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Pharm 120 Midterm Flashcards

1
Q

What is the who definition of health

A

state of complete physical, mental and social well-being and not just absence of disease

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2
Q

How does Rootman and Raeburn define health

A

bodily, mental and social quality of life of people and permit them to use their iniviatives to maintain their health

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3
Q

what are the key components and mechanism of a good healthcare system

A
  • robust financing mechanism
  • well maintained facilities
  • well trained and paid workforce
  • reliable data
  • logistics to deliver medicine and technologies
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4
Q

What is Medicare

A

Canada’s publicly funded healthcare system
integration of all 13 provincial health care systems

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5
Q

what is the main principle of Medicare

A

Universal coverage for all citizens and permanent residents to obtain health services throughout the country and between provinces

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6
Q

What are provincial governments responsible for in Medicare

A

Management, organizatin and deliver of health services

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7
Q

What is the federal governments responsibility to Medicare

A

Sets national standards for healthcare
provides funding support
support delivery for specific groups

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8
Q

What are the Main characteristics of Medicare

A

1) Curative system - curing illness
2) Fragmented- integration of 13 provincial healthcare systems
3) Mixed funding - 65-70% from government (public), 35-30% Private

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9
Q

What makes up the private funding portion of Medicare

A

Out of pocket
Private insurance

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10
Q

How was the public-private spilt impacted by covid

A

The public funding increased to 75%

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11
Q

How much does canada spend on healthcare as % of GDP

A

12.7 %

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12
Q

Where is most of the Medicare money being spent

A

Hospitals(25%), drugs(13%) and physicians(13%

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13
Q

How much of the Ontario provincial budget is spent on Healthcare

A

about 1/3

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14
Q

What services weren’t covered under HIDS

A

hospitals for tuberculosis
mental hospitals
nursing homes
capital expenditures
administrative cost

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15
Q

What are the 5 principles of the Canada Health Act

A

Universality -all residents entitled to health insurance
Portability - coverage must be maintaind if person moves
Public Administartion
Accessibiity -access to services must not be impeded by financial or other barriers
Comprehensivness- all services provided must be insured

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16
Q

What were the 3 underlie recommendations of the Momanow Report

A

1) Strong leadership to keep medicare a national asset
2) system must become resposnive and efficient
3) must make strategic investments to adress priority concerns

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17
Q

What were the differences between teh Romanow report and the Kirby Report

A

Romanow opposed private funding
Kirby supportative of increase private healthcare

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18
Q

What are the public health programs in the US

A

Medicare
Medicaid
Children’s health insurance program
Veterans Administration
Indian Health System

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19
Q

What are the 4 divisions of Medicare

A

Part A- covers Hostipal visits, free for age 65+ and anyone can get
Part B- covers outpaitent services, low deductable
Part C- private companies offer Medicare like beneifits (better plans)
Part D - RX drug plans run by private insurance companies but paid by governemts in addition to Medicare

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20
Q

What was the donut hole in Part D

A

There was a coverage gap where after a certain threshold patients had to pay out of pocket for high cost drugs

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21
Q

What is the split in funding for healthcare in US and how does it compare to Canada

A

Public - 45% and private 55%
Public 70 % and private 30%

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22
Q

What are the 4 tiers of the Medicare Part D Formulary

A

Teir 1- lowest copayement, most generic drugs
teir 2- medium copayment, preferred, brand name drugs
teir 3- higher copayment, non preferred brand drugs
Teir 4- higest copayment, very high cost drugs

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23
Q

What is Medicaid

A

state based program for poorest USA citezens

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24
Q

What is ObamaCare

A

improves access to care, improved medicare for seniors, expanded employer coverage

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25
WHat was the impact of Obama Care
Decreased the amount of uninsured people by 20 million but increased premiums, and medicare spending
26
How Does Canada compare to life expectancy to USa
Canada has higher life expentency and Candaian men life as long as USA women
27
How does infant mortality rank between Canada and USA
Canada has lower infant mortality than USA
28
How Does Canada's Health spending relate to USA
USA spends significantly more on Healthcare
29
In the 19th century how were hospitals viewed
provided care for people without homes (Poor, sailors, immigrants) Seen as community housing A place to go to die
30
Descibe the hospital and labrotory era
hosipitals evolved to a place where medical knowledge is built where patients were veiwed as cells and not humans
31
What was the Tuskegee Study
In 1932 researches wanted to study the long term effects of syphilis and when penicillin became a treatment the subjects were not given treatment
32
What are some examples of discrimination in Canadian Healthcare system
Native people are dismissed quickly, they transform their appearence
33
How were hospitals viewed in the 20th century
a place where advanced medical treatment is provided
34
How were hospitals orginally funded
charity
35
How are hospitals being funded
Money moves from MOHLTC (ministry of health) to LHIN (health integration networks) to Hospital Service Accountability agreements. where source of gov funding was hospitals global budget
36
What was the Health System Funding Reform
MOHLTC changed funding to patient based funding where funding is based on volume and types of patients served (Health-based allocation-HBA) and (quality-based procedures (QBP)
37
What makes up the majority of hospital expenditures
2/3 of expenditure is compensation and benefits excluding MDs
38
How are hospitals governed
hospitals are funded by government but are privately owned and are governed by board or directors
39
What is Accreditation
ensures that health care provided organizations are meeting set of standards accreditation is not mandatory but requied for hospitals offering residency training
40
Are Facilities in hosipitals required to be licensed
all facilities in a hospital must be licensed (ie pharmacy and med lab)
41
What is the authority within hospitals
1) admin has say on governence and staffing 2) MDs have say in pt admission, medical care and discharge
42
What is alternative Level of care
chronic patients that take up almost 1/10 of hospital beds
43
What was the More beds, Better Care Act
patients that are designated requiring ALC are to be transferred to LTC to free up acute beds
44
How can Pharmacist reduce ALC
decrease hospital readmission decrease medication incident, increase role in community
45
What are the 3 types of Residential Care
1) Retirement homes 2) Supportative Housing 3) long term care facilities
46
Out of the 3 types of residential care which has the most supportive care
Long term care facilities (LTCF) have high support where government funds services, there is 24/7 nursing services and have a contracted pharmacist
47
What is the future for long term care facilities
commitment to have 30,000 more beds by 2028 (76000 = 106000)
48
How are LTCF currently funded
extension of health service not covered by canada health act, thus provinces decide which services are funded
49
What is home care
delivery clinical care and educating clients to care for themselves by RN, social workers, pharmacist, etc..
50
What are the goals of homecare
1) help people maintain health in their own homes 2) prevent the need for acute and LTC beds
51
WHo pays for homecare
Government private donations Private insurance Out of pocket
52
what is primary care
family physcian led services that deliver health care services to individual
53
What is primary healthcare
population health in all settings and health services that capture both individuals (health services) and communities (health promotion and disease prevention)
54
What are the WHO declaration of ALma-Ata principles
Acessibility Active public participation health prmotion, disease prevention and management Use of tech and innovation intersectional cooperation and collaboration
55
What is a primary care physician
Not just family medicine specialist so many roles are involved in primary care
56
What is a primary care team
Interprofessional, integrated teams made up of many healthcare practitioners and supprt staff
57
What was the primary care model in the past
primarily single physician/private practice operated on a FFS model
58
What were the issues of past Primary care models
FFS were outdated and didn't reflect pt complexity administration had high workloads lack of support networks
59
What was the primary care reform
shift to group based practices blended FFS with base salary and bonus opportunity focused on pt enrolment, comprehensive care and alternative payment methods
60
How did COvid impact primary care
fewer canadians have a family doctor in 2023 (4% decrease)
61
what is the timely access when patients are sick
67% get same day response 33% can book same day or next day appointment and 30% have follow up appointment wuth family doctor after discharge
62
Why is their a need for comprehensive Team based care
most people dont have access to comprehensive primary care
63
What is Team Primary Care
focus of training primary care providers to work in interprofessional teams
64
What are the 4 Cs of Primary care
1) first contact 2) Comprehensiveness 3) coordination 4) Continuity
65
How do we integrate pharmacist into Primary Care teams
1) determine what will be valuble to the team and patients 2) develop a pharmacist job description (what can we do) 3) Educate team about pharmcist role 4) educate yourself about the roles of other team members 5) ensure clinic infrastructure supports pharmacsit role 6) Be highly visible and accessible 7) ensure your skills are strong 8) provide proactive care and take responsibility for outcomes 9) regularly seek feedback 10) devalop and maintain professional relationships
66
What are Social determineants of health
conditions in which people are born, grow, live, work, and age and are shaped by distribution of money, power and resources
67
What is most reposnible of health inequalites
social determinents of health
68
What is interrelationship between SDOH
a change in one area changes in another thus making solutions to SDOH equally complex
69
How should SDOH be addressed
Nurses require and understanding of SDOH and thier health outcomes to provide pateint centered care nurses can use their knowledge to advocate for system level change
70
What are the ethical principles that govern healthcare practice and which one is impacted by SDOH
Benificence Non malifience Respect for persons/justice- to treat all patients fairly and equitabily - to treat pt fairly and equitabily we must improve conditions that contribute to the inequality
71
How can pharmacist address SDOH
Community engagement and advocacy (Community) Prevention stratgies, interdisciplinary collaboration (Practice) Sensitive pt education, meds affordability (Patient)
72
What are the sustainable development goals
Universality-applied to all countries Integration - one goal success is linked to the others aspiration - goal to seek transformational solution Leaving no one behind

Pharm Cards (5 decks)

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