Module 11 lecture, part 2 Flashcards
Critical policy issues
Access to care
Cost of care
Quality of care
Role of research in policy development
Cost of care and critical policy issues
Cost containment through payment cuts to providers
PPS: successful in curtailing inpt cost only
Subcategories of access to care and critical policy issues
Providers
-Ensuring a sufficient number and desirable geographic distribution
-The # of health professionals affects policies related to access and cost
Integrated access
Three main concerns in Medicare policy
-Spending should be restrained to keep the program viable
-The program is not adequately focused on the management of chronic conditions
-The program does not cover long-term nursing home care
Minorities
Rural areas
Low income pop
Persons with AIDS
Quality of care and critical policy issues
Six areas for quality improvement in the “Crossing the Quality Chasm” report by IOM (2011)
Research on quality by AHRQ
Malpractice reform
Role of research in policy development
Documentation: gathering, cataloging, correlating of facts
Analysis: feasibility, efficacy, practicality of an intervention
Prescription: research that shows a course of action
8 forces of future change
Social and demographic forces
Economic forces
Political forces
Technological forces
Informational forces
Ecological forces
Global forces
Anthro-cultural forces
Demographic changes and effects and future change
Demographic changes: becoming bigger, older, and ethnically diverse
Effects on:
-The need for health care
-How the needs will be met
-The nation’s ability to afford HC: expanding gov’t programs on an unsustainable financial path
-Implications for supply of health professionals
Cultural factors will create ongoing challenges
Uninsured immigrants without documents tap into resources
Personal lifestyle choices cannot be fully incentivized
Economic forces and future change
Factors determining the availability, cost, and affordability of HC svcs
-National debt: spending cuts, tax increases, and economic growth needed
-Economic growth
-Employment
-HH income: incomes have fallen
Uncertain effects of the ACA on employment and income
Political forces and future change
Policy intertwined with almost all aspects of HC delivery
-Education and immigration policies affect the number and qualifications of the HC workforce
-Effects on total economic spending and taxes
-Americans remain divided on major policy issues, including HC
Technological forces and future change
Tech will continue to revolutionize HC, but cost increases will create challenges
Technologies that increase self-reliance and cost efficiency will receive much attention
The overall effect of tech: an increase in costs without utilization control measures
Informational forces and future change
IT’s numerous applications in HC delivery
Indispensable tool for managing HC orgs
Garnering IT’s potential for HC delivery and management of HC orgs will continue well into the future
Ecological forces and future change
Major implications for PH
-New dzs
-Natural disasters
-Bioterrorism
World pop growth
-Intensify human-animal-ecosystems interface
-Probability of engendering new dzs
Dealing with new ecological threats
-Will divert resources from routine HC
Global forces and future change
Globalization intensifies cross-national cultural, economic, political, social, and technological interactions
-Health and HC will be affected in diverse ways through multiple pathways
-Example: the effectiveness of professionals that are part of “brain drains” or “brain gains”
Some signs of increasing globalization
Drugs manufactured in Asia to be exported to western nations
Medical tourism
Cross-border telemedicine
Desire of foreign hospitals and clinics to move into the US
Anthro-cultural forces and future change
Beliefs, values, ethos, and traditions
Espoused primarily by the middle class Americans
Historically, acted as a strong deterrent to radical changes in HC
Opposition to ACA