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Flashcards in Hours 5 and 6 Deck (36):
1

How has the number of uninsured changed since passage of the ACA (2010 to 2016)?

Almost 50 million uninsured Americans in 2010 to about 28.1 million in 2016; 44% decrease in the number of uninsured since the passage of the ACA in 2010

2

what did the uninsured rate among the non elderly population look like from 1998-2016?

in 1998 it was 16.6% and then it decreased to 10.3%

3

What are factors that limit access to health care?

accessibility, availability, affordability, acceptability,

4

what do we need to consider when it comes to accessibility?

Is a person able to transport him/herself to the physician/health care provider for health care?
What is the proximity of the patient to the health care provider?

5

what do we need to consider when it comes to availability?

Does the health system have the capacity (facilities and providers) to accommodate patients when services are needed

6

what do we need to consider when it comes to affordability?

Is the patient able to afford needed services?
Do they have insurance?
Are there payment plans available?

7

what do we need to consider when it comes to acceptability?

Is the patient and his/her health care provider compatible?
Does the physician accept different cultures and religious beliefs?
Language barriers

8

What are the demographics of the current (2016) uninsured in terms of age, race, work, status, etc?

1)Family Work Status
No workers – 15%
Part-Time – 11%
1 or more Full-Time Workers – 75%

Most uninsured live in families with employed family members

2)Whites account for the highest number uninsured individuals

Hispanics and Blacks more likely to be uninsured

Lack of insurance impacts individuals of all races

3) Marital status
Separated: 11.2%
Married: 8.8%
Singe/Unmarried 16%
Widowed: 13.9%

education
No High School Diploma (27.3%)
Graduate (5%) – BS (7%)
High School Degree (15.2%)

4) Age
Children ≤ 19 = 5.4%
Adults 19 – 64 = 12.1%
≥ 65 = 1.2%

Group having the most difficulty obtaining insurance are of working age

9

who does lack of insurance affect the most?

Lack of insurance affects individuals at all income levels, but the poor the most

10

how would you define the Federal Poverty Level (FPL)?

“A measure of income issued every year by the Department of Health and Human Services (HHS). Federal poverty levels are used to determine your eligibility for certain programs and benefits, including savings on Marketplace health insurance, and Medicaid and CHIP coverage.”

11

How does lack of insurance impact access to health care?

1)Less likely to get preventive care, costing more in the long-run
2)More likely to postpone care
3)More likely to seek care in an emergency room
4)Less likely to receive recommended care and to fill prescriptions
5)Overall decrease in access possibly due to loss of insurance
6)Gaining insurance can result in improved health status

12

men are more likely to have health insurance through their jobs? T/F

T

13

Women are more likely to be insured through their job, and less likely to seek care through dependency? T/F

false, less likely to be insured; more likely to seek care through dependency though they are more likely to visit doctors and get routine care

14

research also indicates that children who are uninsured for part of the year have more access problems than those with full year coverage? T/F

true

15

how is cost defined?

price x quantity

16

what drives the overall healthcare cost?

Number of beneficiaries
Health of beneficiaries
Services per beneficiary
Cost per unit of services
Quality of the service

17

what is the health care cost formula

Quantity of beneficiaries ^ Quality (health) of the beneficiaries

X

(Quantity of services X Cost of Services)^Quality of the services

18

how is the health system defined by WHO?

“All the activities whose primary purpose is promote, restore or maintain health”

19

what are the three primary objectives in health care according to WHO?

1)Improving the health of the population they serve;
2)Responding to peoples expectations;
3)Providing financial protection against the costs of ill-health.

20

According to the WHO, what are the Health System Building Blocks?

Health Services Delivery
Health Workforce
Health Information
Essential Medicines
Health Financing
Leadership and Governance

21

WHO Health Services Delivery Indicators

Availability of inpatient and outpatient facilities

22

WHO Health Workforce Indicators

Number of health workers per 100,000 population
Number of graduates from health professional schools

23

WHO Health Information Indicators

Review of national systems – are information systems in place?

24

WHO Essential Medicine Indicators

Availability of 14 essential medicines
Median consumer price for 14 essential medicines

25

WHO Health Financing Indicators

Total expenditures on health
Ratio of out-of-pocket payments for health to total expenditures on health

26

WHO Leadership and Governance Indicators

Review of national health policies

27

what is the organization of the US Healthcare System?

Many models to explain the structure of the US Healthcare System based on:
-How care is delivered
Primary, secondary, tertiary care
-Organizational structure
HMO, ACO, IPA, PPO
-Who pays
Public, private, individual

28

Components of the Healthcare System?

Patients, providers, payers, support systems

29

what are the three major organizational segments?

support segment, payer/purchaser segment, provider segment

30

what are the two types of providers? Name examples

private and public

private
Acute care hospitals
Physicians and other professionals
Diagnostic services

Public Sector
Veterans Administration
US military hospitals and clinics
US Pubic Health Service

31

who pay the bills? examples

private and public entities

private
Private insurance companies
Employers
Individuals

Public
Medicare – elderly
Medicaid – low income
Tricare – military retirees

32

what are the two types of support sectors? examples

private and public

private
Health information technology companies
Billing companies
Education and training
Supply chain

Public
US Department of Health and Human Services
State health departments
Local health departments

33

what are the hospital types by service?

Acute Care
Psychiatric
Rehabilitation Hospitals
Specialty Hospitals

34

what are the hospitals by teaching status?

Major Teaching Hospitals
Other Teaching Hospitals
Non-teaching Hospitals

35

in terms of hospital ownership? what makes up the largest percentages?

community hospitals by 87%, followed by non-profit (51%), then profit (19%), and lastly state/local (17%)

36

what can we say notice about community hospitals between urban and rural settings?

urban increases by about 3.1% and rural decreases by 25.8%