Module 1 Flashcards

Question

TERTIARY care

Answer 1

More specialized consultative care usually in-hospital (e.g cancer treatment, neurosurgery, cardiac surgery)

Answer 2

-25% -important provincial variation -most of health care resources go towards tertiary, quaternary

Answer 3

* Gatekeeper model * Patient choice of physician . . . up to a point * Limited “rostering”/ “empanelment” * Usually (but not always) a family doctor * Most physicians are contractors, not employees of government

Answer 4

* Access - First-contact care for each health concern * Continuity - Patient-focused (rather than disease focused) care over time * Coordination – Follow-up when services are needed elsewhere * Comprehensive – Broad range of services, referral to other services where needed

Answer 5

PRIMARY CARE ◦ “Family doctor-type” services delivered to individuals (Muldoon 2006) ◦ First-contact access ◦ Long-term continuity ◦ Coordination ◦ Comprehensiveness (Starfield 1998) PRIMARY HEALTH CARE ◦ Approach to health policy and service provision that includes population-level public health functions as well as individual patient care ◦ May also include additional principles articulated by the WHO ◦ Universal access ◦ Commitment to health equity ◦ Community participation (WHO)

Answer 6

* Public health programs and policies generally target populations rather than individuals ◦ Population health assessment ◦ Health promotion ◦ Disease and injury control and prevention ◦ Surveillance ◦ Emergency preparedness ◦ Epidemic response * Primary care has role in individual-level prevention * Cancer agencies oversee dedicated screening programs ◦ Breast cancer, cervical cancer, colorectal cancer

Answer 7

* Emergency Department (ED) ◦ Staffed by specialist Royal College of Physicians and surgeons of Canada (RCPSC) fellows or specialist family physicians ◦ ED also serves as primary care (especially after hours) for many patients * Emergency medical services (EMS) ◦ Transportation (road or air ambulance) ◦ Pre-hospital or inter-hospital patient care ◦ Some out-of-pocket payment

Answer 8

* Specialist physician ambulatory services ◦ Generally provided in outpatient departments of hospitals, some provided in private doctors offices ◦ Variety of payment models (will come back to this in later modules) ◦ Some specialist and diagnostic services may be provided in for-profit clinics * Hospital services ◦ Mostly organized by regional health authorities ◦ Some hospitals run by health authorities, some privately administered (not-for-profit)

Answer 9

* Inpatient rehabilitation ◦ Orthopedics – e.g. joint replacement surgery, amputations ◦ Stroke, brain dysfunction, spinal cord injury * Outpatient rehabilitation (often physiotherapy and occupational therapy) ◦ Also covered by: ◦ Workers compensation Private health insurance ◦ Out-of-pocket payments

Answer 10

* Prescribed by physicians, nurse practitioners, midwives, dentists (limits on classes of drugs for non-physician prescribers) * Inpatient (in hospital) drugs covered by public provincial insurance * Outpatient prescription drugs covered by some combination of ◦ Private insurance ◦ Public insurance: ◦ Every provincial and territorial government has a prescription plan that covers outpatient prescription drugs for designated populations (e.g. seniors and social assistance recipients. ◦ Coverage under Non-Insured Health Benefits (NIHB) Program for First Nations and Inuit peoples ◦ Out-of-pocket * Over-the-counter drugs also have a role to play! ◦ Covered for inpatient care ◦ Outpatient out-of-pocket plus private insurance

Answer 11

* Treatment now largely on an outpatient basis ◦ Episodic treatment in the psychiatric wings of hospitals ◦ Pharmaceutical therapies overseen by psychiatrists * Family physicians provide majority of primary mental health care * Services by non-physician providers (psychologists, counselors) largely private (health insurance or out-ofpocket)

Answer 12

* Serve older adults, as well as individuals of any age with physical or learning disabilities or chronic diseases. Also home supports available to people with short-term needs. * May be offered in a range of settings (home, assisted living, chronic care institutions) ◦ Mix of public, non-profit, and for-profit institutions * Referrals can be made by doctors, hospitals, community agencies, families and patients themselves

Answer 13

* Care provided by friends and family members plays a substantial role in health care * Some estimates suggest up to 75% of healthcare is delivered by informal caregivers, totaling 5.7 billion unpaid hours per year * Some financial support in the form of: ◦ Tax credits ◦ Compassionate Care Benefit (paid leave) * Direct support for caregivers vary widely

Answer 14

* Delivered by independent practitioners operating their own practices ◦ Private health insurance (~54%) or outof-pocket * Much lower public support than almost all wealthy countries * Wide socioeconomic inequities

Answer 15

* Covers most basic dentistry for uninsured Canadians with net household income <$90,000 * Open to seniors over 87, then applications for other age groups phased in by 2025