Health Reform Flashcards
What is primary care
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
What is secondary care
Offered in hospitals admitted for treatment- route is often through primary provider
Diagnosis treatment surgery more concered with CURE vs prevention
What is tertiary and quaternary care
Tertiary pateints requiring further specialist care in specialized facilities quaternary is super specalist ivesigatvie surgeries
What are two others branches of care
Public Health, Health promotion and Health protection
Alternative and complemnatry care
What is the framing of this problem
You want better acess to health care
Better quality/integrated patient centerd care
Spending control
Wait times
Access to services at all levels
What are the three type of policy legacies
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)
What is moral hazard
Insulating people from risk may make them less concerned with potential negative consequences
What is primary care
First point of contact with system; services are provided comprhensively continuously and not affected by social physical or cultural charactersitics
Focuses on the provider
What is PHC
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)
What is cream skimming
Where you take all the good patients that do not cost as much
What is collary
You have to have a system in the first place
What is the data saying
Most of the budjet is spent on health care
9 or 10th place in the world for health care
What is the rise in health spending on
General infliation mostly
Other
Population growth
Aging
Where is most of the money being spent
Hospitals
What groups cost alot of money
Babies and older population
Is physicans increasing
Yes but not enough to keep up with the population
What is becoming a more attractive occupation
Specalitist not as much as family physicans
What part of medicine is spending the most and the least
Family medicine is spending the least and thoracicardivascualr surgert and neurosurgey is spending the most
Where is most of the expenses going in Ontario
Hospitals then OHIP
What is alphabet soup
all of these orginzations come together in a team to provide back coverage for each other wehn they are way or after hours
What is a key focii
Chronic disease management so that they stay out of hospitals
What is Fee for service
Numver of dollars per service provided
What is blended FFS
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
What is blended capitation
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
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
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
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
What are PREMS
Help to understand a patients experience when they recevied health care
What is PROM short term and long term
Short term is feedback on immediate individual care
Long term is on longer cilincal outcomes
What is PREM short and long term
Short - feedback on current intergration of care
Long - Feedback on system of integrated care
What is activity based-funding
The type and volume of services provided
Complexity of the patient population
What is a case mix
Takes different patients high needs vs low needs and measures them using a standardized tool
What is resource intensinty weight
How many resources does that person reuqire and there stay
What do they use mental health
SCIPP
Hospital budjet is mostly what
Case mix based
What is the health based allocation model
Rehabilitation and complex care
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
What is OHT
Where there patient and data is provided to all providers so better hand off information follows the patient standardized records
What are QBPS
Funding for QBPS follows the patient
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)
What is wrong with HBAM
Every hospital is different so you have to tweak it
What are advantages of bundle care
Bridge the gap between health care facilities
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
What is payment price
Payment price is set for each case mix group in advance of the funding period
What is payment by patient
Providers are paid a set price for each patient they treat
