Health and Society/PD Flashcards
Business of Medicine, Implicit Bias, Global Health, AOSC, Ethics
What are the different types of private insurance based on funder and plan structure?
- By funder
- Self-funded/self-insured
- Group health insurance
- Individual/non-group
- Medicare/medicaid
- By plan structure
- Indemnity (unmanaged care)
- Managed care
- High Deductible Health Plan (HDHP)
Why is it important to have a sensitive case definition when you are investigating an outbreak?
It is important to identify every case
- Isolate and control the infection early
- Especially if the disease is highly contagious with terrible or unknown outcomes
What is a high deductible plan?
How does it work?
A plan with low premiums and a high deductible
Deductible is at least $1400 for an individual or $2800 for a family
The total yearly pocket expenses cannot be more than $6900 for an individual or $13,800 for a family
Limits apply to in-network services
What is the leading cause of death in Africa?
Communicable disease
Which “regulatory unit” would investigate potential conflicts of interest in research?
The ORI - Office of Research Integrity
Systemic differences in which 3 systems are the biggest sources of health disparities?
- Operation of health care systems
- Legal regulatory environment
- Discrimination
Gathering specific information about an individual to prevent group sterotypes from leading to potentially inaccurate information is an example of which strategy for mitigating implicit bias?
Individuation
Give two examples of public health insurance
Medicare
Medicaid
In an outbreak, what is the difference between a primary and secondary case?
Why is it important to distinguish between them?
Primary = from the implicated source
Secondary = infection from human infected with a primary case
Secondary cases must be exculded when you are trying to identify the source of the infection
What is indeminity health insurance?
How does it work?
Indemmity health insurance = unmanaged care
The insurer pays a percentage of whatever the hospital bill is
No networks, referrals, or requirements for a primary care provider
(These plans are less common now as insurers are doing more to control their costs)
Who sets the income that is “medicai eligible?”
States
Federal government levels teh playing field
- States with higher per-capita income get less fed. government support
- States with lower per-capita income get more federal government support
In what scenarios would you use a very specific case definition?
- Mild infections
- Limited resources
- When you are in the analysis/risk assessment stages
- You need to eliminate the influence of the false positives after the danger/panic time period is over
What is an implicit bias?
A preference for a social group that is unconscious and automatic
Rank the managed care plans from most to least flexible
- PPO (Preferred provider organization) = most flexible
- EPO (Exclusive provider organization)
- POS (Point of service)
- HMO (Health maintenence organization = least flexible
Who bears the risk in a self-insured/self funded employee-sponsored insurance plan?
How do these plans work?
The employers
The company keeps the premiums paid by employees in their own accounts, and the insurance company just administeres insurance (interfaces with hospitals, etc).
This is usually found in larger companies
The emplyer has freedom about the plans that they offer to employees
Give 4 exampels of managed care plans
How do they work in general?
PPO, EPO, POS, HMO
Each has some requirements for PCPs, referrals, in network benefits. Plans vary by fee for service vs. capitation, as well as flexibility vs. affordability
In what scenarios would it be appropriate to quarantine a patient?
A patient has a severe infection or suspicion for a possibly new or re-emergent disease
Quarentine until diagnosis is confirmed; if positive, until symptoms are over
(I think this is accurate, based on the practice test)
When should you practice beyond your scope?
Never
What requirements are needed to initiate a trial involving human participants with a severe condition?
- Feasibility
- Protocol and consent
- Recruitment plan
- Scientific and ethical review
- IRB submission and approval
- Funding (internal, external, or both)
What is the WHO’s definition of equity?
“Equity is the absence of avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically.”
Applies to health determinants, access to resources, and human rights norms
What constitutes an emerging infection?
A disease for which at least one of the following is true:
- New in humans
- New to a population/geography
- More individuals are contracting it than usual
- Has new attributes
- Ex: Drug-resistant bacteria
What constitutes an epidemic?
An increase in the number of cases of disease above what is expected
Depends on time, place, and population; relative to baseline
Rank the managed care plans from most affordable to least affordable
- HMO (Health maintenence organization = most affordable
- POS (Point of service)
- EPO (Exclusive provider organization)
- PPO (Preferred provider organization) = least affordable
Which “Regulatory Unit” would be involved in grant submission?
The OSR - Office of Sponsored Rsearch
