Health Care USA ch 1

Recent government programs try to maintain balance between what 3 things?

access, cost & quality of care

Govrenment- sponsered programs of the 1960s were designed to improve access for older adults & low income without the regard of ____

inflationary effects on costs

What is the primary goal of the market?

contain costs

What position is the largest component of the health care workforce?

Nurses

How has the behavior of patients changed?

In the past patients were compliant & grateful with authoritarian health care providers. Now patient participation is encouraged in every health care decision, producing improved outcomes .

Why do older adults make up the increasing proportion of total populations?

Birth rates have decreased & life expectancies have increased

natural history of disease

The sequence of its origin & progression when untreated.

first level of prevention

(prepathogenesis period) individual at risk, but not yet affected. Identifies factors that increase likelihood of individual contracting the disease.

presymptomatic disease

risk factors combine to produce a disease, clinically undetectable

clinical horizon

point at which medical science becomes able to detect the presence of condition

primary prevention

measures designed to promote health & prevent disease occurence ex. exercise, nutrition, immunizations, seat belts

secondary prevention

early detection & prompt treatment to achieve early cure or slow progression

In what area is most preventative care focused?

secondary

Tertiary prevention

Consists of rehabilitation & maximizing functional capacity when disease has occurred & left residual damage.

Which stage is the most costly?

Tertiary

What is the focus of change regarding the levels of prevention?

In the past, the focus was on curing & rehabiliting. Now we are refocusing on preventative.

Why is the "prevention" method unable to work for the USA?

over 40 million lack adequate health care coverage

What is the natural history of aging?

A blueprint of health services & community needs

Uninsured & underinsured are most concerned with cost, quality, or access to health care?

access

Who is the core of the industry & responsible for quality & cost, to a large extent?

providers

Who is the dominant authority over the health care system?

The governments

What makes the government the dominant authority?

They are payers (Medicaid & Medicare), regulators, providers (public hospitals, state & local depts), tax authorities

How many adults use alternative therapies?

1 in 3. and there are more visits to alternative therapies than primary care physicians.

In Jan 1995 several of the largest individual insurance companies began paying for

unconventional therapies for heart disease & other chronic conditions

Plans such as Blue Cross Blue Shield are being replace by ____

Managed care plans (MCOs)

Who are managed care plans owned by?

insurance companies, hospitals, physicians

What are the most common MCOs?

HMOs Health Maintainence
Organizations

What does managed care include?

provider panels, limited choice of providers or pay additional, gatekeeping- referral needed for specialty or inpatient service, risk sharing for providers,& quality management