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26 Cards in this Set
- Front
- Back
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Factors determining public policy
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- codification of mainstream values
- influence of interest groups - polarized congress |
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mainstream values
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- individualism of people
- fear of government - fear of loss/change of life - don't look at good of whole |
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Characteristic of US population that guide policy
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Polarized congress
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History of reform
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Truman - 1948
- Economic turmoil after WW2 - Ineffective appeals to public and congress Johnson - 1965 - Political capital, won by landslide - Incremental change with Medicare Clinton - 1992 - People judged success by how it effected them - 90% of people agreed there was a crisis |
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Examples of incremental change
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- Subsidize children health insurance
- Changes in managed care - Encourage small business owners to buy policies together - Reduce Medicare/Medicaid spending |
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History of mental health
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1800s - kept at home
1841 - Dorthea Dix reform 1930s - physical "cures" 1946 - Act to treat vets 1955 - Opened Act to public 1965 - Medicaid 1977 - Mental Health System Act 1980 - Reagan shoots down Act 1992 - Clinton includes mental health reform |
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ADL vs. IADL
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ADL - dependence on others for assistance with core functions
IADL - ability to perform household and social tasks |
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Health reform at state level
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- Republicans need crisis, Democrats need money
- Role of special interest - Timing - Continuum - Effective leadership - Media - No single payer |
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Common violations of long term care
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- Improper use of restraints
- Inadequate attention to activities - Respect for autonomy - Pressure sores - Inadequate food/hygeine |
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Free vs. Health market
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Free - Choice
Health - Physician's choice Free - Price on demand Health - Providers Free - Information symmetry Health - Asymmetry Free - True competition Health - 3rd party payers Free - No government intervention Health - 46% Free - Negotiations Health - None Free - Quantity/Quality based on demand Health - Supply |
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Why not shop around for better care?
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- Urgent
- Hidden prices - Collusion - Licensing - Hospital priveleges |
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Clinton's Health care reform
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Problem - Health was issue
Politics - Clinton elected due to reform Policy - Plan came too late and economy improved |
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HIPAA
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Health Insurance Portability and Accountability Act
- Protected info - Know who has info - File complaints - Written requests required |
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Agenda setting
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Problem, Politics, Policy, Window
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Financing Pharmas
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Tax breaks
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Formularies
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- Lists
- Generic, Listed Brands, Unlisted brands |
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Hospice care
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Focus on comfort and managing pain of dying patients
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Problems of rural health care
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- Less doctors
_ Less care - More car deaths - More drugs/alcohol abuse - Bad mental/dental - Higher rate of male suicide |
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Changes in the FDA
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- Ladies' Home Journal
- Upton's Jungle - 1938 Food and Drug Act - 1962 Drug Amendment Act - 1997 faster drugs |
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Hospital growth
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Grew til 1910
Steady til 1945 Grew til 1980 Steady now |
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Emergency room care
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- Nonurgent
- Urgent - not acute - Emergent - acute |
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DTC advertising
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US only
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High pharma prices
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Lots of use, more varied, more complex
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Shortage in pharmacists
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- More demand
- Less applicants - Changes in practice - More consulting - Competition amongst pharmacies - More women |
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Three desires
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- Quality - Give physicians the power to choose the best prices, products, and practices
- Cost - Degree of control over total health care expenditure - Access - Degree of equity arraigned in distribution of health care |
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Define hospital
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An institution with at least six beds whose primary function is to deliver patient services, diagnostic and therapeutic, for particular or general medical conditions
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