UNIT 3 AOS 2 Flashcards
Old public health
It is concerned with the collective effort to improve the health status of the entire population. It refers to the particular ways that governments monitor, regulate and promote health status and prevent disease.
When first public health measures were introduced it was understood that bacteria was a major cause of disease. The poor living conditions that much of the population lived in resulted on pressure on governments to address it
Old public health measures
Focused on the establishment of:
- Government funded water and sewage systems so people had clean water to drink and better sanitation
- Improved nutrition
- Improved housing conditions
- Better work conditions
These focused on the physical environment
Old public health measures affect
- Reduction in deaths from infectious diseases
- Improved housing = reduction in respiratory diseases such as pneumonia and influenza
- Improved nutrition = better established immune systems, enabling them to fight infectious diseases or recover more quickly from them
- Improvements in life expectancy and infant mortality rates
Biomedical model of health
Responsible for much of the improvements in life expectancy in Australia since 1990. It receives majority of health care funding.
It treats symptoms once they’re present and deals with treatment and diagnosis rather than prevention. It is a costly approach as it relies heavily on medical technology and medical professionals.
Biomedical model characteristics
- Focuses on individuals with disease or injury
- Attempts to return person to pre-illness state
- Involved medical professionals and technology
- Treats and diagnoses conditions once they’re present
- It is a quick fix or ‘bandaid’ approach
Examples of biomedical model
- Stitches to assist in healing of cut
- Surgery to remove appendix
- Chemotherapy to treat cancer
- Medication to lower blood pressure
- X-rays to diagnose fractured bones
Biomedical model advantages
- Creates advances in medical technology and research (responsible for x-rays, antibiotics and anesthetics)
- Enables many common problems to be effectively treated which could otherwise cause death
- Extends life expectancy as many causes of death that were common in the past can now be effectively treated
- It improves quality of life as many chronic conditions can be managed with medication, therapy or surgery
Biomedical model disadvantages
- Relies on professionals and technology and so is costly
- Doesn’t always promote good health as it encourages a reliance on quick fix solutions and does not encourage people to be responsible for their own health
- Not every condition can be treated/cured.
- Affordability. Not all individuals can afford the medical technologies and resources
The social model of health
As medical technologies and knowledge developed, there was an expectation that it would solve health problems being faced at the time. However, lifestyle diseases become a main contributor of mortality and morbidity.
It was thought that by being exposed to appropriate health information, people would change their behaviours. It became obvious that even though people were aware of the consequences, the knowledge on its own was not enough to change behaviour.
Became evident that there were many factors which can affect health and wellbeing; physical, sociocultural and political environments
Social model of health characteristics
- Addresses the broader determinants of health
- Focuses on health promotion and preventing disease and injury
- Targets whole communities, not just individuals who are sick
Social model advantages
- Promotes good health and assists with preventing disease
- Promotes overall wellbeing, not focused on disease that is already present
- Can be cost effective, health promotion investment is often significantly cheaper than treating diseases
- Focuses on vulnerable populations
- Sustainable as education can be passed from one generation to the next
- Responsibility of health is shared
Social model disadvantages
- Not every condition can be prevented as some are genetic
- Does not promote advances in medical technology or knowledge
- Does not address health concerns of individuals
- Health promotion messages may be ignored
Social model principles
- Involves intersectorial collaboration
- Addresses the broader determinants of health
- Acts to reduce social inequities
- Acts to enable access to healthcare
- Empowers individuals and communities
Involves intersectorial collaboration
Collaboration between government and non-government organisations and stakeholders who have influence over the social and environmental factors of health.
- Eg. Vic government working with Lilydale Council and local principals to organise fun runs to help prevent lifestyle diseases such as CVD
Addresses the broader determinants of health
Behavioral factors, such as reducing tobacco smoking and food intake, are key to improving health and wellbeing. These factors are influenced by broader factors such as culture, gender, SES, physical environment and geographic location.
- Eg. implementing smoking-free zones around restaurants to reduce second hand exposure. Focuses on preventing diseases such as lung cancer rather than treating them when they occur.
Acts to reduce social inequities
To achieve this, the sociocultural factors that contribute to inequities in health status must be addressed. Many individuals are influenced by sociocultural and environmental factors.
- Eg. government funded sporting programs implemented in schools which allows those with low SES to have equal opportunities
Acts to enable access to healthcare
Healthcare has a significant influence on health and wellbeing and is a contributing factor in the health status experienced by most people.
- Eg. establishing bulk-bill medical centres so individuals who are financially struggling can also have access to healthcare.
Empowers individuals and communities
Means people can participate in decision making about their health and wellbeing. Empowering them with health knowledge and skills means they are more able to make positive changes to their health and wellbeing.
- Eg. governments creating programs for girls providing free basic sports coaching courses. This empowers girls to get more involved in physical activity.
Ottawa Charter
An approacher to health developed by the WHO which attempts to reduce inequalities in health. Helps organisations incorporate health promotion ideas into their strategies, policies and campaigns.
WHO health promotion definition
The process of enabling people to increase control over, and to improve, their health
Ottawa charter basic strategies for health promotion
- Enabling: Health promotion aims aims to reduce difference sin current health status and ensure the availability of equal opportunities and resources to enable all people to achieve their full potential.
- Mediating: Health promotion demands coordinated action by all concerned.
- Advocacy: Political, economic, social, cultural, environmental, behavioral and biological factors can all favour or harm health. Health promotion aims to make these conditions favourable, through advocacy for health
Ottawa charter action areas
- Build healthy public policy
- Create supportive environments
- Strengthen community action
- Develop personal skills
- Reorient health services
Build healthy public policy
Decisions made by government and non-government organisations regarding laws and policies that affect health and wellbeing.
- Compulsory wearing of seat belts
- ‘No hat no play’ policy
- Banning smoking in public areas
Create supportive environments
A supportive environment is one that promotes health and wellbeing and assist people in making and practicing healthy behaviours.
- Investing in sustainable energy production
- Shaded areas at pools
- Providing cycle tracks in the local community
Strengthen community action
Focuses on building links between individuals and the community and encourages the community to work together to achieve common goals.
- Community groups organising a range of activities promoting harm minimisation strategies around drug use
Develop personal skills
Education is a key aspect of this. Education refers to gaining health-related knowledge and gaining life skills that allow people to make informed decisions
- Attending healthy cooking classes
- Educating school students about how to practice safe sex
- Learning to recognise changes to moles on skin
Reorient health services
Refers to reorienting the health system so that it promotes health and wellbeing as apposed to focusing on diagnosing and treating illness, like the biomedical model of health. It must encompass all members of the community.
- Focusing on healthy eating instead of surgery to reduce impact of CVD
- GP’s providing information on quitting smoking to patients who present as smokers
- Quit campaign advertising appearing on billboards and TV
Medicare
Medicare is Australia’s Universal Health Insurance Scheme. It enables all Australian citizens and individuals from countries with a reciprocal agreement, access to free or subsidised (public) healthcare. Medicare pays 75% of the schedule fee
Medicare covered services
- GP consultations
- In-hospital stays (public hospitals)
- Eye tests performed by an optometrist
- X-rays
- Pathology (blood tests)
What services does Medicare NOT cover?
- Dental examinations and treatment
- Accomodation and other private hospital costs
- Home nursing care
- Ambulance services
- Allied health services
- Glasses/ contact lenses
Medicare advantages
- Free to join
- Choice of out of hospital doctor
- Available to all Australian citizens
Medicare disadvantages
- Still may need to pay a gap fee
- Not all health services are covered
- Long waiting lists. Served in order of clinical need
- No choice of in hospital doctor
Medicare funding
- Medicare levy: Most income earners pay 2% of their income through taxes. ‘Most’ because low income earners don’t may taxes
- Medicare surcharge: High income earners ($90,000) who don’t have private health insurance pay an extra 1-1.5% tax. It is income tested
- General taxes: Used if no funding is left elsewhere
Bulk billing
This is when the GP only charges the schedule fee (as set by the government $37.05). No money is exchanged, you simply present your Medicare card and sing the form to say you received the service.
Medicare safety net
The is when financial assistance is provided to individuals or families with high medical costs.
Once an individual or family has contributed to a certain amount of out of pocket costs for Medicare services in a calendar year, financial support is provided by the government making Medicare services cheaper for the remainder of the year.
Pharmaceutical benefits scheme
The PBS is implemented by the federal government. The purpose is to provide lifesaving and disease preventing medication to the Australian community at a subsidised cost where consumers make a copayment. Therefore making medication more affordable.
Allows medicare card holders to over 4000 common prescription medications at a significantly reduced cost
PBS patient copayment
The patient copayment for most PBS subsidised medication was $38.80, or $6.30 for concession card holders. The government pays the rest
PBS safety net
Individuals or families with high PBS listed medicine costs are protected through the PBS safety net. Once they have spent a certain amount within a calendar year, the patient only pays a concessional payment rate of $6.30 rather than the normal $38.80
NDIS
A national insurance scheme that provdes services and support for people with permanent, significant disabilities, and their families and carers. It works to assist individuals to live and ordinary life.
Funding can provide wheelchairs, doctors, teachers, housing, talking watch etc to those who are with the NDIS. NDIS is based on an individualised plan based on that person’s goals now and for the future.
NDIS role
NDIS has three main roles in helping individuals with a disability to:
- Access mainstream services, such as health, housing and education
- Access community services, such as sports clubs and libraries
- Maintain informal supports, such as family and friends
NDIS funding
Funded by federal and participating state/territory governments
NDIS eligibility
To be eligible to access NDIS, an individual must be under 65 years and meet both the residency and disability requirements.
Residency:
- Australia citizen, permanent resident or on a protected special category visa/
- Live in Aus where NDIS is available
Disability:
- Likely to be permanent
- Severely reduces your ability to effectively participate in activities
- Affects your social and economic participation (ability to work and earn an income)
- Likely to require NDIS support for your lifetime
Private health insurance
Extra healthcare, on top of Medicare, where individuals pay a premium for services that Medicare doesn’t cover. There are different levels of coverage
Private health insurance covered services
- Allied healthcare (physio, chiro)
- Alternative therapies (acupuncture, massage or Chinese medicine)
- Ambulance transport
- Dental services
Private health insurance incentives
- Medicare surcharge: High income earners pay an addition 1-1.5% tac if they don’t have private health insurance
- Lifetime cover: Australians are encouraged to take out private health insurance before they turn 31, otherwise they will pay an additional 2% for every year they are over the age of 30. Caps at 70%q
- Government rebate: Government covers part of an individual’s premium.
Private health insurance advantages
- Shorter waiting times
- Choice of in and out of hospital doctor
- Choice of hospital
- Services covered that Medicare doesn’t
- May get own room for in-hospital stays
Private health insurance disadvantages
- Costly
- May still need to pay a gap fee
- Not all services are covered
- Qualifying periods
