Public Health Flashcards
What is the principle of GP management?
shared decision making
What is multimorbidity?
having multiple chronic diseases to manage at one time
What is appropriate vs problematic polypharmacy?
Appropriate polypharmacy: where drugs are helping pt function at their max capacity
Problematic polypharmacy: prescription inappropriate
What are the core principles of the NHS?
that it meets the needs of everyone
that it is free at the point of delivery
that it is based on clinical need, not ability to pay
What is the definition of health inequalities?
Health inequalities are the preventable, unfair and unjust differences in health status between groups, populations or individuals that arise from the unequal distribution of social, environmental and economic conditions within societies, which determine the risk of people getting ill, their ability to prevent sickness, or opportunities to take action and access treatment when ill health occurs.
What is the inverse care law?
The inverse care law is the principle that the availability of good medical or social care tends to vary inversely with the need of the population served.
This was shown by Julian Tudor Hart in 1971 and still is the case today
What are the findings from the marmot review?
The more deprived the area, the shorter the life expectancy. eg sheffield bus route
Mortality rates are increasing for men and women aged 45-49 – perhaps related to so-called ‘deaths of despair’ (suicide, drugs and alcohol abuse)
Child poverty has increased (22% compared to Europe’s lowest of 10% in Norway, Iceland and The Netherlands); children’s and youth centres have closed; funding for education is down.
There is a housing crisis and a rise in homelessness; people have insufficient money to lead a healthy life; and there are more ignored communities with poor conditions and little reason for hope.
What is the structure of Maslow’s hierarchy of needs?
physiological: food; housing; money; sex; sleep; homeostasis; excretion
→ safety: security of body; employment; resources; morality; safety family; safety healthy and body
—> love/belonging: friends/ family/ intamacy
—> esteem: self-esteem; confidence; achievement; respect -
–> self-actualisation: morality; creativity; problem of solving; lack of prejudice; acceptance of facts
What is the definition of domestic abuse?
DA is between those who are over 16 yrs by partners or family, with controlling, coercive, abusive, violent or threatening behaviour - can include financial, emotional, psychological, physical, sexual
What are the 3 domains of public health?
health protection, health improvement, improving services
What is a health needs assessment?
A systematic approach for reviewing the health issues affecting a population which leads to agreed priorities and resource allocation that will improve health and decrease inequalities
a needs = ability to benefit from an intervention
What is the difference between an epidemiological, comparitive and corporate health assessment?
epidemiology - Defines problem and size of problem, Looks at current services, Recommends improvements (may not get felt need across)
comparitive - compares services of one population to another (may not be able to find good comparitive)
corporate - Takes into account views of any groups that may have an interest eg patients, health professionals, media, politicians (ppl may have vested interests)
What is the difference between bradshaws needs - ?
think of FENC
felt: indiv. perception of deviations from normal health
expressed: seeking help to overcome variation in normal health
normative: professional defines intervention for expressed need
comparitive: compare severity, range of interventions and cost
what are maxwell’s 6 dimensions for assessing health service quality? (3As and sEs)
Equity - pts treated fairly
Effective- does the intervention have desired
Efficiency
Appropriate - is the right treatment being given to the right people at the right time? is it being under/mis/overused?
Acceptable - do the people find the services acceptable
efficient - output maximised for a given input?
Access - can ppl access it
What is a health behaviour?
prevent disease eg stay active
What is a illness behaviour?
seek remedy eg go to drs
What is a sick role behaviour?
aimed at getting well eg abx
Describe the transtheoretical model of change ( think of: PC PAM)
Pre contemplation Contemplation preparation action maintainence
Describe the theory of planned behaviours
attitudes (to their behaviour), subjective norms (social pressures) and percieved behaviour control (do they believe they can control their behaviour) –> predicts intention
Describe the health belief model
Indiviudals with change depending on demographics and psychological characteristics –> percieved susceptibility to condition, percieved severity of conditions consequnces, believe taking action reduces susceptibility, benefits of taking action outweights the cost
Bolam vs Bolitho rule for medical negligence?
The Bolam Test had stipulated that no doctor can be found guilty of negligence if they are deemed to have acted “in accordance with a responsible body of medical opinion.”
The Bolitho Test helped to clarify what was meant by “a responsible body,” defining it as one whose opinion had a “logical basis.
What are the different types of medical error?
Errors of commission: doing something.
Errors of omission: not doing something
sloth systems lack of skill mistriage ignorance bravado/ timidity playing the odds poor team working communication breakdown fixation + loss of perspective
Describe the swiss cheese model
Latent failures are the first three layers, with active layer being the actual unsafe act:
organisational infleunces -> unsafe supervision -> preconditions for unsafe acts -> unsafe act
What are never events?
a serious, largely preventable patient safety incident that should not occur if available, preventative measures have been implemented.
