PUBH 203

Question 1

What is a right?

Answer 1

A right is a justifies demand made of some specifiable other (who then has the obligation or responsibility to meet the demand)

Question 2

General tax

Answer 2

Mandatory payments collected from individuals or corperations by a government entity to fund government activity
- NZ health system

Question 3

Hypothecated tax

Answer 3

taxes earned for specific activities; eg ACC levies, EQC levies for insurance

Question 4

Social insurance

Answer 4

Employers and employees contribute to a scheme that covers health costs
- usually mandatory
- Government oversees scheme
- Risk pooling
- germany, Aussie, france

Question 5

Private insurance

Answer 5

Individuals arrange their own insurance (usually through their employer)
- individual choice and variety
- rationing occurs through deductibles, premiums, copayments, exclusions
- equity issues cost barriers
- united states

Question 6

Out of pocket payment

Answer 6

refers to the money that individuals have to spend for healthcare.
- used to control demand and reduce health spending
- unfunded medicines/care, full costs or co-payments
- major cause of financial hardship, bankruptcy and ill health
- equity issues, cost barriers

Question 7

What are policy instruments

Answer 7

Ways that governments implement policies; legislation/ regulation, fiscal: taxation, fiscal: expenditure, organisational change, persuasion

Question 8

Example of policy instrument: Legislation/regulation

Answer 8

Seatbelt laws, alcohol MLPA

Question 9

Example of policy instrument: Fiscal; taxation

Answer 9

Tobacco, alcohol taxes

Question 10

Example of policy instrument: Fiscal; expenditure

Answer 10

Free 1st year uni, flu vaccines

Question 11

Example of policy instrument: Organisational change

Answer 11

health system reforms

Question 12

Example of policy instrument: persuasion

Answer 12

safe drinking campaigns

Question 13

What are the 5 international health policies and goals

Answer 13

1. Sustainable development goals
2. world health organisation
3. Ottawa charter for health promotion
4. UN conventions
5. universal health coverage

Question 14

What are the 4 parts of the walt and gilson policy triangle

Answer 14

Actors, process, content, context

Question 15

Walt and Gilson: Context meaning

Answer 15

Political, economic, social,cultural,regional, national and international factors that affect/ influence policy

Question 16

Walt and Gilson: content meaning

Answer 16

What the policy is made of: visions, aspirations, ambitions, aims and objectives
AND the details of how those will be made real

Question 17

Walt and Gilson: process

Answer 17

Agenda setting
policy formulation
decision making
implementation
evaluation
(continuous loop)

Question 18

Walt and Gilson: actors

Answer 18

Individuals, groups, organisations that have power and influence at the local, regional, national and international levels.

Question 19

What are 5 key attributes of a good doctor

Answer 19

1. Technical competence
2. integrity and trustworthiness
3. good communication
4. respect and caring
5. putting patients first

Question 20

What does it mean by technical competence in terms of being a ‘good doctor’?

Answer 20

Has knowledge training experience and skills
continuously updates knowledge and skills
knows their limits
practice guided by standards and guidelines

Question 21

What does it mean by integrity and trustworthiness in terms of being a ‘good doctor’?

Answer 21

wont take advantage of patients
no financial exploitation
maintains confidentiality
ensures informed consent is always given

Question 22

What does it mean by good communication in terms of being a ‘good doctor’?

Answer 22

listens and engages with patients, explains and provides information
spends adequate time
maintains patients records
coordinates care, makes referrals, communicates with other care providers

Question 23

What does it mean by respect and caring in terms of being a ‘good doctor’?

Answer 23

Is kind, courteous and compassionate
treats with respect
respect privacy
has cultural competence, especially with respect to Maori

Question 24

What does it mean by putting patients first in terms of being a ‘good doctor’?

Answer 24

places care of the patient above all other interests
prioritises patient care over research interests
does not perform unnecessary procedures for extraneous purposes

Question 25

What are the 5 parts of the policy cycle

Answer 25

Agenda setting - problems and solutions are put into the attention of public and/or policy makers
Policy formulation - considering options and solutions
Decision making - finding an agreed upon solution
Implementation - conversion of new laws and programs into practice
evaluation - is the policy working, are goals being met

Question 26

Whats opportunity cost

Answer 26

the value or benefit of the next best alternative

Question 27

rationing/ prioritising

Answer 27

decisions made about how to allocate resources when resources are scarce

Question 28

Cost effectiveness analysis

Answer 28

cost per life (or life year) saved = cost of intervention/ lives (life years) saved

Question 29

Cost utility analysis

Answer 29

A cost- effective analysis take into account quantity and quality of life (rather than just years of life)

Question 30

economic evaluation

Answer 30

A systematic framework for explicit analysis
makes decisions based on cost + utility
requires value judgements to ensure equity and fairness

Question 31

What are three ways PHARMAC decreases drug prices

Answer 31

reference pricing
cross company deals
competitive tendering

Question 32

what is refernce pricing

Answer 32

When you compare the price of the product to the same from other companies or previous prices to get the best price

Question 33

What is cross company deals

Answer 33

When similar products are sold alongside others from the same company in order to get good deals on them

Question 34

Competitive tendering

Answer 34

When potential suppliers bid against each other in order to get a client/ contract

Question 35

What is the main way PHARMAC is able to get good deals on drugs for New Zealand

Answer 35

It is the monopsony drug buyer - meaning that theres no competition between buyers

Question 36

What are the WHO building blocks

Answer 36

Service delivery
LEADERSHIP / GOVERNANCE
HEALTH WORKFORCE
INFORMATION
MEDICAL PRODUCTS, VACCINES & TECHNOLOGIES
FINANCING

Question 37

service delivery

Answer 37

delivering safe and effective healthcare to those who need it when and where they need it with a minimal waste of resources

Question 38

Health workforce

Answer 38

A well-performing health workforce is one which works in ways that
are responsive, fair and efficient to achieve the best health outcomes
possible, given available resources and circumstances. I.e. There are
sufficient numbers andmix ofstaff, fairly distributed; they are competent,
responsive and productive.

Question 38

health information system

Answer 38

A well-functioning health information system is one that ensures
the production, analysis, dissemination and use of reliable and timely
information on health determinants, health systems performance and
health status.

Question 39

medical vaccines, products and technologies

Answer 39

A well-functioning health system ensures equitable access to essential
medical products, vaccines and technologies of assured quality,
safety, efficacy and cost-effectiveness, and their scientifically sound and
cost-effective use.

Question 40

health financing system

Answer 40

A good health financing system raises adequate funds for health, in
ways that ensure people can use needed services, and are protected
from financial catastrophe or impoverishment associated with having to
pay for them.

Question 41

leadership and governance

Answer 41

Leadership and governance involves ensuring strategic policy
frameworks exist and are combined with effective oversight, coalitionbuilding, the provision of appropriate regulations and incentives,
attention to system-design, and accountability