L88, 89 Flashcards
What is the difference between public health and population health?
Public Health: jumps in and deals with the problem at that point in time
Population health: Tries to see what the needs of a certain population is and to find a permanent solution for a health problem in society
What is Emergency Medical treatment and Active Labor Act of 1986
All hospitals that participate in Medicare have to and cannot turn down a pt who needs urgent health care or a woman in labor and that act was passed because of a problem that arose before
Accountable Care Act of 2010
Expand coverage of Medicaid
Covers preventative tests like colonoscopy and mammography as well as screening tests
Who does population health has to consider?
Everyone in the population, including the disparities that are separated based on income, race, …
Primary Prevention
When we do something even before the diseases occur
ex: immunization and condoms
Secondary Prevention
aims to reduce the impact of a disease or injury that has already occurred
Screening for people who are asymptomatic or managing the disease when it first starts
Tertiary Prevention
aims to soften the impact of an ongoing illness or injury that has lasting effects. This is done by helping people manage long-term, often-complex health problems and injuries
Is the surgeries, care, clinical intervention when the disease is full on there
What is the prevention paradox?
The prevention paradox describes the seemingly contradictory situation where the majority of cases of a disease come from a population at low or moderate risk of that disease, and only a minority of cases come from the high risk population (of the same disease). This is because the number of people at high risk is small.
What is an example of the prevention paradox?
Rose describes the case of Down Syndrome where maternal age is a risk factor. Yet, most cases of Down Syndrome will be born to younger, low risk mothers (this is true at least in populations where most women have children at a younger age). This situation is paradoxical because it is common and logical to equate high risk populations with making up the majority of the burden of disease.
Another example could be seen in terms of reducing overall alcohol problems in a population. Although less serious, most alcohol problems are not found amongst dependent drinkers. By achieving a small reduction in alcohol misuse amongst a far larger group of ‘risky’ drinkers with less serious problems, this will result in a greater societal gain than reducing problems amongst a smaller number of dependent drinkers.
The paradox in BP
People w/ very high BP are at highest risk of CVD so the physician monitor them more closely in comparison w people who have relatively high BP but less
However, most CVD cases come from people who have a ‘lower’ BP because they are way bigger in #
So a Public Health approach would be to take care of the high number not the high risk. So these people have a lower risk but they get the most intervention!–> paradox
How do we have to think in terms of population health?
It is not how we do better in terms of tertiary care, but in terms of how we can for the population and the individuals
what is surveillance?
It is the ongoing collection of data about a certain problem (ds) and the constant evaluation and their dissemination for the purpose of prevention
What is the expected effect of surveillance?
Going up the incline of quality but the key is to keep repeating!
What is the best level in the prevention chain?
Io > IIo > IIIo
What are the goals of surveillance?
1) Identify new diseases, Injuries, Hazards, Epidemics
2) Estimate Magnitude and Determinants of a ds
3) Targetted Intervention
4) Track trends and distribution
5) Identify failure of prevention (sentinel Health Event)
