module 3 - economics and healthcare

Question 1

what does public health economics focus on?
- goal

Answer 1

production, distribution, and consumption of goods + services as r/t public health
- goal: increase QOL for general population

Question 2

“country’s price tag”, consumer spend, gov spend, importing + exporting = is the economy growing or NOT

Answer 2

gross domestic product

Question 3

examples of quality indicators

Answer 3

readmission rates, pressure ulcer #s, infant mortality rate, life expectancy

Question 4

explain the following factors that affect resource allocation
- uninsured
- access to services
- rationing

Answer 4

• uninsured: people without insurance = NOT LIKELY to seek healthcare unless emergency
• access to services: can ppl even reach the services they need
• rationing: how to distribute limited resources

Question 5

solutions that the affordable care act has created for resource allocation?
- marketplace
- medicaid expansion
- insurance

Answer 5

• marketplace: allows people to buy own insurance if qualified
• medicaid expansion: more ppl qualified
• insurance: raised age of staying on parents’ insurance (26yrs)

Question 6

___ and ___ have the greatest effect on longevity

Answer 6

behavior + lifestyle

Question 7

___ and ___ have the greatest effect on the development of illness

Answer 7

environment + biology

Question 8

where do the largest portions of health spending come from?

Answer 8

physician services + care in hospital settings

Question 9

t/f: more diverse individuals d/t health disparities are known to have poorer healthcare

Answer 9

true

Question 10

what is defensive medicine

Answer 10

doctors order ALL tests to make sure everything is ruled out (but expensive)

Question 11

who is eligible for medicare

Answer 11

> 65yrs, disabling illness, ALS, ESRD

Question 12

who is eligible for medicaid

Answer 12

specified low income; needy, children, aged, blind, and/or disabled; those eligible to receive federally assisted income

Question 13

insurance for military members

Answer 13

tricare, VA

Question 14

federal program for Native Americans + Alaskan Natives

Answer 14

indian health services

Question 15

group where county funds come from property taxes; federal funding from grants/special programs

Answer 15

health departments

Question 16

what are block grants?

Answer 16

federal government funds given to local government
- General provision on how it’s spent
- Lets community ID and prioritize their needs WHILE capping spending to what is received

Question 17

explain the following types of private support insurance
- PPO
- HMO
- third party

Answer 17

• PPO: network covered (more flexibility), can go out of a healthcare company (ex. advocate)
• HMO: pick PCP, PCP has to give referral for you to access HC somewhere else
• third party: decides what they cover

Question 18

retrospective reimbursement
- explain
- encourages:
- disadv:

Answer 18

traditional fees for services; set AFTER services are given (“fee for service”) ; based on cost per unit of services
- encourages: inflation of prices in one area to offset losses
- disadv: cost shifting

Question 19

prospective reimbursment
- explain
- encourages:
- disadv

Answer 19

amount of $ to be paid established before services are offered (3rd party payer)
- encourages: orgs stay within budget limits; gives incentives for providing less services to control costs
- disadv: overemphasize controlling costs + compromises QOL