Module 2 lecture part 1 Flashcards
Why is the US health system a public health issue?
Less than optimal health outcomes
Lack of access to needed health services
Inconsistent quality
The excess capacity of the health system
Accountable to its ends users and ultimate payers for the quality and results of its services?
What prevention level is health promotion? What state is addressed?
Primary
Health
What prevention level is specific promotion?
What does it adddress?
Primary
Health
What prevention level is early case finding and prompt tx?
What state does it address?
Secondary
Illness
What prevention level is disability limitation? What state does it address?
Tertiary
Illness
What prevention level is rehabilitation?
What state does it address?
Tertiary
Illness
What strategy do most Americans associate with healthcare?
Disability limitation because this is where most resources are deployed
What is the practice domain of health promotion? Who does it target?
Public health
Community
What is the practice domain of specific promotion? Who does it target?
Public health
Community or risk group
What is the practice domain of early case finding and prompt tx? Who does it target?
Public health and primary medical care
Individual
What is the practice domain of disability limitation? Who does it target?
Secondary/tertiary medical care
Individual
What is the practice domain of rehabilitation? Who does it target?
Long term care
Individual and group
When can there be conflicts between medicine and public health?
When there are overlapping domains
What is incidence?
The number of new cases of illness, injury or a health event
What is prevalence?
The number of existing cases
What is prevalence affected by?
Incidence and duration
What can reduce prevalence?
Both incidence and prevalence
What does primary prevention reduce: incidence or prevalence, and why?
Incidence because it stops dzs or conditions before they occur
What does secondary and tertiary prevention reduce: incidence or prevalence, and why?
Prevalence by shortening duration and minimizing the consequences of dz or injury
How can the US healthcare system be described?
Economic dimensions
Relationship to PH
Implications of demographic trends
-Aging pop
-Ethnic and racial diversity
-Changes in family structure
-Persistent inequalities in access to services
HC resources
What is 85% of all healthcare expenditures?
Personal healthcare services
What makes up half of personal healthcare service spending?
Hospitals
Physicians
Other clinical services
What percentage of health expenditures is funded through the gov’t?
48%
What percentage of health expenditures is funded through private health insurance?
33%
What percentage of health expenditures is funded through out-of-pocket costs?
12%
What was the trend of essential public health spending between 1980 and 2012 as compared to overall health spending?
Declined
What was the trend of gov’t PH activity and population-based health activity expenditures as compared to overall health spending?
Modest increase until 2000
Decline since 2000
What are several important demographic and utilization trends?
Aging pop
Ethnic and racial diversity
Changes in family structure
Persistent inequalities in access to services
By how much will the pop over 65 and over 85 increase between 2000 and 2030?
Double
Why will tx costs increase?
Chronic dzs become more prevalent with aging
What role does ethnic and social diversity play?
Implications for health service needs
Importance of cultural competence for health professionals
What changes in family structure are taking place? What changes in needs occur as a result?
1 in 3 children live in a one-parent household
Women’s labor force participation
Married women with young children under 5 in the labor force- both increased
Access, availability, and types of services
The non-white population is growing __ times faster than the white pop. How fast is the Hispanic pop increasing?
3
5x
What are some issues related to access to health services?
US is falling behind industrialized countries in health insurance coverage
Declining health insurance coverage since 1980 for most age groups
Persistent inequalities in access to services
Poor performance on Healthy People 2010 targets for access to health
What changes in human resources have occurred?
Greater increases in women physicians and international medical graduates
More rapid growth of medical and surgical specialties; resulting in a surplus
A continuing shortage of RNs
What changes in hospitals have occurred?
Community hospitals decreasing
Increase in # of hospital employees per 100 avg daily pts
Hospital outpatient visits increasing
What changes in healthcare delivery systems have occurred?
Proliferation of group medical practices, HMOs, PPO, ambulatory surgery centers, and emergency centers
Around what fraction of the US pop is being served by a managed care org?
1/2
