Health Reform Flashcards

1
Q

What is primary care

A

Provided in home clinc or health care
Basic medical attention from a provider offer medication- prescribing services, immunizations, screening, counselling, pharmacy, dental and opthlamic care

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2
Q

What is secondary care

A

Offered in hospitals admitted for treatment- route is often through primary provider
Diagnosis treatment surgery more concered with CURE vs prevention

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3
Q

What is tertiary and quaternary care

A

Tertiary pateints requiring further specialist care in specialized facilities quaternary is super specalist ivesigatvie surgeries

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4
Q

What are two others branches of care

A

Public Health, Health promotion and Health protection
Alternative and complemnatry care

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5
Q

What is the framing of this problem

A

You want better acess to health care
Better quality/integrated patient centerd care
Spending control
Wait times
Access to services at all levels

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6
Q

What are the three type of policy legacies

A

HI: Importance of instiutions in influencing outcomes the philsophical approach not just health care hard to make a change to something that is apart of the community
PD: prior policy constraints it is hard to change the path we have done something the same way for so long
CJ: key decesions that help set future polices (canada health care act)

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7
Q

What is moral hazard

A

Insulating people from risk may make them less concerned with potential negative consequences

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8
Q

What is primary care

A

First point of contact with system; services are provided comprhensively continuously and not affected by social physical or cultural charactersitics
Focuses on the provider

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9
Q

What is PHC

A

First level of contact with the national health system close as possible to where people live and work populations as well as individuals (adresses social determinants and enviornmental determinants)

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10
Q

What is cream skimming

A

Where you take all the good patients that do not cost as much

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11
Q

What is collary

A

You have to have a system in the first place

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12
Q

What is the data saying

A

Most of the budjet is spent on health care
9 or 10th place in the world for health care

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13
Q

What is the rise in health spending on

A

General infliation mostly
Other
Population growth
Aging

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14
Q

Where is most of the money being spent

A

Hospitals

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15
Q

What groups cost alot of money

A

Babies and older population

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16
Q

Is physicans increasing

A

Yes but not enough to keep up with the population

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17
Q

What is becoming a more attractive occupation

A

Specalitist not as much as family physicans

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18
Q

What part of medicine is spending the most and the least

A

Family medicine is spending the least and thoracicardivascualr surgert and neurosurgey is spending the most

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19
Q

Where is most of the expenses going in Ontario

A

Hospitals then OHIP

20
Q

What is alphabet soup

A

all of these orginzations come together in a team to provide back coverage for each other wehn they are way or after hours

21
Q

What is a key focii

A

Chronic disease management so that they stay out of hospitals

22
Q

What is Fee for service

A

Numver of dollars per service provided

23
Q

What is blended FFS

A

Combines traditional FFS with an additonal payment for patients enrolled with the physican so might get extra money for giving there enrolled patient a flu shot

24
Q

What is blended capitation

A

Paid a set amount per enrolled patient regarldess of how many service they provide with additonal FFS for payment for non-enrolled patients or services outside the set scope

25
What is blended salary
Recieve a base salary for their time but can earn additional income trhough premiums and incenetives for meeting performance or quality goals
26
What are PROMS
Measurement tools that patients use to provide information on aspects of their health status that are relevant to their quality of life including symptoms functionality and physical mental and social health
27
What is belended complement
Payment depends on the number of physicanians in the organization combined with additional premiums and incentives for working in undeserved or rural areas
28
What are PREMS
Help to understand a patients experience when they recevied health care
29
What is PROM short term and long term
Short term is feedback on immediate individual care Long term is on longer cilincal outcomes
30
What is PREM short and long term
Short - feedback on current intergration of care Long - Feedback on system of integrated care
31
What is activity based-funding
The type and volume of services provided Complexity of the patient population
32
What is a case mix
Takes different patients high needs vs low needs and measures them using a standardized tool
33
What is resource intensinty weight
How many resources does that person reuqire and there stay
34
What do they use mental health
SCIPP
35
Hospital budjet is mostly what
Case mix based
36
What is the health based allocation model
Rehabilitation and complex care
37
What is bundled care
Where knee or hip replacment removes the ability to remove patients early one provider is payed and they have to negoiate with other people that provided care Hospital will be payed then work out an agreement with community
38
What is OHT
Where there patient and data is provided to all providers so better hand off information follows the patient standardized records
39
What are QBPS
Funding for QBPS follows the patient
40
What is HBAM
Looks at the personal profile in the health card how many people in the area recieve services based on those people and their needs and how much do we expect to cost (take the people and what needs to be and how many units of stroke activity will be see and how many dollars will be pay for stroke activity)
41
What is wrong with HBAM
Every hospital is different so you have to tweak it
42
What are advantages of bundle care
Bridge the gap between health care facilities
43
What is disadvantages
Hard to find providers that want to be held accountable who gets paid and when has to have some encomy is something
44
What is payment price
Payment price is set for each case mix group in advance of the funding period
45
What is payment by patient
Providers are paid a set price for each patient they treat
46