Lesson 6 Flashcards
What are the 5 A’s of Access
Acceptability Availability Accomodation Affordability Accessibility
What do the 5 A’s of access constitute?
A set of 5 dimensions of fit between the patient and the health care system.
What is availability?
Availability = Existence of service barriers
The relationship of the volume and type of existing services (and resources) to the clients’ volume and type of needs.
What are some examples of availability?
How much confidence do you have in being able to get good medical care for yourself and family when needed?
How satisfied are you with your ability to find one good doctor to treat your whole family?
How satisfied are you with your knowledge on where to get good health care, in normal & emergency scenario.
What is accomodation?
Accomodation = organisational barriers
The relationship between the manner in which supply resources are organised, and the expectation of clients.
What are some examples of availability?
All things considered, how much confidence do you have in being able to get good medical care for you and your family when you need it?
How satisfied are you with your ability to find one good doctor to treat the whole family?
How satisfied are you with your knowledge of where to get healthcare?
How satisfied are you with your ability to get medical care in an emergency?
What is acceptability?
Acceptability = Psychosocial Barriers
The relationship between client’ and providers’ attitudes to what constitutes appropriate care.
What are some examples of acceptability?
Appearance of the doctor’s office?
Neighbourhood of the doctor’s office?
Other patients you usually see at the doctor’s office?
What is accessibility?
Accessibility = Geographic Barriers
The relationship between the location of supply and the location of clients, taking account of client transportation resources and travel time, distance & cost.
What are some examples of accessibility?
How satisfied are you with how convenient your physician’s offices are to your home?
How difficult is it for you to get to your physician’s office?
What is affordability?
Affordability = Financial Barriers
The cost of provider services in relation to the client’s ability and willingness to pay for these services.
What are some examples of affordability?
How satisfied are you with your health insurance?
How satisfied are you the doctor’s prices?
How satisfied are you with how soon you need to pay the bill?
What is DALY’s?
The previous GBD plan only took into account mortality and NOT disability.
Summary measure of population health that combines data on premature mortality and non-fatal health outcomes (disabilities) to represent the health of a particular population as a single number.
How is DALY’s calculated?
YLD ( years lived with disability) + years of life lost ( YLL)
Why use DALY’s?
Provides a comparable measure of outcomes
Enables comparison between diseases to:
- prioritise health interventions
- monitor health interventions
- assess changes of these burdens over time
What is YLL (Years of life lost)?
Represents MORTALITY - by counting years lost due to PREMATURE DEATH caused by a disease.
i.e. the years lost if a person dies before reaching the average life expectancy of that country.
Can be counted in the form of:
Number of deaths from the disease in a year.
Years lost per death relative to an ideal age.
What is YLD (Years lived with disability)?
Represents MORBIDITY - by counting years lived with the disease.
Number of cases with non-fatal outcome with the disease.
Average duration of non-fatal outcome until recovery/death.
Disability weight.
What is a key feature of DALY’s (a strength)
Enables comparisons between diseases by using one measurement unit that compares premature death AND disability.
What is the epidemiological transition?
Characteristic shift in common causes of death and disability from perinatal and communicable (infectious) diseases to non-communicable ( chronic diseases)
What is the risk transition?
Changes in risk factor categories as countries shift from low to higher income countries, where common risks for perinatal and communicable diseases ( e.g. unhygienic water ) are overtaken by non-communicable disease risk factors e.g. tobacco.
What is the trend of the leading global risk factors contributing to the GBD from 1990 to 2015?
Increasing risk for NCDs
Decreasing risks for perinatal and communicable diseases
What is the double burden of disease?
In many lower-middle income countries previous risk for peri-natal and communicable diseases are common with increasing risks for NCD.
What are the 5 myths about NCD’s or chronic diseases? (Rich, poor, old, chronic, rich ie the rich sandwich)
Affects mostly the rich L or M.C countries should control infectious diseases first Primarily affect old people Chronic diseases can't be prevented Affects mostly high-income countries
What are the realities of the 5 Myths regarding NCD’s or Chronic diseases?
NCD’s mostly affect the poor
Double burden requires an intervention in both countries
Almost 50% of young people are affected by NCD’s, not the elderly
Significant proportions of premature heart disease strokes, cancer and diabetes can be prevented
> 80% of NCDs in low-and middle-income countries
