lecture 9 Flashcards
how is healthcare defined?
Services provided to individuals or communities by agents of the health services or professions to promote, maintain, monitor, or restore health
- Not limited to medical care (therapeutic actions by or under the supervision of a physician)
- sometimes extended to include home care and self-care
what is the medical model of healthcare?
focuses on the treatment of diseases and injuries
- favours surgery/ drug therapy, and rehabilitation through physical therapies
- usually in the physicians office, a hospital or other formal and regulated healthcare institutions
- influenced by the payment system
what is the social model of healthcare?
sees medical care as one part of a complete healthcare system
- includes personal/ family counselling, home care, and adult daycare programs as part of the healthcare system
- tries to keep older people in their own homes (aging in place)
- includes long term care, which combines medical/ nursing care with social and community services
multidisciplinary
Clinicians still important contributors but not the only or the centre
what is the healthcare promotion model?
focuses on prevention and self-care
- aims to prevent disease through lifestyle change, increased knowledge about healthy behaviour, and environmental improvement
- includes programs that promote fitness and those that warn about
- actions that most people do not associate directly with healthcare: workplace safety regulations, seatbelt legislation, pollution control
Easily intergrateable into the social model
what are the 4 ‘stages’ in the healthcare and health care practitioners ‘pyramid’?
-top of pyramid-
tertiary care
- regional level or provincial
- highest cost per person
- advanced/ prevents morbidity
secondary care
- district
- some of the population
- moderate cost
- reduce severity/ manage comorbidity
primary care
- local
- most of the population (access)
- interprofessional care team
- prevention and management
self-care, community programs, public health
- region and provincial
- population-wide
- low cost per person
- focus on prevention through policy and education
-bottom of pyramid-
Canadian healthcare system is a mixture of which 3 models?
medical
social
health promotion
what is the main challenge of the Canadian healthcare system?
- wait time
- issues with continuity of care and transition to long-term care
what is the Canadian Health Act (1984)?
what 5 main criteria MUST be achieved?
- publicly funded health care insurance
- national standards for each province and territory
- public (non-profit) administration
- comprehensiveness
- universality
- portability
- accessibility
note*
Costs Canada;
- almost 12% of the GDP and increasing
- mostly for medical costs
Older people accounted for what % of all provincial and territorial government health spending?
44%
true or false:
older people see specialists and generalist practitioners more often than younger people
true
true or false:
older people are more likely to be hospitalized and spend longer in hospital
true
The proportion of health system expenses spent on seniors has been stable over the last decade
In all the time periods, population aging adds _____ (less/more?) than ___% to the growth in healthcare costs.
less than 1% in the growth in healthcare costs
true or false:
population aging is the main reason for growth in healthcare expenses
false
population aging is NOT the MAIN reason for growth in healthcare costs
healthcare access note*
reasonable access is a human right
impacts all aspects of health
Canada Health Act addresses all Canadians
what are some inequities in accessing healthcare?
geography
socio-economic status
cultural values
what were the results in the study of 38,574 women older than 65yrs with Medicare coverage undergoing breast cancer treatment (radiation therapy).
- white women had the shortest delay in initiation of treatment due to close proximity or RT facility to their residence
- the distance traveled by a patient to a RT facility had the biggest impact on the variation in timing of RT initiation
what needs need to be addressed for older adults?
- more homecare
- also, for emotional and social needs - transfer from acute care to chronic or long-term care
- not covered totally by OHIP
(these affect the poorest older adults)
what are some benefits of home and long-term care?
safety
social interactions/ physical activity
nursing/ medical care
note*
consider answering these when studying:
- Which factors contributed to excess mortality in the time period
between March 2020 to Sep. 2021? - Which population(s) were more vulnerable?
- How do you explain within-Canada differences?
what % of excess mortality in NW territory and what % directly due to COVID?
1% excess and 10% directly due to COVID
- probably more deaths were indirectly related to COVID
the proportion of older adults who live in a long-term care facility ______ (increases/ decreases?) with age
increases
true or false:
(long-term care in old age)
the Canada health act does not include all nursing home care costs in its definition of covered services
true
true or false:
(long-term care in old age)
costs remain the same across provinces
false.
costs vary considerably by province
takeaway lecture notes*
➢The key to a productive and healthy aging population is application of wholistic ‘healthcare’ not a “sickness treatment system”
➢By addressing all aspects of health
➢Dynamic combinations of health promotion, social, and medical models
➢With constant adjustments and evaluations
➢Main issues in old age are lack of a proper plan for continuity of care, mismatch between required continuity of care and the Canadian system, and unaddressed vulnerabilities of older adults in long-term care facilities
