U3AOS3 - Australia's Health System And Changes Flashcards
1
Q
life expectancy changes
A
- over time improvements have been made with an increase in life expectancy on an average 30 years in 2017 compared to 1900 (both males and females)
- in 1961-1972 life expectancy at birth hit a plateau
- lower fertility rates over time the age profile of the population has also changed since 1900
2
Q
cardiovascular disease
A
- involves the heart and blood vessels and interferes with how blood is circulated through the body
3
Q
cardiovascular disease changes
A
- since 1900 the different forms of cardiovascular disease have been leading causes of death
- death rates reached their height in the mid 1960s and while there has been a decline they are still a major cause of death
4
Q
respiratory diseases
A
- diseases affecting the lungs and other parts of the body involving breathing including asthma, flu, chronic obstructive pulmonary disease
5
Q
respiratory diseases changes
A
- pneumonia and influenza were leading causes of death for respiratory diseases but were replaced by deaths from chronic obstructive pulmonary disease
- aside from the Spanish Flu epidemic (1918-19) rates steadily fell
- by the early part of the twentieth century deaths from respiratory infections were common among mining workers
- asthma deaths have fallen considerably
6
Q
injury and poisoning
A
- this includes motor vehicles accidents, suicide, assault, poisoning, drowning, burns and falls or medical / surgical complications
7
Q
injury and poisoning changes
A
- motor vehicle death rates fell in 2000 due to compulsory wearing of seatbelts in 1970
- male death rates from injury and poisoning were affected by war deaths // deaths that occurred overseas were not counted
- work related accidents have contributed to a significant proportion of accidental deaths since 1900 often due to limited OH+S requirements
8
Q
public health
A
public health is concerned with the organisation and collective effort to improve health status of the entire population > particularly in how governments monitor, regulate and promote health status and prevent disease
9
Q
old public health
A
at the beginning of the 20th century the living conditions for many Australians were very poor
practices introduced by the government to address these concerns was known as old public health
from this significant improvements occurred in life expectancy, maternal and child mortality as well as overall death rates
10
Q
old public health - key policies
A
- government funded water and better sanitation
- quarantine laws
- intro of better quality housing
- improved food and nutrition
- improved working conditions
- provision of prenatal and infant welfare services
- discovery of vaccines
11
Q
discovery of vaccines
A
- vaccines brought around a reduction in morbidity and mortality from diseases such as smallpox, polio, hepatitis B etc.
- max vaccinations were introduced in public health policies
12
Q
biomedical approach to health
A
this essentially focuses on the physical or biological aspects of disease, it involves diagnosing when symptoms are present
- focuses on tech or services used to diagnose and cure disease
- individuals are the focus of this in comparison to populations
- the aim is to bring a person to a state of pre-illness
- doesn’t aim to address the causes / conditions itself is the focus
13
Q
biomedical approach / dominance of medical science
A
- became dominant in the 20th century as people aimed to understand causes and treatment of diseases
- this led to an increased demand for hospital and medical care
- treatment involves a skilled diagnosis and tech in treatment
14
Q
biomedical approach / advances in medical tech
A
- allow us to better diagnose, treat and cure // causes an interest in life expectancy
- in WWII antibodies were discovered along with vaccines working which helped reduce deaths
- discovery of penicillin helped treat many infections including a reduction in maternal mortality
15
Q
biomedical approach - advantages
A
- funding this approach brings about improvements in tech and research
- enables common problems to be effectively related
- extends life expectancy
- improves quality of life
16
Q
biomedical approach - disadvantages
A
- relies a professional health workers and tech and it is therefore costly
- it doesn’t always promote good health and wellbeing
- not every condition can be treated
- not all individuals can afford medical technologies needed for the treatment
17
Q
new public health
A
as lifestyle diseases increased the government thought if people about the risks they would improve their decisions
- health promotion campaigns were created to inform people
- this allows for a better understanding of physical, sociocultural and political environments here on health and wellbeing behaviours
- understanding of this led to more effective targeting of information
18
Q
social model of health
A
- addresses the broader determinants or factors of health
- involves intersectoral collaboration
- acts to reduce social inequalities
- acts to enable healthcare
- empowers individuals and communities
Aliens impersonate athletic antelopes excitedly.
19
Q
addresses the broader determinants or factors of health
A
- examples of factors include eating a healthy diet or smoking
- the factors are often influenced by broader determinants such as gender, culture or ethnicity
- the factors or determinants are found to have a strong link to health status and are increasingly becoming the focus of health promotion strategies
20
Q
involves intersectoral collaboration
A
- many government + non-government groups influence sociocultural and environmental factors
- all groups inside and outside the health sector work together in intersectoral collaboration to effectively address sociocultural, physical and environmental factors
21
Q
acts to reduce social inequalities
A
- many individuals and population groups are influenced by sociocultural and environmental factors
- the factors that cause inequality need to be addressed
22
Q
acts to enable healthcare
A
- healthcare has significante influence on health and wellbeing some factors that need to be considered include geographical barriers, economic barriers and education levels
23
Q
empowering individuals and communities
A
- this allows people to have a say in decision making that affects their healthcare
24
Q
social model of health - advantages
A
- less expensive than the biomedical approach
- focuses on vulnerable population groups
- education can be passed down from generation to generation
- responsibility for health and wellbeing is shared
25
social model of health - disadvantages
- not every condition can be prevented
- does not promote development of tech and medical knowledge
- doesn't address the health and wellbeing concerns of the individual
- health promo messages may be ignored
26
ottawa charter for health promotion
- one of the responses to the social model of healthcare at the WHO's international conference on health promotion
- the aim has to establish guidelines to help organisations and key stakeholders to incorporate health promotion ideas into strategies, policies and campaigns
27
ottawa charter for health promotion - three strategies
advocate
enable
mediate
28
advocate
- advocate for factors that support health and wellbeing
- refers to actions designed to gain support from governments and societies necessary to improve health and wellbeing for everyone
- includes media campaigns, public speaking, conducting and publishing of research or lobbying government
29
enable
- focuses on achieving equality in health and wellbeing by working with those in populations who have lower health status
- aims to reduce differences in health status to ensure equal opportunities and resources
- includes access to education, employment and adequate housing
30
mediate
- changes required to promote health and wellbeing including funding, legislation and policies cause conflict // mediation attempts to deal with this
31
the ottawa charter - five key action areas
- building healthy public policy
- create supportive environments
- strengthen community action
- develop personal skills
- reorient health services
Bad cats smell dead rats
32
building healthy public policy
- relates to decisions made by the governments regarding laws that make it harder for people to undertake unhealthy behaviours
33
create supportive environments
- recognises the impact that broader determinants have on health status
- a supportive environment is one that promotes health and wellbeing by being safe, satisfying and enjoyable
34
strengthen community action
- focuses on links between individuals and the community
| - giving the community a sense of ownership increases likelihood of effectiveness
35
develop personal skills
- education is a key aspects of this area
- this refers to gaining health-related knowledge and skills to enable people to make informed decisions that indirectly affect health and wellbeing
36
reorient health services
- refers to changing the health system to promote health and wellbeing not only diagnosing and treating illnesses
- this means addressing all factors that affect health and wellbeing
37
improving health status - lung cancer
- tobacco smoking accounted for most of the deaths
- a range of policies and health promo (social model of health) as well as improved technology inc. better tech and more effective treatments (biomedical) contributes to improvements
- anti smoking campaigns introduced in early 1970s
- improvements in understanding the disease and medical technology increases rates of survival
38
medicare
Australia's universal health insurance scheme
- gives all Australia and people from countries with a reciprocal agreement
- it operates in the public sector
39
medicare covers
out of hospital expenses
in hospital expenses
medicare safety net
40
out of hospital expenses
- medicare will pay some or all fees relating to many essential healthcare services
- listed on the Medicare benefits schedule .. sometimes there will be a copayment for the parent to partially cover
- usually dental procedures aren't covered unless for children 2-17 (medicare provides $1000 worth of dental treatment over two years)
41
essential healthcare services
- consultation fees for doctors and specialists
| - tests and examinations needed to treat illnesses
42
in hospital expenses
- in public hospital accom, treatment and initial treatment as well as aftercare
- if an individual chooses to be admitted to a private hospital 75% of treatment from the doctors and specialists but not accom., transport, fees and medication
43
medicare safety net
- provides extra financial assistance for those that incur significant out of pocket costs for Medicare services
- this comes into effect after a family has contributed a certain amount within a calendar year and provides extra gov. support
44
what medicare doesn't cover
- most private costs
- most dental examinations and treatments
- home nursing care and treatment
- ambulance services
- most allied health services
45
medicare - advantages
- choice of doctor for out of hospital services
- applicable to all Australian citizens
- reciprocal agreement between Australians + other countries
- covers most common healthcare services
- medicare safety net provides extra financials contributions for medical services once an individuals' or families' co-payment reaches a certain level
46
medicare - disadvantages
- no choice of doctor for in hospital treatments
- waiting lists for treatments
- doesn't cover alternative therapies
- often does not cover full amount of doctors consultations
47
medicare funding
levy
levy surcharge
general taxation
48
levy
all people pay an additional 2% on the taxable income of most taxpayers
- some low income people or those with special circumstances may be exempt from paying the levy
49
levy surcharge
- applicable for people without private health insurance earning >$90,000 or >$180,000 for families
50
general taxation
- also used to fund government services
51
pharmaceutical benefits scheme
the government subsidies medicine
- started off making all medicines free but now it aims to make them subsidised (consumers have to make a co-payment) // the contribution amount is lower for concession card holders
- available medicine is reviewed three times per year by the pharmaceutical benefits advisory committee // this takes into account effectiveness, safety and cost effectiveness
52
national disability insurance scheme
the national insurance scheme that provides services and support for people with permanent and significant disability as well as for their family and carers
53
NDIS main requirements
- individual must be aged <65 when applying
- must live in Australia and be a citizen or hold a permanent visa
- disability requirements
- affects capacity for social and economic participation
- likely require lifetime support
54
disability requirements
- likely to be permanent
- impairment substantially reduces your ability to participate effectively in activities unless you have assistance from others / assistive technology or can't perform at all
55
once requirements are met
- an individualised plan is created based on current and future participant goals as well as functional support requirement and how the individual wnt the plan managed over time
56
through the plan individuals can
- access mainstream services and support
- access community services and support
- maintain informal support arrangements
- receive necessary and reasonable funded supports
57
private health insurance
a type of insurance where members pay a premium in return for payment towards health related costs not covered by Medicare
- participants pay a premium depending on the level of cover and people required
- the basic benefit is to be admitted as a patient into a private hospital and have choice of doctor
- most of the cost of private hospital is covered but the patient may still have a gap
58
private health insurance - incentives
- private healthcare rebate (income tested for families and individuals)
- lifetime health cover (time based)
- medicare levy surcharge
59
private healthcare rebate
- can either be through a reduced premium or as a tax refund
60
lifetime health cover
- if people take up private insurance before 31 don't have to pay an extra percentage on their premiums for each year over 30
- max loading 75%
61
medicare levy surcharge
- this is waived if people have private health insurance over a certain income
62
private health insurance - advantages
- enables access to private care
- choice of doctor
- shorter waiting times
- extras may be covered
- helps keep costs of Medicare under control
- high income earners with private health insurance don't pay Medicare levy surcharge
- rebate for eligible policy holders
- lifetime cover incentive
63
private health insurance - disadvantages
- costly in terms of premiums
- sometimes have a gap
- qualifying periods apply
- policies can be complex to understand
64
funding
- relates to the resources that are provided to keep the health system adequately staffed and resourced so a high level of care is available to those who need it
65
funding assists in improving healthcare by providing
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healthcare infrastructure
highly trained health professionals
medical supplies
public health programs
advances in knowledge and technology through research
```
66
increasing healthcare costs have occured due to
an aging population
increasing incomes
more expensive technology and services
increased costs of medication
67
three areas of funding
federal
state
individuals
68
federal
- provides state gov. grants
| - makes payments through Medicare, PBS and NDIS
69
state
- provide funding for public hospital operations
70
individuals
- pay medicare levy in federal government
- high income earners without private health insurance also pay medicare levy surcharge
- pay income tax + GST on goods and services
- purchase insurance
71
funding is put into these areas
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hospitals
primary healthcare
referred medical services
other services
research
```
72
hospitals
greatest recipient of funding (public and private)
73
primary healthcare
relates to general health-related goods and services outside hospitals
74
referred medical services
specialist consultations referred by a GP
75
other services
patient transport, aids and appliances
76
research
tries to discover new ways of preventing, diagnosing and treating illness
77
sustainability
the capacity to provide a workforce and infrastructure into the future
- also needs to be innovative and responsive to emerging needs
78
sustainable funding
- available funds must be available to ensure that the health system can continue to cater to the needs of the population into the future
- requiring the health system help it remain sustainable by promoting the efficient use of funds and other resources
79
key considerations for sustanability
research and monitoring (improves effectiveness of services and efficiency)
ensuring adequate funding and regulation of the health system
ensuring an efficient health workforce and system (reduces health related costs)
promoting disease prevention and early intervention (reduces people who need services)
80
sustainability - medicare
- determining which services which will be subsidised can preserve funds for the most necessary services
- increased Medicare levy allows for providing the necessary funds to maintain the health system and introduced the NDIS
81
sustainability - PBS
- continually reviewing medicines means only those with the greatest benefits are subsidised
- the TGA verifies the effectiveness of all medications
82
sustainability - NDIS
- each participant in the NDIS receives an individual plan meaning only necessary funds are spent per person
83
sustainability - private health insurance
- incentives such as the private health insurance rebate and lifetime loading maximise funding provided through the system
84
access
an accessible health system is one that can provide all people having access to quality health services based on their needs regardless of geographic or socioeconomic status
- patient co-payments need to be considered as delayed treatments can contribute further to ill health
85
access - medicare
- provides access to people of all SES to services
| - provides funding for telephone and video consultations (assists people outside major cities)
86
access - PBS
- all Australian citizens and permanent residents are entitled to discounted medicine
- promotes access to essential medication for low income earners (concession co-payment amount)
87
access - NDIS
- improves access to health services for people with life long disabilities
- been rolled out in every region of Australia
88
access - private health insurance
- the federal gov rebate can increase access to lower income earners
- can increase access to healthcare services too expensive otherwise
89
other organisations which increase healthcare access
- Royal Flying Doctors Service (provides healthcare for Australians outside of major cities)
- Rural Retention Program (provides funding to doctors going out in rural areas)
90
access to culturally appropiate healthcare
- Indigenous Health Incentive
| - Close the Gap Initiative
91
Indigenous Health Incentive
provides extra support for medical practices to provide culturally appropriate healthcare for Indigenous people
92
Close the Gap Initiative
provides further housing for indigenous health workers and helps plan appropriate delivery
93
equity
equal access decisions make sure the system is equitable
| - an equitable system meets and recognises to people with different needs
94
equity - medicare
- Medicare Safety Net (frequent users receive financial support)
- Mental Health Treatment Plans (eligible for 10 individual or 10 group sessions per calendar year with the cost covered by Medicare)
95
equity - PBS
- the PBS Safety Net (further protects families from large overall expenses due to PBS listed medications)
- concessional co-payment amount (provides greater assistance to unemployed or low income)
- many indigenous australians can qualify for reduced PBS payments under the closing the gap initiative
96
equity - NDIS
- individualised treatment plan ensures people get the support they need
- those who require used of the NDIS don't have to pay more if they use it
97
equity - private health insurence
- low income receive a rebate
- those 65 and older receive a greater rebate
- people who use their insurance more don't have to pay a higher premium
98
other equity actions
- interventions for outside of major cities / Indigenous
- public dental health services (especially for vulnerable groups)
- continuity between healthcare providers (aims to increase the level of care and communication between different professionals)
99
road safety
relates to the interventions put in place to reduce the risk of crashes, death and injury caused to individuals as a result of using roads
- road users include pedestrians, cyclists, drivers etc
100
why is road safety being targeted
- from 1925 there have been over 187,000 deaths on Australia's roads
- Males almost 3X more likely than females
- Double rate for indigenous males than non-indigenous males
- Young people (in 2017 112 drivers 17-25 killed)
- Large social and economic impacts
101
most road deaths are preventable and due to factors such as
driver fatigue, distraction and error
non-compliance with road law, speeding and failure to use restraints
infrastructure inc. road quality, barriers and lighting
vehicle quality
102
effectiveness - road safety
Australia experiences road deaths and injuries but the impact of health promotion interventions has been significant
- population and car is increasing while road trauma levels are decreasing
103
road safety examples of interventions
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TAC campaigns
Kids on the move programs
Driver reviver program
Black spot program
P.A.R.T.Y program
Natural road safety 2011-20
```
104
TAC campaigns
since 1989 TAC has played a large role in promoting road safety by focusing on a range of road safety issues to change public behaviour
105
TAC - main actions
- providing resources to target speeding and drink driving
- creating high profile, hard hitting, mass campaigns
- focusing on drink-driving, speeding fatigue and young drivers
- providing public education programs to support police enforcement
- conducting road safety research
106
TAC example campaigns
'If you drink, then drive, you're a bloody idiot'
'Wipe off five'
'Drinking, driving. They're better apart'
'Take a break, fatigue kills'
107
TAC links to ottawa charter
- reorient health services (provide education of risks assumed with road risk)
- develop personal skills (relating to young drivers, fatigue, drug driving)
108
driver reviver
the driver reviver program is a national program campaigning to reduce road collisions by addressing fatigue
- each holiday season up to 220 sites open up around Australia to provide motorists a safe place to stop and relex (creates a supportive environment)
109
driver reviver - links to ottawa charter
- by using a range of organisations including SES, Lions Club, Police etc. (strengthens community action)
- it also (develops personal skills) by offering holidays motoring tops on their website
110
P.A.R.T.Y. program
Tries to prevent alcohol and risk-related trauma in youth
- focusing on trauma prevention and health promotion initiative that seeks to (develop personal skills) of young people by providing a real experience of a major trauma service
- operating at Royal Melbourne and Alfred hospitals the program (reorients health services) by utilizing the experiences of pressures including emergency services, doctors, nurses, allied health professionals and researchers
111
links to ottawa charter
```
build healthy public policy
create supportive environments
strengthen community action
develop personal skills
reorient health services
```
112
indigenous health initiative (IHI)
trying to achieve equality in health status and life expectancy between indigenous and non-indigenous people
113
IHI aims
- close the gap of life expectancy
- halve the gap in mortality rates for indigenous children under five within a decade
- ensure all indigenous four year olds in remote communities have access to early childhood education within five years
- halve the gap for indigenous students in writing, reading and numeracy skills
- halve the gap for indigenous students in yr 12 or equivalent
- halve the gap in employment outcomes between Indigenous and Non-Indigenous Australians within a decade
114
delivering deadly services initiative (DDSI)
training the health workforce in cultural awareness and employing people from the local community are two features which enable Indigenous people to feel comfortable when accessing services
- increases the rate at which Indigenous people access healthcare
115
DDSI links to OC
- program develops personal skills by focusing on cultural awareness training for staff
- also creates supportive environments leading to indigenous clients reporting that staff were more 'aware and supportive' with nurses demonstrating greater cultural awareness when engaging with clients
116
the 2 spirits program - overview
embraces a whole community approach to improve sexual health and wellbeing of Indigenous gay men and sistergirls through education, prevention, health promotion and community development activities
117
the 2 spirits program - links to OC
- reorients health services by working with community members and providing resources and campaigns including peer education workshops and retreats
- has programs that strengthen community action by holding community forums focusing on HIV/AIDs, sexual health and wellbeing as well as discrimination
- forums can also develop personal skills and increase knowledge and understanding in communities
118
considering program effectiveness
- how the program addresses a significant health issue for Indigenous Australians
- improvements made in health and wellbeing
- the number of participants taking part in the initiative
- feedback provided by participants
- action areas of the OC that are evident
- whether the initiative is culturally appropiate
- whether the program meets the specific needs
- what funding has been used / is needed
119
australia dietary guidelines
developed by the National Health and Medical Research Centre. they aim to:
- develop healthy dietary patterns that promote health and wellbeing in the community
- reduce risk of developing a range of dietary related conditions such as hypertension etc
- lower risk of developing chronic conditions such as type 2 diabetes
120
guideline 1
to achieve and maintain a healthy weight, be physically active and chose amounts of nutritious foods and drink to meet your energy needs
121
guideline 2
enjoy a wide variety of nutritious food groups from these five groups everyday:
- vegetables and legumes
- fruit
- lean meat, poultry and fish
- grains (mostly whole grains)
- milk, yoghurt, cheese and alternatives
122
guideline 3
limit intake of foods containing added salt, sugar, fat and alcohol
123
guideline 4
encourage, support and promote breastfeeding
124
guideline 5
care for your food, prepare and store it safely
125
australian guide to healthy eating
this is a food sectoral chart reflecting guidelines 2 and 3 (pie) // also shows people need to drink water
- doesn't show serving sizes or composite foods
126
nutrition australia
the major community education body for nutrition
- goal is to promote optimal health and wellbeing for all Australians by encouraging a variety of food sources and physical activity
127
nutrition australia key objectives
- act as a source of information on key nutrition issues
- produce material on nutrition for all stakeholders (inc. consumers)
- act as consultants to gov. departments, the food industry and consumer groups on issues relating to food and nutrition
- encourage innovation
128
healthy eating pyramid
a simple visual guide to the types and proportions of foods that make up a healthy diet
- shows the five core food groups and healthy fats in four layers representing the proportions for consumption
- serving sizes and composite foods aren't included
129
healthy lunchbox week
- provides plenty of lunchbox inspiration for parents and kids
- about creating healthy and nutritious lunches for kids
- reflects actions of the ottawa charter by:
creating supportive environments, strengthening community action and developing personal skills
130
challenges in bringing about dietary change
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personal preference
attitudes and beliefs
willpower
food security
time constraints and convenience
education, knowledge and skills
health and wellbeing factors
family, culture, society and religion
food marketing and media
```
131
funding - Medicare
- Medicare funds part or all of the fees associated with health services - including doctor and specialist consultations, pathology tests and fee-free treatments in public hospitals
132
funding - PBS
- Essential medicines are subsidised through the PBS, providing treatment for many conditions, promoting health outcomes
133
funding - NDIS
- The NDIS can provide funding for a range of resources that promote health status, including carers who can provide support with daily living and staying socially connected
- Assistive technology such as wheelchairs and bed rails
134
funding - private health insurence
- Private health insurance provides much of the funding for private hospitals which are responsible for around 40 per cent of hospital treatments
- The federal government funds the private health insurance rebate which means private health insurance is more affordable for more people
