in the Advocacy Cycle
- Identify the Problem
- Conduct Research and Gather Data
- Establish Principles, Priorities, and outcomes
- Develop and implement advocacy plan
- Build support educate and manage opposition
- Assess and Re-evaluate
What are the components of Health Policies?
- Access
- Costs
- Quality
Ways a PT can advocate for PT Legislation at the state level?
- Attend lobby day and delegate assembly
Advocate at the national level?
- PT Political Action Committee
- PTeam/Grassroots
- Governmnet Affairs Committee
Advocate at the international level?
- World Confederation for PT
- World Healthcare Congress
How PTs can advocate for the future of the profession?
- APTA Mentoring program
- Item writers for NPTE
- Become a CAPTE member
- APTA’s Branding the PT
- Attend Student Conclave Meetings
- Fund raise for the foundation of PT
- Participate in “Celebrating PT month”
Current Advocacy Issues?
- Medicare Therapy Cap
- PT unable to bill Telehealth
-Caps on rehab: an essential health benefits - Copay switch needed from specialist to primary
-Education and Workforce Legislation - Closing Loopholes for self-referral
- Concussion Management