Revision EH - what need to know Flashcards
what is the medicare rebate for:
a) GP services
b) out-of-hospital services
c) in-hospital services
a) 100%
b) 85%
c) 75%
What is a schedule fee vs a reccommeneded fee?
SF= Fee for a given service set by the AUS government
RF= guide for doctors with suggested fees set by AMA
What does ‘the gap’ in medicare refer to?
difference between total cost of med treatment and schedule fee
What is the PBS safety Net and it’s purpose?
safety net threshold.
When reach a certain $ amount spent on medications will qualify.
protects those with chronic conditions from large medical costs
What does an odds ratio tell us?
The odds that one thing is related to another.
OR>1 = exposure MAY INCREASE risk of disease
OR<1 exposure may DECREASE risk of disease
What is relative risk and what does it mean?
estimation magnitude of association
RR>1 = risk of disease INCREASED as result of exposure
what is relative risk reduction and how is it interpreted?
Tells you by how much the treatment reduced the risk of bad outcomes relative to the control group
e.g
the incidence of disease in those exposed is 1% and the incidence of disease in those not exposed is 2%, then the RRR is 50% = , this is read as “your risk of disease is 50% greater than someone who is not exposed”
Absolute risk vs relative risk
absolute risk provides the direct probability of an event occurring, while relative risk compares the risk between two groups
interpretations of a P value
P<= 0.05 = less than 5% chance of difference due to chance.
P> 0.05 = probability that chance explains the difference is too high for null hypothesise to be rejected = not statistically significant
what is a confidence interval and how is it interpreted?
= Range in which reflects certain degree of assurance of where the true value lies.
interpretation
- can not include 1
if the interval contains the null value (e.g., 0 for a difference between two groups), it suggests that there is no statistically significant difference
What is population driven by?
fertility, mortality and migration
what is used to asses fertility?
CBR: live births per 1000
TFR: children woman likely to have in reproductive life
How is mortality measured?
CDR: deaths per 1000 of the population
Describe the current shift in Population in Australia (Indigenous Australians and Non-Indigenous Australians)
Non= contracting (TFR is below the replacement rate, living longer)
IA= expanding
Define infant mortality and child mortality rates
IMR= the number of children that die under one year of age in a given year, per 1,000 live births,
CMR= deaths of children aged 1-4 per 1000 live births.
What does the Demographic transition theory present?
Changing the composition of society
What does the Epidemiological transition theory present?
changing disease types and patterns
what is a replacement rate?
adjusted fertility rate required to maintain the population
what is the dependency ratio?
non-working: working age
potential socioeconomic burden on the working age by the young and elderly.
Health inequality vs inequity
Inequality = differences in health status
inequities: unjust, unfair or preventable
what are the upstream, midstream and downstream factors of health?
upstream = environmental factors, socioeconomic characteristics, broad features of society and knowledge, attitudes and beliefs
midstream= psychological factors, health services
downstream- biomedical
what are Social Determinants of Health?
Causes of the causes of ill-health
What is a Social Gradient? what is it caused by?
Graded relationship between SES n health in which poorest have worst health status.
caused by: natural selection, behavioural/cultural factors, structural factors and psychosocial capital
How can SDoH affect our health?
it affects:
- risk associated with developing disease
-the disease it self
-the capacity that people have to take action to prevent/treat
what are the ‘Solid Facts’ of the SDoH?
Stress
Social Gradient
Early
Social exclusion
work
unemployment
social support
addiction
food
transport
what is the impact of inequity and inequality on marginalised populations?
impacts: well-being/ stress levels, work opportunities, SES, resource access, health access and education access.
COMBINATION = profound impact
what is needed to help overcome inequity and inequality in marginalised populations?
multi-level response (systems, services and providers)
patient-centered care (offsets inequities)
What can be done on a system level to mitigate impacts on marginalised populations?
Universal coverage
Access to PHC
workforce innovation
financial subsidies/incentives
continuity of care
What can be done on a service level to mitigate impacts on marginalised populations?
Organisational influences (preventive care, use local workforce etc)
information systems
delivery system
health Lit and self-management support
community linkage
What can be done on a provider level to mitigate impacts on marginalised populations?
Patient centered
Culturally sensitive, aware of SoDoH, better communicators (Teach-Back)
Socialisation vs Acculturation
S= EVERYBODY goes through it (embeds culture and societal expectations)
A= when change culture, becomes evident when a change setting as what you have been taught NO LONGER MATCHES
What are the 5 stages of Migrant Acculturation?
Pre-contact
Contact
Conflict
Crisis
Adaption
what are the outcomes of accultruation?
Assimilation (don’t maintain old)
Integration (mix)
isolation (hold onto original)
marginalisation (forced to isolate)
what is langauge discordance?
when someone not knowing the language is expected not to comprehend, so you don’t take the time to try
Xenophobia
fear, hatred, and hostility to anybody from outside one’s own group
-What is ethnocentrism?
cooperation with members of one’s own group and noncooperation towards members of other groups based on our own cultural value
What are the three types of racism and their meanings?
I
Institutionalised = access to resources, services and healthcare opportunities different
Personally mediated = prejudice/ discrimination about ability, motive and intents (of others)
Acceptance (by stigmatized race) of negative messages about worth and ability.
what does the National Standard Indigenous Identification question ask?
are you of Aboriginal or Torres Strait Islander origin?
What are the historic factors that continue to impact health and wellbeing of ATSI population?
Loss of Land and Culture
Separation from families
Discrimination and racism
crowded living conditions
limited access to health care ]
cultural alienation
What is the life expectancy gap and what are its trends?
8 years
increases with remoteness
what is section 100 of the PBS?
helps improve access = providing for certain drugs to be available as pharmaceutical benefits, in addition to those available under normal PBS arrangements
The review included the following Section 100 programs:
Highly Specialised Drugs (HSD) Program
Aboriginal Health Services Remote Access (AHSRA) Program
what is the purpose of the CTG campaign?
National health and social policy initiative in Australia
improving the health and wellbeing (ATSI) people
close gap in: infant mortality, improve life expectancy and health outcomes, increase access to services….
