MOUDLE 2 Flashcards
How much of our health is due to the health care we receive?
Only 10% - 20% of our healthcare outcomes is due to medical care, and the rest comes from other factors such as individual behaviour, environment, genetics, social circumstances.
Why does the US spend 60% of funding on medical services and resources?
- Medical care is a short-term fix, other factors such as housing take too long.
- Unwillingness to act in other areas such as poverty.
- Problems with healthcare systems
- Can’t change/ inability to affect other areas.
Identify at least 3 current health challenges faced by the OECD (worldwide)
- Financial barriers
- Recovery from Covid -19
- Unhealthy lifestyles
- Barriers to access (esp. in primary
care) - Quality of care, including patient-
centred care - Digital health has potential to
transform, but many countries ill-
prepared
Identify at least 3 current health challenges faced in NZ
- Shortage of less than 500 hospital beds
- Budget issues: 92% of vote health goes to NZ health (running services, not preventing the illness), overspending as Health NZ $130 million extra every month, the NZ vote health budget increased by 0.4%.
3.
Name the government targets
- Faster cancer treatment
- Shorter stays in emergency departments (95% of patients to
be admitted, discharged or
transferred from an emergency) - Increased rates of immunisation for children
- Shorter waits for first specialist
assessment - Shorter wait times for (non-emergency procedures) elective
treatment (95% of people wait
less than four months)
What is “gaming” in the context of health targets in EDs?
Gaming is the process of manipulating the healthcare system data, to make it seem like the target has been met, without improving the health and care of the patient. Examples are clock stopping.
How can senior manager impact gaming?
Because senior managers make priorities within the healthcare system, they become the prime motivation to game over the moral attributes of the staff.
In Tenbensel et al. (2019), what was one major concern with the implementation of emergency department (ED) targets?
Data manipulation, like clock stopping, undermined the integrity of the target
According to Tenbensel et al. (2019), what was a key reason gaming increased over time in relation to ED targets?
Organisations became more skilled at exploiting loopholes
What is SEP?
The social and economic factors that influence what positions individuals and groups hold within the structure of society. The factors must be objective, measurable and meaningful.
What are the factors to measure SEP for individuals vs populations?
Individuals = Education, Income, Occupation, Housing, Assets and wealth. Populations measures would be area measures and population measures.
What is difference between area and population measures?
Area measures are measures that measure deprivation and access in an area (neighbourhood/ suburb). Population measures are measures that measure
- Income inequality
– Literacy rates
– Gross Domestic Product (GDP) per capita
in a population (country).
What is the difference between poverty and deprivation?
Poverty refers to the lack of income and resources to obtain normal standards of living whilst deprivation is the conditions and quality of life that are of a lower standard than is ordinary in a particular society.
What is area deprivation?
Area deprivation is a measure of SEP, measuring someone’s relative position to society based on the AREA they live, not the individuals themselves.
What is the key difference between NZDep, IMD and GCH? (They are ALL measures of area).
NZDep focuses on the general deprivation in NZ using census data whilst IMD allows you to drill down to
explore the drivers of area deprivation. GCH classifies neighbourhoods on a scale from ‘Urban 1’ to ‘Urban 2’
based on population size, and from “Rural 1’ to ‘Rural 3’ based on
drive time to their closest major, large, medium, and small urban
areas.
What are the variables included in the NZDEP 2023?
Communication, income, employment, qualification, owned home, support, living space and living condition.
What section of the Dahlgren & Whitehead Model of health determinants does the area-based measures like NZDep (New Zealand Deprivation Index), IMD (Index of Multiple Deprivation), and GCH (Geographic Classification for Health) represent?
Living and working conditions.
List the points that make inequality and inequity different from each other.
- Inequality are just the measurable differences in health. This is to SEP, area, age, gender, disability and ethnic group. Inequity refers to the inequalities being unfair or stemming from injustice. These arise due to the unequal distribution of resources WHICH DO NOT REFLECT HEALTH NEEDS. The way resources are shared doesn’t match the real health problems people are facing.
List the factors that have an impact on equity.
Progress
Place of residence
* Race/ethnicity/culture/language
* Occupation
* Gender/sex
* Religion
* Education
* Socioeconomic status
* Social capital
What is the gini co-efficent? a / (a+b)
The ratio of the area between
the line of perfect equality and
the observed Lorenz curve
to the area between the line of
perfect equality and the line of
perfect inequality
What does 0 and 1 mean in the Gini co-efficent?
0= Equality (equal society) and 1 is not an equal society (perfect inequality).
What are the implications of income inequities?
An unequal society
Less social cohesion
Less trust between groups
Increased stress
Reduced economic productivity
Poorer health outcomes
Why reduce these inequalities?
They are unfair
2. They are avoidable
3. They affect everybody
4. Reducing inequities can be cost effective
Define the term access
Access is viewed as a set of more specific areas (dimensions of access) of fit between the patient and the
health care system.
Give an example of a avaiblity question.
All things considered, how much confidence do you have in being able to get good medical care for you and your family when you need it?
o How satisfied are you with your ability to find one good doctor to treat
the whole family?
o How satisfied are you with your knowledge of where to get health care?
o How satisfied are you with your ability to get medical care in an
emergency?
What is the difference between potential and realised access?
Potential is about the ability to access a certain healthcare whilst realised access is the utilisation of the healthcare services.
Give examples of avaliablity
Types of health services available
– Not all services are recognised and subsidised by ACC
– Lack of knowledge of the services and eligibility of
ACC (Potential and Realised Access)
What does the Preston curve represent?
It demonstrates the association between life expectancy and GDP (Gross Domestic Product, how much money a country makes) for different countries.
What does the gini coefficient represent?
It demonstrates the level of inequities in the population, with values ranging between 0 and 1.
