Health Care Organization, Primary Health Care and Structural Violence Flashcards
Describe health care organization in Canada.
It is a complex, diffuse, and decentralized arrangement of actors and services.
True or false. There is one single national health system.
False. There are 15 single-payer, universal, and public systems in Canada.
What is the Canadian Healthcare Act?
Canada’s federal legislation for publicly funded health care insurance
What is the primary objective of the Canadian Healthcare Act?
To protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers
What are the 5 founding principles of the Canadian Healthcare Act?
Public administration
Comprehensiveness (insurance plans coverage)
Universality (equity and equality)
Portability (care at home)
Accessibility (equity and equality)
What are functions of the federal in the healthcare system?
Establishing standards, funding, providing health care to specific groups (first nations, inuits, members of the Canadian Forces, veterans, inmates, some refugees), etc.
What are functions of the provinces/territories in the healthcare system?
All medically necessary services provided by hospitals and physicians.
“Medically necessary” is determined by provinces and territories
What is the mission of Public Health Agency Canada?
Promote and protect the health of Canadians
True or false. In Québec, the prevalence of chronic diseases is increasing faster than anywhere else.
True
True or false. In Québec, 30% of patients seen in primary care have 5 or more chronic diseases (multimorbidity).
False. 50% of them.
What is the RUIS?
Réseau Universitaire Intégré de Santé
Facilitate specialized care, medical education and research throughout the province
Favoring complementary and integration of care
Mandate to institute a culture of collaboration
What is a CLSC?
Centres Locaux de Services Communautaires
Attempt at integration at a structural level
Wide range of services : routine, prevention, nursing services, rehabilitation, reintegration, public health services
What is a GMF?
Family medicine groups
Group of family physicians who are responsible for a large group of patients and work in collaboration with nurses and other professionals
What are the goals of a GMF?
Improve access to family MD and hours available
Improve quality patient follow-up, and continuity of care
Decrease unnecessary visits to ER
What is the CIUSSS/CISSS?
Centre intégré (universitaire) de santé et de services sociaux
What is the organizational difference between the healthcare system before and after the Bill 10 reforms?
In 2004, there were 18 health and social services regional agencies, in which there were 94 health and social services centres
In 2015, there were 13 integrated health and social services centres and 9 integrated university health and social services centres
What is the goal of public health?
Keep people healthy
Prevent injury, illness and premature death
Combination of programs, services and policies that protect and promote the health of all Canadians
Name implementations of public health.
Health promotion, protection, surveillance
Population health assessment
Disease and injury prevention
Emergency preparedness or disaster response
What are the 5 levels of prevention? Briefly describe each of them.
Primordial : prevent risk factors
Primary : eliminate risk factors, prevent occurrence of disease
Secondary : detect and stop disease development before symptoms occur
Tertiary : reduce negative effects of the disease
Quaternary : identify those at risk for overmedicalization
To what level of prevention does “interrupt the chain of causality” belong?
Primary
What are the 4 pillars to prepare for emergency or plan for disaster?
Prevention and mitigation
Preparedness
Response (care)
Recovery
What is social justice?
The fair distribution of society’s benefits and responsibilities.
Focus on eliminating the causes of inequities.
Social justice involves which structures of a society?
Political, social and economic
What is health equity?
The fair distribution of resources for health.
The absence of systematic disparities in health.
What is the difference between inequity and inequality?
Inequity refers to unfair, unjust, or morally wrong disparities, whereas inequality refers to unequal distribution of resources.
What are broad approaches for health equity?
Improvement of daily living conditions
Tackling the inequitable distribution of resources
Increasing the public’s awareness of, and health professionals’ training in the SDoH.
True or false. Social determinants of health are underlying causes of poor health.
True
True or false. To improve health, one needs to think at an individual level.
False. One needs to think at a community-population level.
What can we encourage for better health at a community level? (2 examples)
Advocate for social prescribing
Referral to community-based support groups
True or false. Physicians, nurses and other healthcare providers can serve as effective health advocates and valuable resources for the community, not just for their clinic or hospital.
True
Define leadership in the field of public health.
The ability of to influence, motivate, and enable others to contribute towards the effectiveness and success of their community and/or the organization in which they work. They inspire people to craft and achieve a vision and goals. Leaders provide mentoring, coaching and recognition. They encourage empowerment, allowing others to lead
What are the general competencies of leadership?
System transformation
Achieve results
Lead self
Engage others
Develop coalition
What are the levels of care? What types of care do each of them provide?
Primary care : early detection, routine, health promotion and prevention
Secondary care : in a hospital, care provided by specialists
Tertiary care : complex care/pathologies, teaching hospitals
Quaternary care : experimental treatments and procedures
What are the 5 primary health care principles?
Accessibility
Public participation
Health promotion
Appropriate technology
Intersectoral collaboration
Describe Accessibility (PHC Principle).
Access to promotive, preventive, curative, rehabilitative, supportive/palliative care
Describe Public Participation (PHC Principle).
People are invited to participate in making decisions about the health needs of their own community. This requires to be flexible, responsive, and have a respect for diversity including alternative approaches to address those needs.
True or false. Health promotion focuses on the individual behaviour only.
False. It goes beyond the focus on individual behaviour towards a wide range of social and environmental interventions.
Describe Intersectoral Collaboration (PHC Principle).
Health and well-being are linked to economic and social policies.
Providers from accross health sectors (local, national).
What are the 3 levels of PHC interventions?
Upstream (very broad approach, working with higher forces)
Midstream (more in the field, implementing in institutions)
Downstream (more specific, promoting access to care)
What are the 8 elements of PHC (WHO)?
Education on health problems and prevention
Promotion of food supply and nutrition
Adequate supply of safe water and basic sanitation
Maternal and child care
Provision of essential drugs
Immunization against major infectious diseases
Prevention and control of locally endemic diseases
Appropriate treatment of common disease and injuries
What are the 3 main things to consider for health promotion according to the Population Health Promotion Model?
On what should we take action?
How should we take action?
With whom should we act?
What is structural violence?
Social structures that stop individuals, groups and societies from reaching their full potential (i.e. economic, political, legal, religious, cultural)
Think about how they affect the education and healthcare systems
What is anti-racism?
The active effort to eliminate all forms of racism including individual, institutional, structural, and systemic racism.
What is anti-oppression?
Actions that challenge social, historical, and existing intersectional inequities and injustices within systems and institutions that privilege groups to dominate over others.
True or false. The Indian Act’s aim is to foster respect for the Indigenous People.
FALSE. The aim is to assimilate and eradicate them >:(
How can we ensure cultural safety?
Considering the historical and social contexts as well as structural and interpersonal power imbalances that shape health and health care services.
Progress towards achieving health equity.
What is cultural humility?
Being open to the cultures of other individuals and communities.
What is the difference between reflection and reflexivity?
Reflection is used to examine our interpretations of a situation. Reflexivity is the ability to understand and question our own context.
What are the 6 critical indigenous determinants of health?
Balance
Life control
Education
Material resources
Social resources
Environmental and cultural connections
