U3AOS3 - Australia's Health System And Changes Flashcards
life expectancy changes
- 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
cardiovascular disease
- involves the heart and blood vessels and interferes with how blood is circulated through the body
cardiovascular disease changes
- 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
respiratory diseases
- diseases affecting the lungs and other parts of the body involving breathing including asthma, flu, chronic obstructive pulmonary disease
respiratory diseases changes
- 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
injury and poisoning
- this includes motor vehicles accidents, suicide, assault, poisoning, drowning, burns and falls or medical / surgical complications
injury and poisoning changes
- 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
public health
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
old public health
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
old public health - key policies
- 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
discovery of vaccines
- 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
biomedical approach to health
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
biomedical approach / dominance of medical science
- 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
biomedical approach / advances in medical tech
- 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
biomedical approach - advantages
- funding this approach brings about improvements in tech and research
- enables common problems to be effectively related
- extends life expectancy
- improves quality of life
biomedical approach - disadvantages
- 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
new public health
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
social model of health
- addresses the broader determinants or factors of health
- involves intersectoral collaboration
- acts to reduce social inequalities
- acts to enable healthcare
- empowers individuals and communities
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addresses the broader determinants or factors of health
- 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
involves intersectoral collaboration
- 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
acts to reduce social inequalities
- many individuals and population groups are influenced by sociocultural and environmental factors
- the factors that cause inequality need to be addressed
acts to enable healthcare
- healthcare has significante influence on health and wellbeing some factors that need to be considered include geographical barriers, economic barriers and education levels
empowering individuals and communities
- this allows people to have a say in decision making that affects their healthcare
social model of health - advantages
- 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
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
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
ottawa charter for health promotion - three strategies
advocate
enable
mediate
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
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
mediate
- changes required to promote health and wellbeing including funding, legislation and policies cause conflict // mediation attempts to deal with this
the ottawa charter - five key action areas
- building healthy public policy
- create supportive environments
- strengthen community action
- develop personal skills
- reorient health services
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building healthy public policy
- relates to decisions made by the governments regarding laws that make it harder for people to undertake unhealthy behaviours
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
strengthen community action
- focuses on links between individuals and the community
- giving the community a sense of ownership increases likelihood of effectiveness
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
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
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
medicare
Australia’s universal health insurance scheme
- gives all Australia and people from countries with a reciprocal agreement
- it operates in the public sector
medicare covers
out of hospital expenses
in hospital expenses
medicare safety net
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)
essential healthcare services
- consultation fees for doctors and specialists
- tests and examinations needed to treat illnesses
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
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
what medicare doesn’t cover
- most private costs
- most dental examinations and treatments
- home nursing care and treatment
- ambulance services
- most allied health services
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
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
medicare funding
levy
levy surcharge
general taxation
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
levy surcharge
- applicable for people without private health insurance earning >$90,000 or >$180,000 for families
general taxation
- also used to fund government services
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
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
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