Final ( Exam 2) Study Guide
Final ( Exam 2) Study Guide 1101
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This 11 page Study Guide was uploaded by Gabriela Saint-Louis on Thursday April 23, 2015. The Study Guide belongs to 1101 at George Washington University taught by Tamara Henry in Spring2015. Since its upload, it has received 178 views.
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Date Created: 04/23/15
SCENARIOS Public Health Final Exam 2 Study Guide gt Physical environment 0 Unaltered environment Specifically looks at naturally occurring elements that we can t alter depending on your level of exposure can be bad ex radon exposure happens in our environment sunlight Altered water treatment how we manage waste is problematic oil spills chemicals radiation how we dispose of biological products hazardous waste management issue Benzene organic compound in the environment 0 causes leukemia and a host of other diseases references to exposure length Built manmade construction produces so many other things that go into the construction process Pollution etc how we as humans build our communities urban planning and public health altered and built environment change as the population grows the more people we add the more the environment will change significant gt Accreditation processes 0 Implies a process of setting standards for educational and training institutions and enforcing these standards using regularly scheduled institutional self study or outside review used by most health professions to define and enforce educational expectatio gt 10 essential public health services and what they mean pg 235 table 0 ASSESSMENT Monitor health status to identify and solve community health problems ex Vital statistics health surveys surveillance including reportable diseases Diagnose amp Investigate health problems and health hazards in the community ex Epidemic investigations CDCEpidemic Intelligence Service State Public health laboratories 0 POLICY DEVELOPMENT inform educate and empower people about health issues Mobilize community partnerships and action to identify and solve health problems develop policies and plans that support individual and community health efforts 0 ASSURANCE Enforce laws and regulations that protect health and ensure safety Link people to needed personal health services and ensure the provision of health care when otherwise unavailable ensure the provision of competent public and personal health care workforce evaluate effectiveness accessibility and quality of personal and population based health services 0 ALL THREE IOM Institute of Medicine CORE FUNCTION Research for new insights and innovative solutions to health problems gt Know the differences between Medicare and Medicaid 0 Medicaid for those below the poverty level varies state to state not the same for everyone Medicaid can be higher or lower or bare minimum depending on where you live states have the ability to define the poverty level Schip all kids are eligible for even if you are homeless and no ID 0 Medicare 65 and older now available for disabled as well do not cover eyeglasses and hearing aids 4 parts to Medicare A D 1 Part D prescription drug portion 2 Part B voluntary supplementary insurance you can contribute a certain amount of money per month in the even something happen to you it can cover the costs MULTIPLE CHOICE gt Know everything about primary care physicians gt Know about all aspects of US vs UK health care 0 US spends 18 of their GDP on health care 3 trillion per year about 9000person 0 UK spends about 8 of their GDP on health care 0 US spends more money on specialists as opposed to UK who spends more on primary care which drives down the overall cost of health care 0 Table 114 US vs UK The United States spend more per person and as a percentage of GDP US has a higher percentage of uninsured individuals even after the implantation of the ACA The US healthcare system is more complex for patients and providers of care and costs far more to administer The US healthcare system places more emphasis on specialized physicians and on nurse practitioners and physician assistants to prvide primary care I the US encourages rapid adoption of technology especially for diagnosis and treatment I USgt places greater emphasis on giving patients a Wider choice of clinicians I US has a more complex system for ensuring quality nd a unique system of malpractice law I Universal coverage through National Health Service I NHS single payer With capitation plus incentives for general practitioners I Primary care general practitioners 66 vs 33 in US I Specialists 33 vs 66 in USgt I limited choice of general practitioners greater choice With private insurance I only spends 8 of GDP on Health Care gt Medicare D O relatively new prescription drug coverage plan it is a complicated plan that is open to those Who are enrolled in parts A and B of Medicare gt All hazards approach 0 uses the same approach to preparing for many types of disasters including us of surveillance systems communications systems evacuations and an organized healthcare response 0 the allhazards approach has been Widely endorsed by public health agencies and organizations in part at least because it recognizes the need for basic public health infrastructure to respond not only to the dramatic crisis or emergency but dayto day needs as well gt COMMUNITY ORIENTED PRIMARY CARE COCP O a structured effort to expand the delivery of health services from a focus on the individual to also include an additional focus on the needs of communities 0 serving the needs of communities brings healthcare and public health efforts together 0 Can be seen as an effort on the part of healthcare delivery sites such as community health centers to reach out to their community and to the governmental public health institutions 0 The six sequential steps of COPC I Community de nition how is the community defined based upon geography institutional affiliation or other common characteristics e g use of an Internet Site I Community characterization What are the demographic and health characteristics of the community and What are its heath issues I Prioritization What are the most important health issues facing the community and how should they be prioritized based upon objective data and perceived need I Detailed assessment of the selected health problem What are the cost effective and efficient interventions for addressing the selected health problem based upon an evidencebased assessment I Intervention hat strategies Will be used to implement the intervention I Evaluation How can the success of the intervention be evaluated gt Food Drugs and Health issues pg 4 0 Food Safety Modernization Act passed giving the FDA and USDA increased authority to ensure the safety of foods I the key to the law was ability to tract foods including their origin date of production and other data that could be useful in locating the source of the food if a disease outbreak occurred and investigating the outbreak s cause 0 Drug safety I IOM has concluded that nearly 100000 Americans die each year as a result of adverse effects of drugs Thus from the populatin perspective as well as well as the individual patient care drug testing and monitorying for safety are important public health issues gt 6 C s of primary care 0 caring individualized care based on individualized relationships Continui follow up etc patient followed over years 0 coordinated care usually has to do with diagnosis and treatment dealing with more than one individual 0 comprehensive care hopes they can solve your problems overall usually medical home contact first point of contact with healthcare system 0 communitv connect individual patient with community resources 0 O gt Primary Secondary and Tertiary carefacilities 0 Primary refers to first contact with providers who can handle the majority of problems for which patient seeks care 0 Secondary specialty care provided by clinicians who focus on one or small number of organ systems or a specific service 0 Tertiary refers to the type of institution in which care is delivered often academic or specialized centers such trauma burn center etc gt Characteristics of health care quality pg 197 101 0 Access and Service I access to needed care and good customer service 0 Qualified providers 39 personnel licensed and trained and patients satisfied with services 0 Staying healthv I Quality of services that help people maintain good health and avoid illness 0 Getting better I quality of services that help people recover from illness 0 Living with illness I Quality of services that help people manage chronic illnesses gt Know the benefits of the ACA 0 Greater protection for individuals amp Families I prohibits excluding or charging more for those With preexisting conditions I eliminates lifetime and annual caps and prohibits resindding coverage except for fraud I allow employees to change jobs Without fear of losing insurance or covering for it in full 0 Fewer uninsured I children can stay under parents insurance until age 26 I penalties for business that do not offer adequate insurance likely to increase the number of insured I estimated 30million additional individuals Will be covered 0 More standardized coverage I Standardized insurance packages With defined essential benefit packages limits on cost sharing and a choice of cost and payment levels 0 More competition in offering insurance I private insurances Will lower their costs because of competition in offering insurance 0 Expansion of the exchanges I The legislation may lay the groundwork for a regional or national approach to purchasing health insurance 0 Higher Taxes on highincome individuals I Medicare taxes Will increase 0 continuing efforts to control costs 39 not really a bene t but more a future implication not addressed by the ACA gt Systems thinking 0 An approach that examines multiple in uences on the development of an outcome or outcomes and attempts to bring them together in a coherent Whole gt Study bold items and also be aware of all CHARTS as it relates to the outline and notes on Blackboard Chapter 7 SmallpoxTable 7 1 See Table 7 2 to contrast i No animal reservoirl Disease is limited to humans ii Short limited persistence in environmentljrequire human to human contact iii Absence of long term carrier state I post recovery you no longer have the virus and cannot transmit it to others iv Long term immunity results from infection unlikely to ever get disease again v Vaccination also establishes long term immunity H ex Live smallpox vaccine is very successful and has not mutated to become more infectious vi Herd immunity protects those who are susceptible prevents perpetuation of an epidemic Il80 of population must be vaccinated to interrupt spread of infection vii Easily identified diagnosed diseaseljpresentation is easy to ID viii Vaccination effective post exposure you can still be treated post infection Chapter 8 Impact of mercury Box 84 Chapter 9 0 Primary Secondary and Tertiary Care Primary refers to first contact with providers who can handle the majority of problems for which patients seek care 2 Secondary refers to specialty care provided by clinicians who focus on one or small number of organ systems or a specific service 3 Tertiary care refers to the type of institution in which care is delivered often academic or specialized health centers such as trauma burn center etc Chapter 10 Type of coordinated care Intended Functions amp challenges with implementation Table 102 Type of coordination Extended Function Challenges with implementation Clinicianpatient relationship Continuity development of oneto one relationships built on knowledge and trust over extended periods of Time Multiple clinicians involved in care Team rather than individual Frequent changes in insurance Coverage require change in Health professional Institutional coordination Coordination of individual s info Between institution need to inform Individual clinical and administrative Decision making Different structures and Governance often lead to lack Of coordination bw inpatient Facilities and bw inpatient and Outpatient facilities Financial coordination Implies comprehensive coverage for Services provided by the full range Of Institution Aims to maximize the efficiency of The care received and minimize the Administrative effort required to Manage the payment system Lack of comprehensive Insurance coverage often Means essential services Cannot be delivered or can t Delivered at the most efficient Or effective institutional site Coordination bw Health care amp Public health Coordination of services bw clinical Care and public health requires Communication to ensure followup And to protect the health of others Lack of coordination of Services between public health services and clinical care is Often based on lack of L communication Chapter 11 0 US Health care system characteristics 33 primary care 66 specialists We spend the most on health care per capita We have the highest of underinsured and uninsured Complex for both patients and providers and costs more to administer US healthcare system places emphasis on MDs Pas and NPs US encourages rapid adoption of technology US gives patients Wider choices for clinicians CompleX system for ensuring quality and a unique system of malpractice law Market justice vs Social Justice 00000000 0 US market justice 18 GDP Table 112 0 UK social justice8GDP Table 114 0 Canada mixture of both 10 GDP Table 113 To compare health systems utilize this general criteria 1 Method of financing 2 Insurancereimbursement 3 Delivery of services 4 Comprehensiveness of insurance 5 Cost and cost attainment 6 Degree of patient choice 7 Administrative costs Chapter 12 Core Public Health Functions 0 Assessment obtaining data that defines the health of overall population and specific groups within the population including defining new and persisting problems 0 Assurance governmental public health s oversight responsibility for ensuring that key components of an effective health system including health care and public health are in place even though the implementation will be performed by others 0 Policy development includes developing evidence based recommendations and other analyses of options such as health policy analysis to guide implementation including efforts to educate and mobilize community partnerships Table 121 Ten essential Public Health services Chapter 13 II Wavs food can affect health and disease Table 131 A Food and Food Safety 0 Too little food Too much food Deficiencies in vitamins and minerals Contaminants Individual susceptibilities Foodborne communicable disease I 1 in 6 Americans get sick or 100000 annually and 3000 die B Detecting an outbreak Figure 131 0 Cluster a large of people appear to have the same illness in a given time period 0 Outbreak refers to ill persons who have something in common to explain the illness 0 Defining and finding cases which public health officials investigate the size timing and severity see case definition Generating the hypothesis about likely sources 0 Testing the hypothesis 00000 O
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