Intro to Primary Care Lecture

Question 1

Is healthcare universal in the US? Is it expensive?

Answer 1

Nah fam, anytime you get medical care, someone has to pay for it. Healthcare is very expensive, complications such as a broken leg without insurance could cost upwards of $30,000

Question 2

Limits to access to healthcare

Answer 2

• Income
• Location
• Citizenship status
• Race
• Social status

Question 3

Impacts of rising healthcare costs

Answer 3

• Further decreased access
• Affects poor and uninsured disproportionally
• Threatens economic growth and stability

Question 4

US Healthcare spending

Answer 4

A larger portion of GDP (17%) compared with the rest of the world, some of it due to aging populations such as elderly

Question 5

Discrepancies between US Healthcare spending and life quality

Answer 5

• Highest infant mortality rate of any industrialized nation

- 53rd life expectancy in the world

Question 6

Fee for service system problems

Answer 6

Lack focus on outcome of patient for treatment, rewarding providers for good outcomes may help combat rising costs

Question 7

Defensive medicine

Answer 7

The tendency for medical providers to over-order tests due to fear of misdiagnosing or having a bad outcome for a patient and getting involved in a lawsuit

Question 8

Methods to control costs

Answer 8

1) Cost the least while causing the least harm to the health of the population
2) Eliminate healthcare services that produce no benefit such as evidence based medicine
3) Tort reform to limit “defensive medicine” practices
4) New alternative for fee for service “pay for performance”

Question 9

Primary care

Answer 9

Health care that results in preventative care, quality care, better population health outcomes (including lower mortality), and lower costs, health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses in a variety of health care settings (e.g., office, inpatient, critical care, long-term care, home care, day care, etc.).

Question 10

Key elements of primary care (4)

Answer 10

1) first contact care
2) Longitudinal care
3) Comprehensive care
4) Coordinated care

Question 11

***What specialties constitute primary care?

Answer 11

• General/family practice
• General internal medicine
• Pediatrics
• OB/Gynecology

Question 12

Deterrents to primary care providers

Answer 12

• Lower reimbursement compared to specialists
• Extensive scope of understanding
• Limited time off

Question 13

MUA’s and advantages of employment

Answer 13

Medically underserved areas, calculated based on ratio of population per primary care physician, percent of population over 65, infant mortality rate, percent of population below poverty level, grants can be awarded to community health centers

Question 14

HPSA’s and advantages of employment

Answer 14

Healthcare provider shortage areas, with <1 primary care physicians per 3500 residents, National health service corps tuition payment, 10% increase in medicare reimbursement to clinicians

Question 15

Problems of primary care providers in rural PA

Answer 15

• 28% of PCP over 55
• 20% of family physicians considering leaving rural practice
• Lack of time off/free time for family and self
• Lack of CME activities
• Professional isolation
• Undesirable community factors
• Lack of coverage, technology, personnel