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30 Cards in this Set
- Front
- Back
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inverse health care law
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those in greatest need of care are least likely to receive it– poverty, lack of education, health care providers not work in deprived areas
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Describe reasons for variation in medical use
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underuse, regional differences in disease incidence, regional social, cultural differences – (how sick?, role of primary care physician in determining patients referred)
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Give the reasons why clinical practice guidelines were used after 1970
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1. Perceived need to decrease practice variation
2. Decreased health care costs 3. Perception of inappropriate care 4. Federal govt movement for outcome studies 5. Inability of physicians to stay abreast of new research |
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Discuss the results of the IOM medical error study
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Cost of med errors ~$29bil
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Def. sickness
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social role defined buy inability to perform usual roles
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Def. illness
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perception of unwellness, based on symptoms, have a headache,
1. symptom recognition 2. lay consultation 3. prof consultation 4. patienthood 5. return to normal or accommodate |
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Def. disease
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Physical abnormality of the body, can be unnoticeable or undetected
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Know the WHO definition of health
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state of complete physical mental and social well being and the absence of disease
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Social economic status
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Income, education, occupational status
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McKeown's determinants of health
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1. Better hygiene
2. Better nutrition 3. Change in reproductive behavior (fewer babies) |
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Def. death via Uniform Determinant of Death Act
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1. Irreversible cessation of circulatory and respiratory function OR
2. Irreversible cessation of all functions of brain including brain stem death |
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Progression un mortality rates in US
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Declined 1900-1937
Spiked 1918 (influenza epidemic) Rapid decline 1937-1954 (antibiotics) steady 1954-1970 Decrease 1970-present Rates highest in 1st yr and after 40th |
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Age-specific mortality rate
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deaths/size of pool *1000
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Cause-specific mortality rate
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Deaths/mid-year population * 100,000
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Govt spending on health care
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~2tril
16% of GDP $8000 per capita 308mil population |
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3 levels of clinical prevention
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Primary - Averting occurrence (vaccine)
Secondary - Early detection and intervention to reverse progress (cancer screening) Tertiary - Efforts to minimize the effects of disease/disability (physical therapy) |
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History of US medicine since 1880
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1. Found diseases and that they can come through food and water
2. Quarantines 3. Control communicable diseases, build community health departments and hospitals, Hill-Burton Act (build hospitals) 4. Social engineering - Medicare/Medicaid, peace corps, community health programs, control spending, increased spending, HMOs 5. Present - health promotion - healthy people, prevent diseases, set objectives for country and world, eat right, exercise |
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Definition of physician
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Controls the process by which new members are recruited, controls the content and duration of training and licensing, defines scope of work, set policies on standards of practice
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% of women in medicine
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50%
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Osteopath vs. allopath
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Do the same thing, both licensed by state, osteopaths tend to choose general fields, osteopaths look holistically and started with the spine. osteopath = DO allopath = MD
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Role conflicts of nurses
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1. Bedside nursing not satisfying to BS nurses
2. Alternative (more lucrative) employment 3. Shift work - don't want to work weekends/holidays 4. Competition of traditional wife/mother role (90% are women) 5. Dual authority structure between administrator and doctor |
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Complementary medicine status
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(massage, acupuncture) patients may see unqualified practitioners, may miss diagnosis, may stop or refuse effective conventional treatment, may waste money may experience dangerous side effects. Young doctors like it, increasing in med schools
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Cultural aspects of American medicine
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Clinical/scientific
Avoid criticism of social/economic conditions More individual than social |
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Def. Incidence
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Number of new cases
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Def. prevalence
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Number of cases of diseases in a population that exist at one point in time
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Def. quality care
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the portion of a patient's outcome over which healthcare providers, whether individual or organizational, have control
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Infant Mortality rate
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Why - rapid, successive, sensitive measure of healthcare of an area
Neonatal: 0-30 days, measure birth defects, what mother did while carrying Post-neonatal: 30days - 1 yr, measures environments Babies that died in that period/All births * 1000 |
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Homeopathy
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treat patients using highly diluted preparations that are believed to cause healthy people to exhibit symptoms that are similar to those exhibited by the patient
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Chiropractor
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Manipulates spine, can't practice, prescribe, or perform surgery
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Problems of disparity in health care
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Minority women get less pap smears, transportation, day care; premature babies; hispanics develop different kinds of cancer, more workplace deaths
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