CORE 1 - Health priorities in Australia Flashcards

Question

A growing and ageing population

Answer 1

- Healthy ageing - increased population living with chronic disease - demand for health services and workforce shortages - availability of carers and volunteers

Answer 2

Healthy ageing includes behaviours and choices that effect health (e.g. physical activity, good diet, regular family and social activities). The goal of healthy ageing is to enable the elderly to maintain their health into old age, allowing them to be self-sufficient by working and contributing to society longer. This increases economic growth, but also decreases the use of health services by the elderly, who are the largest users of the health care system. Healthy ageing involves people reducing their risk factors for disease, and preventing the progression of the disease after its onset to reduce morbidity and mortality. Healthy ageing is influenced by: 1. Environments: have an important influence on the development and maintenance of healthy behaviours. Maintaining healthy behaviours throughout life, particularly eating a balanced diet, engaging in regular physical activity, and refraining from tobacco use all contribute to reducing the risk of non-communicable diseases and improving physical and mental capacity. 2. Behaviours also remain important in older age. Strength training to maintain muscle mass and good nutrition can both help to preserve cognitive function, delay care dependency, and reverse frailty. 3. Supportive environments enable people to do what is important to them, despite losses in capacity. The availability of safe and accessible public buildings and transport, and environments that are easy to walk around are examples of supportive environments.

Answer 3

As Australia’s population continues to age, there is an increased population living with chronic disease and disability. This is because chronic disease and disability are more prevalent in the elderly. This is especially the case as survival rates from many chronic diseases increases, resulting in decreased quality of living and independence. Chronic disease and disability are more prevalent in the elderly. Survival rates from many chronic diseases increases, resulting in decreased quality of living and independence. Chronic disease is the greatest issue for Australia’s health and has a large burden on the population. With an increased population living with chronic disease and disability, comes an increase in health care expenditure and the need for aged care facilities. Common chronic diseases among the elderly include: - 53% of the have a disability - 49% have arthritis - 38% have high blood pressure

Answer 4

An ageing population increases public spending on health and places an unsustainable strain on health services. An increase in age means and increase in health conditions and disability, making the elderly high uses of health services. • Elderly visit health professionals more frequently meaning more specialists are needed • Number of people living in aged care has risen by 20% • Places a high burden on health system with most residents having chronic illnesses • Increased use of Medicare and PBS means more funding to be allocated and taken away from other areas of need Increased aged care facilities requires increased workforce training in aged care and chronic conditions. Educating elderly with focus on safe use of medication decreases work shortages. • Decrease in overall workforce • Decrease tax payed • Increased need for workers in aged care • Increased demand for carers and volunteers

Answer 5

An ageing population and increased chronic disease means more carers are needed. Care can be informal and unpaid (e.g. family member) or formal and paid (e.g. professional). Informal carers often decrease their work load to care for loved ones, which influences the tax they pay and the stress and health of the carer. Rates of volunteers have decreased recently, but to ensure proper care for the elderly volunteers are needed. As volunteers are not paid, it does not negatively contribute to the financial cost of an ageing population. Many organisations exist to help provide care to elderly in their homes by offering nurses to help with medical care, food delivery service and support for mental and social needs. Organisations include: • Anglicare • Your Aged Care at Home • Nurses on Wheels

Answer 6

Institutional (buildings): hospitals, nursing homes Non-institutional (people): general practitioners, research groups, dentists, pharmaceutical services Primary Health Care: focuses on prevention, health promotion and clinical care (e.g. GPs, nurses, midwives, dentists, pharmacists) Secondary Health Care: Provided by those who don’t have first point of contact with patients. Usually occurs after a referral from primary health provider (e.g. specialists, physiotherapists) Hospitals - provide a wide range of services; emergency, elective surgery, rehabilitation, midwifery services - can be public or private - Medicare covers cost of public hospitals = more access to those low SES - private hospitals require either full payment by patient or combined when using a private health insurer Nursing Home - Service for those suffering from chronic disease or disability and for the elderly - growing industry because of Australia’s growing and ageing population - Can be charitable (private), private (for profit) or government owned - Government provides majority of funding, with private homes requiring more payment from individuals General Practitioner (GP) - Community service, often first point of access into medical and health services - Medicare covers majority of cost - GP’s add additional fees on top of that by the government, although some bulk bill (no extra cost) - After hours GP’s have grown to reduce the use of emergency services, as patience in emergency don’t require immediate treatment – however access to a service of the GP is often not available Dentists - Generally not covered by Medicare - require patients to pay out of pocket or through private health - Some can claim rebates through Medicare under the chronic Disease Benefit Scheme combined with Allied Health Initiative Allied Health Providers - Not normally covered by Medicare - Has allowed for some rebate to be claimed i.e. physiotherapist, osteopath, chiropractor, exercise physiologist, occupational therapist, and psychologists Pharmaceutical Services - Funded through the Pharmaceutical Benefits Scheme (PBS), which provides partial payments for many medications with set amounts being payed by the patient - PBS provides extra funding for those with special needs i.e.; pensions, concession cardholders and war veterans

Answer 7

The overall responsibility for health facilities and services are the Australian health ministers (commonwealth + state) – referred to as the Standing Council on Health. The individual system responsibility is for health ministers and departments in each jurisdiction. Standing Council: - implements the Governments national health reforms - focus on achieving a better health service and a more sustainable health system for Australia - focus on closing the gap between Indigenous and non-indigenous Australians Areas include: - Hospitals - Community Health - Primary Health care - Health promotion - Mental Health - National Drug Safety - Aged Care etc. COMMONWEALTH Gov. - Policy and legislation - Funding to state/territory - hospitals - fund Medicare and PBS - health promotion strategies STATE/TERRITORY Gov. - Health services; hospitals, mental health, women’s health, Aboriginal Health, dental - Assist in health care promotion - regulate the health system, licencing private hospitals and implementing legislation to operate public hospitals. - regulate safe supply of tobacco and alcohol, safety of pharmaceuticals, goods, appliances, blood products and health insurers LOCAL Gov. - Action policies; WHS, parks/community spaces - Community health services and clinics - Early childhood centres - Local health promotion - Waste disposal - Meals on wheels PRIVATE SECTOR - Private hospitals - Dentists - Alternative health care COMMUNITY GROUPS They promote health and are formed on a local needs basis to address specific problems or areas. (e.g. Cancer Council, Family Planning)

Answer 8

Equity of access to health facilities and services = health care and services are accessible to everyone and equally distributed amongst the population. Access to health care is determined by: - Socioeconomic status - knowledge of services - Geographical location - Cultural/religious beliefs Groups experiencing inequity of access RURAL AND REMOTE - Less access to health facilities and services - Limited access to hospital services, especially lack of private hospitals and specialist services - Address the issue; Royal Flying doctor service, e-Health records and Telehealth technology (video calls w/ specialists) ATSI - have poor access to health facilities and services - less access to dentists, GP’s and hospitals - Causes; long waiting times, cost, unavailable services and culturally inappropriate services LOW EDUCATIONAL LEVELS - less access due to lack of knowledge on health - Causes; limits knowledge regarding health needs and ability to navigate health system Initiatives promoting equity - introduction of Medicare and Pharmaceutical benefit scheme - Greatly removed cost barrier to majority of services, but not all i.e. dentists, physiotherapist, psychologists, occupational therapies are not covered – resulting in inequity of access. - Local Hospital Networks have also allowed for improvements, through linking services within a region or specialist networks in state or territory, increasing local autonomy and flexibility to local needs.

Answer 9

Health care expenditure = spending on health goods and services including; hospitals (public/private), primary health care (unreferred medical services, dental etc), other recurrent expenditure and capital. Example: In 2016-17, the gov. spent $74.6 billion on health care, and $2.2 billion on early intervention, which is just 1.4%. Purpose of expenditure v expenditure on early intervention and prevention = to compare the treatment of disease and illness with prevention – necessary to health in Australia, to create an effective health care model that seeks early intervention and prevention as well as treatment of disease and illness. PREVENTION Approaches and activities aimed at reducing the likelihood of a disease/disorder affecting individuals, through interrupting or slowing its progress. - Current focus on Australia regards chronic diseases, thus the drive to improve lifestyle choices in relation to health i.e. decrease smoking, increase physical activity, decrease drugs/alcohol, balanced diet. Implemented Strategies/focus - good hygiene - safe environments - sanitation - immunisation - Cancer screening - health promotion; behavioural and educational (slip, slop, slap; Quitnow) INTERVENTION interfering with the outcome or course especially of a condition or process, in a way that prevents harm or improves function. Implemented strategies/focus - cancer screening programs (breast, prostate, skin etc.) Complications on spending more on early intervention: - Removal of funding from other aspects of health and society - Increase in taxes - Results from increasing this expenditure won’t be noticed for many years Recommendations: - Increase taxes temporarily - Junk food/sugar tax - Increased alcohol/smoking tax IMPORTANCE OF FOCUS ON EARLY INTERVENTION AND PREVENTION - Strain on the health care system – reduces burden of disease and therefore expenditure long term - Quality of life/life expectancy – when diseases are detected early, there is a higher success rate and les vigorous treatment - Saves gov. money and resources – boosts economic performance/productivity

Answer 10

Impact of new treatments and technologies = benefits to health outcomes, increase in cost and questions about equity of access. Examples - Less invasive surgery methods; keyhole surgery used for knees, kidneys and hernias - Drugs for diseases including HIV and cancer (chemotherapy) - Improved artificial organs i.e. kidneys - Ultrasound and MRI for internal imaging ADVANTAGES - improve early detection of diseases and illnesses - improve treatment and prevention, allowing for improved outcomes, quality of life and life expectancy - increase in ageing of our population - less invasive - higher chance of success - quicker recovery DISADVANTAGES - Cost - increased need for health care expenditure, not funded through Medicare - Access - inequity of access, only those of high SES able to seek benefits - less availability in rural/remote areas – due to less cost-effective means - Requires those in rural and remote areas to travel to metro areas in order to access treatment and technology i.e. in later stages of kidney disease.

Answer 11

MEDICARE = provides health cover for all Australians, covering patient costs in hospitals and a large portion of costs for primary health care. - Funded through the tax system and the Medicare levy; currently 2% of a person’s taxable income paid by every tax payer. - There is an additional 1-1.5% increase to those who have a high taxable income (over $90,000 as a single or $180,000 for a family). ADVANTAGES: - free hospital care in public hospitals - subsidised treatment from GPs, specialists, optometrists - Medicare safety net – once individual reaches $470 of ‘gap’ payments, the safety net covers 100% of scheduled fee on out of hospital care - Prioritisation - Small Medicare levy – 2% or 3 – 3.5% for non-private - PBS health care cards – the ordinary PBS rate of $40.30 is decreased to $6.40 for those with a concession card (i.e. chronically ill or disable) - PBS safety net – ordinary people: threshold = $1550.70, then they receive the concession rate of $6.40. Concession card holders: threshold = $390, and then free medication. DISADVANTAGES: - Limited to basic health needs - Misuse of the system - most ancillary care providers, other than Allied health and dental care for those with chronic conditions (i.e. ambulance, hearing services, hospice care, dialysis services) Allied Health = The broad range of health professionals who are not doctors or nurses; physio, osteopath, chiropractor, occupational therapist, psychologist. PRIVATE HEALTH INSURANCE Provides financial cover for part or all of the cost of various health related treatments and services. - Can cover health services not covered by Medicare i.e. physio, dental - Can cover treatment as a private patient in a public/private hospital allowing for freedom of choice of doctors, hospitals and time. - Allows for faster elective surgery/avoids waiting times Benefits - Individuals don’t have to pay the Medicare levy surcharge - Private health insurance rebate (government contributes to health insurance) - This decreases government expenditure and increases personal contributions to health care benefits high SES, but also allows for greater funds to those of low SES - Lifetime health care loading - This loading is 2% each year over the age of 31 where a person has not taken out private health insurance. In other words, if a person takes our private hospital insurance when they are 40 they will pay an extra 20% on top of the price they would have if they took out the cover before they turned 31. This person would also lose their rebate from the government resulting in higher private health insurance prices for people who wait to take out their private hospital cover

Answer 12

Complementary health care: Using unconventional practices in addition to traditional western medical approaches to treat and manage an illness. Alternative health care: Using only untraditional methods to treat and manage an illness. EXAMPLES - natural medicines (herbs, nutrition, homeopathy, Chinese medicine etc) - supplementation (vitamins, minerals, oils, protein, vegetable powders etc) - physiological treatment (physiotherapy, osteotherapy, remedial massage, occupational therapists, acupuncture etc) - energy based treatments (crystals, some forms of massage, acupuncture etc) - can be supplements or herbal vitamins

Answer 13

- 60% increase since 1990 of alternative - increased credibility of many complementary and alternative health services, due to tertiary education - the growing multiculturalism of Australia e.g. Chinese medicine - health insurance cover - regulatory bodies and professional associations being made - Australians seeking a more holistic approach to health. - Many complementary and alternative health practitioners are required to complete 3-7 years of tertiary training. E.g. include the 4-year Bachelor of health science in traditional Chinese medicine at UTS, and Osteopathy, which requires a 5-year university master’s degree offered at Southern Cross University. - the development of regulatory bodies and professional associations has increased the credibility e.g. The Australian Traditional Medicine Society is one such body, as is the Australian Natural Therapies Association

Answer 14

``` There are many services available, including: • Acupuncture • Aromatherapy • Chiropractic • Homeopathy • Meditation • Naturopathy ``` Naturopathy uses natural products to strengthen the immune system and speed up the healing process. Naturopaths often treat patients by improving their diets or providing nutritional supplements, using homeopathic treatments, or herbal medicines. Homeopathy recognises the symptoms unique to each person. It aims to stimulate the individual’s healing powers to overcome the condition. Homeopathic medicines work gently and rapidly to alleviate symptoms. Acupuncture involves inserting very fine needles into the skin. They are left in either briefly or for up to 20–30 minutes. Acupuncture is claimed to be effective in a wide range of conditions, stimulating the mind and the body’s

Answer 15

How do you know who to believe Individuals should make sure they make good decisions regarding CAM, as many of these approaches are not regulated. - Look for qualifications, registration, regulations and research - Research on the internet to find credible sources and reliable information (e.g. government websites, websites with .edu or .org in domain, academic journal articles written by trained professionals) - Ensure people who you ask about the approach have experience and are qualified Questions to ask the provider include: - What qualifications do you have? - Are you registered? - What evidence is there for this treatment? - Are there side effects? If so, are they common? - Will treatment affect other treatments I might or am receiving? What do you need to make informed decisions? - Relevant information from reliable sources from professionals (e.g. doctors, professional associations, registration bodies) - Consult GP for opinions

Answer 16

HEALTH PROMOTION = is the process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions.

Answer 17

- Individuals and families - Groups in the community and industry (e.g. schools, workplaces, media) - Non-gov. organisations – domestic and international

Answer 18

Gov. Develop policies and provide funding (e.g. K-10 PDHPE compulsory and advertisements) EQUITY + SUPPORT Communities Run education and training programs to develop skills in relation to health (e.g. community health centre education) SUPPORT Individuals Take charge of their own health (e.g. research behavioural choices for health) SUPPORT

Answer 19

Gov. Fund, research and create policies around prevention and health promotion. Looking at all the determinants of health and not just curative services (e.g. tv advertisements) EQUITY, DIVERSITY + SUPPORT Communities Conduct research, and be involved in the promotion of health. (e.g. cancer council conducts research around cancer, and promotes better health choices) DIVERSITY + SUPPORT Individuals Seek to make healthy life choices, and help others to do the same (e.g. getting advice from a GP on quitting

Answer 20

Gov. Engage with community groups in creation of policies (e.g. allowing communities to provide feedback on policies) DIVERSITY + SUPPORT Communities Contribute to policies and implementing them (e.g. Aboriginal community-controlled health services) DIVERSITY Individuals Promote and be involved in activities that improve health (e.g. promote fun runs) SUPPORT

Answer 21

Gov. Creation and maintenance of policies that improve health (e.g. Closing the Gap) EQUITY + DIVERSITY Communities Develop and carry out health policies e.g. ATSI involvement in the development and implementation of ‘close the gap’) DIVERSITY Individuals Act in accord with the policies delivered (e.g. not smoking in public areas) SUPPORT

Answer 22

Gov. Planning, implementation and management of infrastructure (e.g. location of hospitals) EQUITY + DIVERSITY Communities Maintain healthy environments and promote healthy behaviours (e.g. fun runs) DIVERSITY + SUPPORT Individuals Make better health choices using the environment (e.g. putting rubbish in the bins provided) SUPPORT

Answer 23

Ensures it is effective in improving health outcomes. Partnerships involve collaboration between many groups including both the government sector and non-government agencies, along with local communities and the individual. This integration of health promotion creates optimal conditions for achieving health promotion goals. Individuals and Communities - should be involved in the development of health promotion programs, empowers them to act in accordance with the promotion (this is opposed to an enforced health promotion, which is likely to be rejected). - implementation and analysis, data analysis, community meetings, consultations and surveys. Government and non-government sectors - work together with individuals and communities - need to share information e.g. research findings, funds, connections The benefits of partnerships in health promotion include: - Addresses needs of individuals and communities - More comprehensive health promotion - Better results in health promotion goals - Empowers individuals to act - More efficient health promotion (no doubling up and reduced waisted time/money)

Answer 24

EXAMPLE – BREASTSCREEN AUSTRALIA This government funded service aims to detect breast cancer early before it has a chance to spread. - BreastScreen NSW runs screening and assessment services at more than 190 fixed and mobile locations (In addition to the permanent clinics, BreastScreen NSW t operates Mobile Units which visit smaller towns on an annual basis) - The state and territory governments have primary responsibility for the implementation of the program at their local level - BreastScreen Australia, which is jointly funded by the Commonwealth/state territory governments. - As a result of these collaborative programs, breast cancer mortality has declined from 62 deaths per 100 000 women aged 50–69 years in 1996, to 52 deaths per 100 000 in 2005. Breastscreen links to the action areas of the Ottawa Charter BHPP – Free mammograms for women 50+ is a Government policy, it ensures Cancer is detected early and survival increased (less money spent on treatment long term), ensures social justice and equity in health RHS – Breast Screen Australia, is n example of RHS, it’s aim is to improve survival from Breast Cancer, it operates in many areas, is free and has mobile centres to ensure equity in rural areas CSE – The Government ensures the infrastructure is in place to support people in order to get mammograms, breast screen NSW has over 190 mobile and fixed screening centre’s SCA – The local community groups are ultimately responsible for the management of breast screen NSW, this is beneficial as the community is aware of individual needs, for example, cultural awareness, language needs, advertising methods – with not to the people DPS – Information on Breast Cancer, screening procedures, treatments Breastscreen and links to social justice - Breast screen NSW ensures equity by offering FREE mammograms to women aged 50+ or 40 + if at high risk. (BHPP – policies must ensure equity) - The environments are supportive of all people, if they are not supportive, they do not provide equity. Breast screen NSW has over 190 mobile and fixed center's, the mobile center's ensure equity and increases access for people in a rural and remote area (CSE) - Community groups must be involved in their own health this ensures equity, for example ATSI must be involved in the mobile breast screen centers that visit rural ATSI communities, this ensures equity and caters for diversity (SCA) - All people must have access to the center's and information on breast screening and cancer / treatments. In order to ensure equity all information is multilingual, there are phone lines and internet services and interpreters available – this ensures equity – information is in over 28 languages. (DPS) - Breast screen NSW accounts for the diverse pocpulation, it offers culturally appropriate centres and all units are staffed by female staff. (CSE) - Translators are available – diversity and equity and supportive environments (DPS) - No need for a referral from a GP – therefore making it much easier for women to access the services, (CSE) - Information for people with a disability - diversity and equity- CSE - Breast screen Australia is an example of RHS, it is in place to ensure equity and social justice for all, especially population groups that suffer from health inequities su ch as ATIS, Rural and remote and low socioeconomic, it offers free mammograms and has mobile screening centres.

Answer 25

Develop personal skills - Equity = Access to education for all individuals. Access can be restricted by money, distance or lack of exposure (e.g. access to free online health courses) - Diversity = A personalised program to target all individuals (e.g. information pamphlets in many different languages) - Support/environments = Empowerment of individuals by giving them knowledge and skills to pass onto others in their area (e.g. healthy food habits) Reorient health services - Equity = All individuals should have equal opportunity to receive professional education and training. - Diversity = Health services must be culturally sensitive and respect the needs of all people (e.g. doctors should be aware of how a patient’s culture influences health) - Support/environments = Services are reoriented in a way that increases the support for communities Strengthen community action - Equity = Resources must be equally available to all communities through equitable distribution by gov. - Diversity = Each community should be consulted about the development of health promotion strategies to improve their health. (e.g. ATSI understand what they need more than anyone else) - Support/environments = When communities are united, it creates a sense of support, which means individuals can rely on others to improve Build healthy public policy - Equity = All people need access to the same legislation and policies (e.g. Medicare, PBS) - Diversity = Different policies are implemented into specific areas where they have different needs. - Support/environments = Workplaces and schools have policies to improve health (e.g. no smoking at work and no-hat-no-play at schools) Create supportive environments - Equity = If an environment is not supportive, it cannot provide equity (e.g. increasing access to health facilities for R/R) - Diversity = All environments are different, meaning they need different types of support, which can be done through recognising diversity. - Support/environments = Encourages healthy choices (e.g. improving lighting of run tracks at night

Answer 26

OTTAWA CHARTER: the main framework for health promotion, which was designed by WHO in Canada (1986) to promote prevention of a disease. ``` DEAD – develop personal skills CATS – create supportive environments SMELL – strengthen community action REALLY – reorient health services BAD – build healthy public policy ``` If every area of the Ottawa Charter is represented through a variety of strategies, then: - The risk of people or populations adopting poor health behaviours is reduced - Those already engaged in poor health behaviours are encouraged to reduce these actions, which results in improvements in their health and a decreased burden on the health system.

Answer 27

DEVELOP PERSONAL SKILLS: the support of personal and social developments to make positive choices – providing information, education for health and enhancing life skills

Answer 28

CREATE SUPPORTIVE ENVIRONMENTS: the places that people live in, with the aim to increase the ability for people to make positive choices in their environment – taking care of each other, our communities and our natural environment.

Answer 29

STRENGTHEN COMMUNITY ACTION: involves the collective actions of the community to promote health – empowering communities, their ownership and control.

Answer 30

REORIENT HEALTH SERVICES: aims to make health systems more focused on strengthening protective factors, reducing risk factors and improving health determinants.

Answer 31

BUILD HEALTHY PUBLIC POLICY: | policies that support health, making it easier to make health promoting choices

CORE 1 - Health priorities in Australia Flashcards

(55 cards)