Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
61 Cards in this Set
- Front
- Back
|
Identify and to briefly describe the 5 macro-level determinants of health in US society.
|
1. Bismarck Model
2. Beveridge Model 3. National Health Insurance Model 4. Out of Pocket Model |
|
|
Identify and briefly describe the 5 major components of the US health care system
|
1.Facilities where care is provided
2. Workforce that provides services 3. Suppliers of therapeutics, equipment and operating supplies 4. Educational and research instituions 5. Financing mechanisms |
|
|
Primarily, a health care system is organized to provide what?
|
-Diagnosis and treatment of health problems
|
|
|
What is the definition of health care system?
|
-Sum of all institutions and processes that support the work of DX and healing
|
|
|
Describe the Bismarck Model?
|
-Germany, Japan, France, Belgium, Switzerland
-Health care providers & facilities are private -Ex: Companies -Financed jointly by employers and employees -All people are enrolled in system |
|
|
Describe the Beveridge Model?
|
-Great Britain, Italy, Spain, Most of Scandinavia, Hong Kong, Cuba
-Hospital, Health care financed, and Health care provided by government -People pay no premiums, no bills |
|
|
Describe National Health Insurance Model?
|
-Combine Bismarck & Beveridge
-Canada -Providers of care are private -Payer of care is provincial -All peiple pay premiums into ONE provinical goverment -Hospital is public owned -Private Dr and PharmD bill one payer agency -Pt. face NO bills |
|
|
Describe Out-of-Pocket Model?
|
-No organized health care delivery or payment system
-Applies to about 160-200 countries too poor and disorganized -Rural poor rely on healers can pay whateva they can (bartering) -Few wealthy, urban people can access Dr. but will pay cash, out of pocket |
|
|
What % of US pay out of pocket?
|
-Cambodia: 91%
-India: 85% -Egypt: 73% -US: 17% -Britain: 3% |
|
|
Most working people <65 yrs, we ___,___ or ___.
|
-Germany, France, Japan
-Private doctors, private insurance, employer-employee shared premiums |
|
|
Native Americans, military personnel, veterans, we are ___ & ___.
|
-Britain or Cuba
-Government-salaried doctors -Goverment owned hospitals and clinics, |
|
|
Those 65+ years old, we are ___?
|
-Canada
-Private doctors who bill a goverment-run, single payer system, Medicare |
|
|
For 45 million, uninsured Americans, we are ____ or ___?
|
-Cambodia and India
|
|
|
What are the 3 other Essentials?
|
-Organization
-Management -Health Care Performance Assessment |
|
|
What is under the Organization?
|
-Health care programs
-Governmental, non-profit and private |
|
|
What is under the Management?
|
-Planning
-Administration -Regulatory compliance -Finanical management |
|
|
What is under the Health Care Performance Assessment?
|
-Quality of care
-Equity -Efficiency |
|
|
What is the single most expensive component of the health care system?
|
-1/3 US health care dollar is spent on inpatient hospital care
|
|
|
Define comunity hospital?
|
-Majority in US
-All nonfederal, short-term general, and specialist hospitals whose facilities and services are available to the public |
|
|
What does the medical condition treated?
|
-Psychiatric
-TB -OB-GYN -Cancer -Eye |
|
|
What are the Quantitative Descriptors of Hospital?
|
-Number of hospital beds
-Length of patient stay (short < 30 days, long >30 days) -Average daily census: calculated as # of total in-pt. days divided by # of days in reporting period |
|
|
Which characteristic have the most # of hospitals?
|
-Non-profit Community
-Also have most Annual admits, Average daily census |
|
|
Which characteristic have the less # of beds?
|
-Federal (46)
|
|
|
Which characteristic have the most average length of stay?
|
-State/Local Community
|
|
|
Which characteristic have the best ratio of Annual admits: No. Hospitals?
|
-Non profit community: 26,000/3,000 = 8.7
-For profit community: 4,700/870 = 5.6 |
|
|
What is the amt. spend by Public hospital and Private hospital?
|
-Public hospitals: 22%, owned and operated by state/local govt.
-Private hospitals: 78%, (60% operated as not-for-profit entity, 18% establish and run as for profit entity) |
|
|
Most hospital are ___ ___?
|
-Non-federal (96%)
|
|
|
Why is Not-For profit Community clearly dominant?
|
-Largest number of hospitals
-Most beds -Most admissions -Greatest average dialy census |
|
|
What is the broad trends of US hospitals?
|
From 1978 to 2005
-No. hospitals: 7,015 --> 5,756 -Beds: 1.4 --> .94 -Mean Daily Census: 104 --> 64 -Pop: 223 --> 296 |
|
|
What % of peiple in US are working the health care workforce?
|
-9.9% of 13.8 million people
|
|
|
What is # of workers/MD in 1920 vs. 2004.
|
-15 workers/MD in 2004
-3 workers/MD in 1920 |
|
|
___ categories of skilled health occupations.
|
700 categories
|
|
|
In 2003, a total of ____ living MDs, of whom ___ were in active practice.
|
-870,000
-84% -Fully 24% of MDs trained outside of North America |
|
|
What is MD Physician/Pop ratio in NC?
|
-2005: 20.7/10,000
|
|
|
What is % of MDs specialize?
|
-70% MDs specialize
-26 primary specialties (internal medicine most 96,000) -Total # specialties and subspecialities 41-145 |
|
|
In 2005, ___ million active, registered nurses.
-Approx ___ nurses/10,000 pop (2009). |
-2.2 million active
-91.5 nurses/10,000 pop. |
|
|
What is the largest professional group in health care?
|
-Nursing Workforce
-1,300,000 w. ass. degree of hospital nursing school diploma |
|
|
What are the major groups of "nurses", all licensed?
|
-RN's
-Licensed practical (vocational) nurses -Nurse assistants (licensed) |
|
|
What is the Key issues for nursing workforce?
|
-cycles of shortage, surplus, shortage, surplus
-Key factor: 400K-500K licensed nurses not working in nursing |
|
|
What is the potential reasons for attrition of Nurse workforce?
|
-Doctor-nurse working relationship
-Hours of work and shift work -High pt-to nurse ratios -Respect from doctors and administrators -Salaries |
|
|
What are the possible expanded roles for nurses?
|
-Public health nurses
-Maternal & child health nurses -Nurse mid-wives -Nurse anesthetists -Nurse practioners -Nurse senisor administrators |
|
|
What is the amt. of dollars on Outlet Sales Medical Products?
|
-$258.8 billion
-Therapeutics via pharmaceutical industry, pharmacist level: $200.7 billion |
|
|
In 2004, what % of health care expenditures went for pharmaceuticals?
|
-10% of health care expenditures
|
|
|
How many dental school, dental hygiene, and Dent assistant?
|
-56 dental school
-286 programs -269 accredited programs |
|
|
What is the US health Care Expenditures in 2008?
|
-Total expenditure 2008: $2.3 Trillion
-Expenditure as % of 2008 GDP: 16.2% -Expenditure per capita: $7,681 -For 2008, the +Health expenditure inc:4.4% +GDP inc: 1.1% |
|
|
Where does the money come from?
|
-In 2007, four parties paid for the nation's 2.0 trillion dollar health care bill
1.Businesses (25%) 2.Households (31%) 3.Other private sponsors (4%) 4.Governments (40%) |
|
|
The money to pay for health care services comes from one or more of the 3 sources?
|
1. Patients: Insurance premiums and out-of-pocket payments
2.Care providers: debt forgiveness, charity care 3. 3rd Party Payers: "Anyone responsible for paying, other than a pt or provider, is 3rd party payer" |
|
|
What examples of 3rd party payers?
|
-Pt's employers if the employer pays all or part of the bill
-Private insurance -Managed care organizations (MCOs) -Foundations -Federal, state&local government |
|
|
What is Private insurance companies of Private third-party payers?
|
-Approach is the group insurance program where employer and worker contribute to the premiums to purchase health insurance form an insurance company
|
|
|
In 2005, the private sector paid for __% of the country's health care service expenditures.
|
-55%
-Made up of two shared: 1. Health insurance industry-40% 2. Out-of-pocket payments: 15% |
|
|
What can lead to out-of-pocket health care expenditures?
|
1. No private health insurance coverage, too young for Medicare, Not medicaid/SCHIP eligible
2.Have private insurance but must 1st pay deductible, must make co-payment contribution 3. Have a managed care organization (MCO) plan, but restriction were violated -Required out-of-plan services -Consulted an out-of-plan provider |
|
|
What are some public sector that functions as a THIRD PARTY PAYER?
|
1. Medicare
2. Medicaid 3. SCHIP |
|
|
What are the four parts to Medicare?
|
-Part A: Hospital, skilled nursing, home
-Part B: Physician, hospital out-pt. services -Part C: Medicare Plus-MCO managed Medicare -Part D: Prescription drug coverage |
|
|
What is Medicare?
|
-Government's third party plan for the nation's 65-year olds and older
-Part A: financed by Social Security System -Part B: financed by general tax revenues (2/3) and premiums (1/3) -Part C: UKN -Part D: financed by premiums |
|
|
What is Medicaid Program?
|
-Intended for healthcare of the poor, uninsured
-Needs-based and involves means-testing -Must applied -Supported by Federal and State taxes |
|
|
What is SCHIP?
|
-State Children's Health Insurance Program
-Aimed at uninsured children who are not eligible for Medicaid -Supported by federal and state govt. -2007 SCHIP expend $8.7 billion (69% federal) |
|
|
What are the common indicators of Health System Performance?
|
-Equity criteria
-Efficiency criteria -Quality of care -Pt. and population satisfaction |
|
|
What is Equity, Efficiency, Quality criteria?
|
-Equity: Access to care, broad health insurance coverage
-Efficiency: low to moderate per capita expend., high proportion of health expenditure going directly to provision of service -Quality of care: infant mortality rates, avg. length of stay for normal delivery, life expectancy from birth |
|
|
Which country have the highest total health expenditures per capita?
|
-USA
|
|
|
Which country have the highest total health expenditures as a Share of GDP?
|
-USA
|
|
|
Describe US infant mortality from 1960-2006?
|
-Decrease from 26 to 6.9 (1,000 death)
-USA have the highest selected infant morality rates (6.9) |
