premid 1 Flashcards by Marianne Nadeen Aini Tupay

Traditionally, chemistry, biochemistry, physics, and physiology form the core knowledge base of pharmacy.

Social and Administrative Pharmacy

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It incorporates the social implication associated with the therapeutic and nontherapeutic uses of pharmaceutical preparations as examined from the perspective of individual and group behavior and the societal systems that exist between them.’

Social pharmacy

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Has a central interest in the beliefs, values, and behaviors that people display in relation to medicine use and society at the individual and organizational levels.

Social and Administrative Pharmacy

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A social science that studies human societies, their interactions, and the processes that preserve and change them.
Explains an individual’s actions as a social phenomenon.

Sociology

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They defined heath in 1948, “a state of complete physical, mental and social well being and not merely an absence of disease or infirmity”.

World Health Organization (WHO)

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It is a positive emphasis on social and physical capabilities.

Health

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• It define as state indicating perfect functioning of the body such a good complexion, clean skin, clean breath, sound sleep, good appetite, etc.

Physical Health

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The pulse rate, BP, body weight, regular activity within normal limits.

• All body organs are structurally and functionally in a normal state. clinical examination, nutrition, anthropometry are evaluation parameters for physical health

Physical health

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It is defined as a state of balance between the individual and the surrounding, world, including the environment.

Mental health

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Characteristics of individual should have, conflicts, well a - adjust with surrounding good self control, know himself, his needs, problems and goals.

• Intelligent enough to solve and face the problem.

Mental health

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It is defined as a quantity and quality of an individual’s interpersonalities and the extent of involvement with the community.

Social health

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Developing good skills improves an individual’s relationships with other people, helps in making friends, help in career and to live independently in adult life.

Social Health

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It is defined as a personal matter involving values and beliefs providing a purpose in an individual’s life.
• Its refer to the spirits or soul.

Spiritual health

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• It includes integrity, principles and ethics, purpose in life, believe in concepts that are subject to state-of-the-art explanation.

Spiritual health

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The social institution that seeks to prevent, diagnose, and treat illness and to promote health in its various dimensions.

Medicine

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The provision of medical services to prevent, diagnose, and treat health problems

Health care

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• Focuses on biological factors of health (e.g., diseases, genetics, pathogens).
• Treats health as the absence of disease.

Biomedical Perspective

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Example: A doctor diagnosing and prescribing medicine for an infection.

Biomedical Perspective

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Health is influenced by social, economic, and environmental factors

Social Determinants of Health (SDH) Perspective

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Example: Poverty, education, and living conditions affect health outcomes

Social Determinants of Health (SDH) Perspective

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• Talcott Parsons (1951)
• Views healthcare as essential for a stable society.
• Good health and effective medical care are essential for the smooth functioning of society.

Functionalist Perspective (Sociology)

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The patient must perform the “sick role” in order to be perceived as legitimately ill and to The physician- patient relationship is hierarchical; The physician provides instructions, and the patient needs to follow them. If you are unable to function well, you are sick

• Healthcare systems exist to maintain social order and productivity.

Functionalist Perspective (Sociology)

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Example: Governments fund healthcare to ensure a healthy workforce.

Functionalist Perspective (Sociology)

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• Focuses on inequalities in
healthcare access. Inequality characterizes the quality of health and the quality of healthcare. People from disadvantaged social backgrounds are more likely to become ill and to receive inadequate health care.

Partly to increase their incomes, physicians have tried to control the practice of medicine and to define social problems as medical problems. Does not solve the social inequality due to national level, lack of implementing rules and regulations with regards to healthcare delivery.

Conflict Perspective

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Explores how wealth and power determine who gets the best medical care.

Conflict perspective

Example: Private hospitals offering better care than public ones.

Conflict perspective

• Examines patient-doctor interactions and how health is perceived

Symbolic Interactionism

Example: Some cultures view mental illness differently, affecting treatment-seeking behavior.

Symbolic Interactionism

The range of personal, social, economic, and environmental factors that influence health status

Determinants of Health

Determinants of health fall under several broad categories:

➤ Policymaking (i.e. crises and disasters) ➤ Social factors (i.e. psychosocial, socio-cultural, socioeconomic, environmental, education) ➤ Health services (i.e. accessibility to health care) ➤ Individual behavior (i.e. lifestyle, habits) ➤ Biology and genetics (i.e. heredity)

Determinants of health reach beyond the boundaries of traditional health care and public health sectors; sectors such as education, housing, transportation, agriculture, and environment can be important allies in improving population health.

➤ Policies at the local, state, and federal level affect individual and population health. Increasing taxes on tobacco sales, for example, can improve population health by reducing the number of people using tobacco products.

Policymaking

Some policies affect entire populations over extended periods of time while simultaneously helping to change individual behavior. For example, the 1966 Highway Safety Act and the National Traffic and Motor Vehicle Safety Act authorized the Government to set and regulate standards for motor vehicles and highways. This led to an increase in safety standards for cars, including seat belts, which in turn reduced rates of injuries and deaths from motor vehicle

It also plays a role in health outcomes. For example, if an individual quits smoking, his or her risk of developing heart disease is greatly reduced.

Individual behavior

Many public health and health care interventions focus on changing individualbehaviors such as substance abuse, diet, and physical activity. Positive changes in individual behavior can reduce the rates of chronic disease in this country.

Individual Behavior

Some biological and genetic factors affect specific populations more than others. For example, older adults are biologically prone to being in poorer health than adolescents due to the physical and cognitive effects of aging.

This disease is a common example of a genetic determinant of health. It is a condition that people inherit when both parents carry the gene for sickle cell. The gene is most common in people with ancestors from West African countries, Mediterranean countries, South or Central American countries, Caribbean islands, India, and Saudi Arabia.

Sickle cell Disease

Examples of biological and genetic social determinants of health include:

- Age - Sex - HIV status - Inherited conditions, such as sickle-cell anemia, hemophilia, and cystic fibrosis - Family history of heart disease - Carrying the BRCA1 or BRCA2 gene, which increases risk for breast and ovarian cancer

The two “breast cancer genes” are known as BRCA1 and BRCA2, usually pronounced as braca, which are abbreviations for Breast CAncer susceptibility genes 1 and 2, where both genes are what everyone has, but some people have mutations on these genes tha can greatly increase the risk of breast and ovarian cancer.

These genes are known as “tumor suppressors”, and when they function normally, they help maintain cell growth at athe appropriate rate. The simplest definition of breast cancer is when harmful mutations present themselves and cells have the potential for unchecked growth.

Breast cancer genes (BRCA 1 and 2)

• It is therefore more than the pyramid of publicly owned facilities that deliver personal health services. It includes, for example, a mother caring for a sick child at home; private providers; behavior change programs; vector-control campaigns, health insurance organizations; and occupational health and safety legislation. It includes inter-sectoral action by health staff.

Health system

Example: Encouraging the ministry of education to promote female education, a well known determinant of better health

Health system

It comprises all organizations, institutions and resources that produce actions whose primary purpose is to improve health” The World Health Report, 2020 -WHO

The health system

It is a complex set of organizations interacting to provide an array of health services.

The Philippine Healthcare system

Largely financed through tax-based system. • Caters to 70% of the population

Public Sector

Specialty, retained and regional hospitals, medical centers, DOH representatives, specialty hospitals, regionals hospitals

National government

Provincial and district hospitals, RHUs, BHSs, municipal hospitals

Local government units

• DOH supervise all the government hospitals under the national government • People centered, affordable

Public sector

Caters to 30% of the population Larger in terms of: • Financial support • Healthcare workers

Private Sector

- Comprises 65% of 1224 hospitals - Market centered, expensive

Private sector

Commercial, Market Orientations Private practitioners, private clinics and laboratories.

Profit

Non-Commercial, Service Orientations Socio- civic groups, religious organizations or foundations.

Non profit

Total Hospitals in the Philippines

1,224

Number of Hospitals in the Public sector

428 hospitals

Number of Hospitals in the Private sector

796 hospitals

Number of City/rural health centers

2,587

Number of Village health stations

20,216

• Mandated to provide national policy direction and develop national plans, technical standards and guidelines of health. • Provides technical assistance, capacity building and advisory services for disease prevention and control.

DOH

• Supplies medicines and vaccines. • Implements guidelines

DOH

Under the Local Government code (1991), they were granted autonomy and responsibility for their own health services.

LGUs

National health programs are:

coordinated by the DOH through the LGUs. (e.g. TB, family planning)

Programs are disseminated to other health stations. - However, some areas are unable to access the healthcare

- Due to devolved setup of the health system, health reforms must not only be implemented at the national level, these must also be promoted at the local government levels. - Difficulties in coordination between the • DOH and local governments often lead to poor policy implementation, and poorly functioning referral systems. - Health is not a priority in most LGUs. - Lack of health referral system mechanisms among the LGUs themselves

Different health system from other regions in the country; not devolved.

Health system in ARMM

• Lack of funding, insurgencies, and relative distance of some areas from the regional center (ie. Sulu, Bataan, and Tawi-tawi) appears to pose challenges and difficulties. • Lack of facilities and skilled health workers at the primary care level.

Health System in ARMM

• These chartered cities have more robust economy that is why they could separate their identities from the respective provinces. • Also, they have their own health service delivery systems. (e.g. City hospitals, health centers, and Barangay Health Stations)

City Health Office, (Chartered cities).

• has Provincial and District hospitals.

Provincial Health Office

The most common stigma is that these are cities that are striving to be first-class.

Municipal Health Office

They have their own barangay health stations, health centers, and City hospitals. Characterized by: A. Communicable Diseases B. Non-communicable Diseases C. Diseases of Industrialization

Component cities

• Provide health insurance to Filipinos • Financial protection is limited • Premiums for the poor are subsidized by the government Specialty and Regional Hospitals

Philippine Health Insurance Corporation (PhilHealth)

• Funded by DOH Provincial and Municipal Hospitals • Funded by LGU’s

Philippine Health Insurance Corporation (PhilHealth)

It measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death. • Most common are non-communicable diseases.

Disability Adjusted Life Years (DALY)

By order timeline to improve healthcare deliver

Health Reform Initiatives

"Adoption of Primary Health Care" - Promoted participatory management of the local health care system.

1979

EO 851 "Reorganization of DOH" Integrated public health and hospital services.

1982

• "The Generics Act" Prescriptions are written using the generic name of the drug.

1988

RA 7160 "Local Government Code" - Transfer of responsibility of health service provision to the local government units.

1991

"National Health Insurance Act" Aims to provide all citizens a mechanism for financial protection with priority given to the poor. - No balance billing.

1995

- Health Sector Reform Agenda - Major organizational restructuring of DOH to improve the way health care is delivered, regulated, and financed.

1999

FOURmula One (F1) for Health. - Adoption of operational framework to undertake reforms with speed, precision, and effective coordination.

2005

AO 2010-0036 'Kalusugan Pangkalahatan" Universal health coverage and access to quality healthcare for all Filipinos.

2010

RA 9502 "Access to Cheaper and Quality Medicine Act" Promote and ensure access to affordable quality drugs and medicines for all.

2008

MAJOR AREAS OF REFORM

Health service delivery Health regulation Health financing

HEALTH REFORMS TARGETED to ADRESS ISSUES such as:

• Poor accessibility • Inequity • Inefficiency

Includes immunization, health and nutrition education, family planning services, treatment for minor illnesses and accidents, outpatient, dental, and laboratory services.

Primary Care Services

Includes outpatient, inpatient, and hospital care, laboratory and special procedures, acute and emergency care, dental care, and mental care.

Secondary and Tertiary Services

Includes acute inpatient rehabilitation, long term care and programs for the elderly and disabled, and palliative care.

Rehabilitative Services

• “Why people go to private facilities”

Quality

• “Why people go to public facilities

Affordable

• Essential for efficient management and operation of the public health system. • Enormous but unevenly distributed in the country (most are in Metro Manila and urban centers

Human Resource for Health

• Philippines is a major source of health professionals in the world. • Fluency in English and skills and training received. • Compassion and patience in caring. • Leading exporters of nurses to the world. • Second major exporter of physicians but migrates as nurses. • Socio-economic and political situations do not contribute to retaining of licensed and skilled professional in the country

It was inspired by the William Beveridge Report for social insurance presented in the English Parliament in 1942.

The Beveridge "public" model

Funding is based mainly on taxation and is characterized by a centrally organized National Health Service where the services are provided by mainly public health providers (hospitals, community GPs, specialists and public health services).

The Beveridge "public" model

In this model, healthcare budgets compete with other spending priorities. The countries using this model, besides the United Kingdom, are Ireland, Sweden, Norway, Finland, Denmark, Spain, Portugal, Italy, Greece, Canada and Australia. This is the first national single-payer healthcare system.

The Beveridge "public" model

“Socialized Medicine Model

The Beveridge Model "Public Model"

“Sickness Funds”

The Bismarck Model "Mixed Model"

It was inspired by the 1883 Germany Social Legislation and National Health Insurance Plan for workers introduced by Otto von Bismark, the Chancellor of Germany.

The Bismarck “mixed” model

Funds are provided mainly by premium-financed social/mandatory insurance and, besides Germany, is found in countries such as France, Switzerland, Japan, Central and South East European (CSEE) countries and Former Soviet Union (FSU) countries. Japan has a premium-based mandatory insurance funds system.

The Bismarck “mixed” model

This model results in a mix of private and public providers, and allows more flexible spending on healthcare. This model looks similar to the US System where healthcare is provided through insurance companies who are paid by employer and employee payroll deductions.

The Bismarck “mixed” model

Under this system, EVERYONE must be covered, and no one is left with no access to care. Hospitals and doctors may not operate for profit, so overall costs are much more affordable. Doctors in Germany earn less than they do in the US, yet they finish medical schooling with little to no debt. Majority of the sick citizens (Germany) can obtain an appointment the next day at a far greater rate than Americans do.

The Bismarck “mixed” model

➤ This is also a single-payer healthcare system which are popular in Asian countries which combines aspects of both Beveridge and Bismarck.

The National Health Insurance Model

Healthcare is paid through higher taxation; however, patients are free to choose any doctor or hospital for their care. Like for Beveridge and Bismarck, there is no profit incentive, prices tend to stay lower, and health outcomes are better.

National Health insurance model

Japan uses this system with a heavy emphasis on preventative care, and such, have some of the highest life expectancies in the world

National Health insurance model

It is also known as the model of “independent customer”. Funding of the system is based on premiums, paid into private insurance companies, and in its pure form actually exists only in the USA.

The “private” insurance model

In this system, individuals are either covered by their employers, covered by a private policy the policyholder purchases themselves or they go without coverage at all.

The “private” insurance model

In this system, the funding is predominantly private, with the exception of social care through Medicare and Medicaid. The great majority of providers in this model belong to the private sector

Private insurance model

5th type of health system ( No System)

Out-of-Pocket Model

Only the developed, industrialized countries -- perhaps 40 of the world's 200 countries -- have established health care systems. Most of the nations on the planet are too poor and too disorganized to provide any kind of mass medical care. The basic rule in such countries is that the rich get medical care; the poor stay sick or die.

Out-of-Pocket Model

In rural regions of Africa, India, China and South America, hundreds of millions of people go their whole lives without ever seeing a doctor. They may have access, though, to a village healer using homebrewed remedies that may or not be effective against disease

All models of health care systems are imperfect and there is no model which is the best and broadly accepted and recommended. There are big differences among countries in relation to the goals, structure, organization, finance and the other characteristics of the health care systems. ➤ These differences are influenced by history, traditions, socio-cultural, economic, political and other factors. But, regardless of all present differences, there are same common characteristics, typical for all organized health care systems.

premid 1 Flashcards

(113 cards)