Module 2 lecture part 1

Question 1

Why is the US health system a public health issue?

Answer 1

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?

Question 2

What prevention level is health promotion? What state is addressed?

Answer 2

Primary
Health

Question 3

What prevention level is specific promotion?
What does it adddress?

Answer 3

Primary
Health

Question 4

What prevention level is early case finding and prompt tx?
What state does it address?

Answer 4

Secondary
Illness

Question 5

What prevention level is disability limitation? What state does it address?

Answer 5

Tertiary
Illness

Question 6

What prevention level is rehabilitation?
What state does it address?

Answer 6

Tertiary
Illness

Question 7

What strategy do most Americans associate with healthcare?

Answer 7

Disability limitation because this is where most resources are deployed

Question 8

What is the practice domain of health promotion? Who does it target?

Answer 8

Public health
Community

Question 9

What is the practice domain of specific promotion? Who does it target?

Answer 9

Public health
Community or risk group

Question 10

What is the practice domain of early case finding and prompt tx? Who does it target?

Answer 10

Public health and primary medical care
Individual

Question 11

What is the practice domain of disability limitation? Who does it target?

Answer 11

Secondary/tertiary medical care
Individual

Question 12

What is the practice domain of rehabilitation? Who does it target?

Answer 12

Long term care
Individual and group

Question 13

When can there be conflicts between medicine and public health?

Answer 13

When there are overlapping domains

Question 14

What is incidence?

Answer 14

The number of new cases of illness, injury or a health event

Question 15

What is prevalence?

Answer 15

The number of existing cases

Question 16

What is prevalence affected by?

Answer 16

Incidence and duration

Question 17

What can reduce prevalence?

Answer 17

Both incidence and prevalence

Question 18

What does primary prevention reduce: incidence or prevalence, and why?

Answer 18

Incidence because it stops dzs or conditions before they occur

Question 19

What does secondary and tertiary prevention reduce: incidence or prevalence, and why?

Answer 19

Prevalence by shortening duration and minimizing the consequences of dz or injury

Question 20

How can the US healthcare system be described?

Answer 20

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

Question 21

What is 85% of all healthcare expenditures?

Answer 21

Personal healthcare services

Question 22

What makes up half of personal healthcare service spending?

Answer 22

Hospitals
Physicians
Other clinical services

Question 23

What percentage of health expenditures is funded through the gov’t?

Answer 23

48%

Question 24

What percentage of health expenditures is funded through private health insurance?

Answer 24

33%

Question 25

What percentage of health expenditures is funded through out-of-pocket costs?

Answer 25

12%

Question 26

What was the trend of essential public health spending between 1980 and 2012 as compared to overall health spending?

Answer 26

Declined

Question 27

What was the trend of gov’t PH activity and population-based health activity expenditures as compared to overall health spending?

Answer 27

Modest increase until 2000
Decline since 2000

Question 28

What are several important demographic and utilization trends?

Answer 28

Aging pop
Ethnic and racial diversity
Changes in family structure
Persistent inequalities in access to services

Question 29

By how much will the pop over 65 and over 85 increase between 2000 and 2030?

Answer 29

Double

Question 30

Why will tx costs increase?

Answer 30

Chronic dzs become more prevalent with aging

Question 31

What role does ethnic and social diversity play?

Answer 31

Implications for health service needs
Importance of cultural competence for health professionals

Question 32

What changes in family structure are taking place? What changes in needs occur as a result?

Answer 32

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

Question 33

The non-white population is growing __ times faster than the white pop. How fast is the Hispanic pop increasing?

Answer 33

3
5x

Question 34

What are some issues related to access to health services?

Answer 34

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

Question 35

What changes in human resources have occurred?

Answer 35

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

Question 36

What changes in hospitals have occurred?

Answer 36

Community hospitals decreasing
Increase in # of hospital employees per 100 avg daily pts
Hospital outpatient visits increasing

Question 37

What changes in healthcare delivery systems have occurred?

Answer 37

Proliferation of group medical practices, HMOs, PPO, ambulatory surgery centers, and emergency centers

Question 38

Around what fraction of the US pop is being served by a managed care org?

Answer 38

1/2