Study guide for the final, part 11 Flashcards

1
Q

Role of research in policy development

A

Documentation: gathering, cataloging, correlating of facts
Analysis: feasibility, efficacy, practicality of an intervention
Prescription: research that shows a course of action

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2
Q

Demographic changes and effects and future change

A

Demographic changes: becoming bigger, older, and ethnically diverse
Effects on:
-The need for health care
-How the needs will be met
-The nation’s ability to afford HC: expanding gov’t programs on an unsustainable financial path
-Implications for supply of health professionals
Cultural factors will create ongoing challenges
Uninsured immigrants without documents tap into resources
Personal lifestyle choices cannot be fully incentivized

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3
Q

Ecological forces and future change

A

Major implications for PH
-New dzs
-Natural disasters
-Bioterrorism
World pop growth
-Intensify human-animal-ecosystems interface
-Probability of engendering new dzs
Dealing with new ecological threats
-Will divert resources from routine HC

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4
Q

Concerns and challenges from MA plan

A

Concerns on cost and waiting time
In the Connector (exchange), premium increases surpass inflation; the state had to set limits on the rise in premiums
Some mixed results on ability to meet HC needs
ED use has continued to rise
Income tax hikes are proposed

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5
Q

Implementing the medical home model

A

Information exchange outside the medical home
Reimbursement that captures critical nonclinical activities, such as care coordination

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6
Q

Lessons from the Vermont Blueprint

A

A pilot program launched in 2006
Shifted to a statewide program after the passage of the ACA
Integration of medical home and COPC models
Medical homes supported by community health teams and an integrated IT infrastructure
Community health teams offer individual care coordination, health and wellness coaching, and behavioral health counseling for a defined pop
Reduced ED use and hospitalizations are necessary for financial viability

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7
Q

Pt activation and SES

A

Considerable difference in activation levels across socioeconomic and health status characteristics
-Lowest among Medicaid enrollees

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8
Q

Definition of pt-centered care

A

Respecting and responding to pts’ wants, needs, and preferences, so that they can make choices in their care that best fit their individual circumstances

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9
Q

The role of pt-centered care

A

Promotes pt activation
Positive impact on pt satisfaction, adherence to tx regimens, and self management of chronic conditions

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10
Q

Training in geriatrics

A

Critical shortage and worse shortage expected in the future
Better outcomes by geriatric professionals without cost increases
Recommendations (IOM, 2008): residency training, better recruitment and retention, and financial incentives for specialists, better pay and benefits for direct care workers in geriatric settings

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11
Q

Six areas of concern in LTC

A

Financing: reform needed in both public and private financing
Resources
Infrastructure
Workforce: a deficit of direct care workers is projected
Regulation
Information tech: interoperable IT systems are needed

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12
Q

What is HEDIS? What does it report?

A

Healthcare Effectiveness Data and Information Set
A tool used by >90% of US health plans to measure performance on important dimensions of care and service.

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13
Q

What are the major provisions of the ACA?

A

Guaranteed issue
Minimum standards
Individual mandate
Health insurance exchanges
Low-income subsidies
Medicaid expansion
Medicare payment reforms

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14
Q

What are the core functions of PH?

A

Assessment
Policy development
Assurance

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15
Q

What essential functions are part of assessment?

A

Monitor health status to identify and solve community health issues
Diagnose and investigate health problems and health hazards in the community

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16
Q

What essential functions are part of policy development?

A

Inform, educate, and empower people about health issues
Mobilize community partnerships to identify and solve health problems
Develop policies and plans that support individual and community health efforts

17
Q

What essential functions are part of assurance?

A

Enforce laws and regulations that protect health and ensure safety
Link people with needed personal health services and assure the provision of health care when otherwise unavailable
Assure a competent PH and personal healthcare workforce
Evaluate effectiveness, accessibility, and quality of personal and population-based health services.

18
Q

Responsibility of board of trustees for hospital

A

A governing body
Legally responsible for operations
Evaluate medical decisions and approve plans and budgets
Appoint and evaluate the CEO
Approve appointment of medical staff