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48 Cards in this Set
- Front
- Back
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Public Health
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A state of affairs in which the public or segment of the public possesses the highest level of physical, social and mental health
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3 types of Public Health
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Physical/Biological health
Phycological health Social Health |
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Scope of Healthcare
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Societal- Health of society as a whole
Individual health |
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Levels of Healthcare
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Primary- Prevention
Secondary- Treatment Tertiary- Rehabilitation |
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Healthcare vs. Medicine
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Medicine- Physical
Health- Physical, mental, social |
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What level of healthcare is medicine?
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Secondary
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What level of healthcare is Health?
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Primary, secondary, and tertiary
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Medicine is.....
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Individual
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Health is....
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societal
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Health Status Indicators
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Life Expectancy
Death Rate Infant Mortality Rate Mortality Morbidity |
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Leading causes of death- 1900
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Pneumonia/flu
TB Diarrhea Senility ALL ARE COMMUNICABLE DISEASES |
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Leading causes of death- 2006
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heart disease
cancer stroke injuries ALL ARE NON-COMMUNICABLE |
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Reasons for decline in mortality rate
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Technology
Better Healthcare hygiene (chlorine, bottled water, indoor plumbing) |
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Age of Social Control
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1960- government intervention in order to make healthcare more efficient
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Roemer's Law
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Every hospital built is a hospital bed filled. Demand is supply driven.
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Public Law 164
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first time government tried to control supply of healthcare. ended by regan
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TEFRA
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Changed the way medicare paid hospitals. Dr's get fixed reimbursement. ONLY APPLIED TO ADMITTED MEDICARE PATIENTS
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DRG
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Diagnostic Related Group- Evaluated need of patient and determined $ reimbursement to hospitals. Created incentive for hospitals to treat people faster.
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CON
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Certificate of Need- Hospital undergoing expansion needed this before expanding. Sometimes hospitals would get a CON and never expand to prevent other hospitals from expanding. If hospital expanded without CON, would loose part of medicare fund.
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Types of Health Data
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Demographic data
health utilization health status |
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Demographic Data
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Describes the population
age sex income |
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Health Utilization
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how people are using health services
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Health Status
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Mortality
Morbidity |
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Uses for health data
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describe a situation
program planning |
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Vital Statistics
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Births
deaths marriages divorces |
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Morbidity incidence
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The number of new cases of a disease that come into being during a given period of time in a defined population
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Morbidity prevalence
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the number of existing cases of a disease in a given population during a given period of time
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Measures of Mortality
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Crude death rate
Disease specific death rate case specific death rate infant mortality rate |
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Crude death rate
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deaths from all causes and populations
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Disease specific death rate
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deaths from a specific disease per population
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case specific death rate
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deaths from a specific disease per number of people with that disease
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infant mortality rate
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number of deaths in the first year of life per number of live births
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Sources of health data
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-National center for health statistics
-health and examination survey (HANES) -Hospital discharge survey -Bureau of vital statistics - Centers for disease control -Social security administration (SSA) - National ambulatory care survey -Health Interview Survey (HIS) -Morbidity and Mortality Weekly review |
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What data can hospitals provide?
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NONE because of confidentiality.
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Motto of healthcare providers
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Do No harm
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General approaches to quality control in healthcare
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Licensing (mandatory)
- personal -institution accreditation programs (not mandatory) Certification -personnel |
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Specific approaches to quality control in healthcare
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Hospital review committees
Government programs |
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Hospital review committees
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Tissue
Quality Assurance Utilization review |
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Government programs to control healthcare quality
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Peer review organizations (PRO's)
Malpractice Litigation |
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Defensive medicine
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to prevent malpractice lawsuits physicians run unnecessary tests and prescriptions
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Criteria of quality healthcare
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effective
efficient accessibility acceptability provider competence |
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Criteria of quality healthcare PROVIDERS are most concerned with
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Effective
Provider competence |
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Criteria of quality healthcare PATIENTS are most concerned with
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Accessibility
acceptability |
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Criteria of quality healthcare PAYERS are most concerned with
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effective
efficient |
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Ways to measure healthcare quality
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Causal model
structure process outcome |
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Measuring quality: Structure
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advantages: easy to measure, inexpensive, easily observable
disadvantages: indirect, has no bearing on outcome |
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Measuring quality: Process
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advantages: widely used methods
disadvantages: little agreement on what constitutes a good process. |
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Measuring quality: Outcome
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a change in health status
advantages: direct measure disadvantages: lag time, difficult to compare outcomes |
