Section 3/Week 3 Flashcards
Where does the largest portion of health care expenditures come from?
Private Insurance
What are the 7 publicly financed health insurances (account for 47% of all care)
- Medicare
- Medicaid
- Indian Health Service
- S-CHIP
- Veterans Affairs
- Defense Dept
- National Health Service Corps
Even though physicians account for only ___ of health care expenditures, they influence ____ of all expenditures.
20%, 70%-80%
What were the 4 requirements the Flexner Report of 1910 laid out for medical schools?
- ) be part of universities
- ) have at least four years of training
- ) have the first two years of that training concentrate on basic lab science
- ) require 4 years of premedical science for all entering students
Physicians as Agents of Reason (Parsons 1951)
- Knowledge based authority
- Altruistic healers, with paternalistic and unbiased approach towards patients
Physicians as Agents of Power (Friedson 1970)
- Control of knowledge based authority
- Physician as self-interested entrepreneurs
- Conflicting loyalties, imperfect agents for patients
When the AMA started in 1846, members were drawn from which set of practice?
Allopathic!
How did nursing begin?
With the Crimean War and Florence Nightingale.
How did the first and second world wars shape the nursing profession?
In WWI, the sub-nurse became the medical physician.
In WWII, the licensed vocational nurse (LVN) was created.
What are a few of the new types of “advanced practice nurses” created during the 1970s-1980s
- Nurse Practitioners
- Nurse Midwives
- Nurse Anesthetists
- Critical care nurses
Describe the registered nurse supply trends in the past 3 decades.
In the 1980s and 1990s, there was a decline in young women who were choosing nursing, but a surge between 2002-2009 helped ease the shortage.
What’s primary care
care found in doctor’s offices or in clinics
What’s secondary care
care obtained from specialists and in hospitals
What’s tertiary care
care obtained at region referral centers
What’s quaternary care
care obtained at national referral centers
Reasons not to go into primary care
- Money
- Prestige
- Specialty
Reasons to go into primary care
-Relationships
Hospitals make up 31% of all health expenditures, how did the government plan to slow hospital related spending
Prospective Payment System (PPS), where a single, pre-determined payment based on the nature of the patient’s illness (Diagnosis Related Group, DRG)
What were the principal effects of PPS
- decrease number of patients treated in the hospital
- overall decrease in need of hospitals
What were the results of the decreased demand for hospital care
- hospitals closed
- shift to for-profit hospitals
How does the ACA seek to expand primary care in order to meet the new demand for primary care physicians due to the expansion in health insurance
- Shifts policy focus of funding graduate medical education to expanding primary care training
- Increased payment for primary care services (10% bonus payment to primary care physicians who treat Medicare patients, increase in medicaid payments to match medicare)
- Support patient centered medical homes
What are patient centered medical homes
teams of providers and various healthcare professionals to provide ongoing, high-quality care
Why isn’t Canada facing an issue with too many specialty doctors
- less of an emphasis on technology
- greater emphasis on risk evaluation
- care rationing prioritizes equal access to health care for all citizens
removes incentive for specializing
how has medical care become an example of a market failure in the US
even though the number of specialty doctors has gone up, the costs of specialty health care have also gone up.
demand for health care commodity is determined by the provider.
