Week 1 health and health care system

Health and the Health Care System Week 1,[object Object],BNURS 323 ,[object Object],Healthcare Politics and Policy,[object Object],Summer 2009,[object Object]

Health,[object Object],Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.,[object Object],Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.,[object Object]

Retrieved Nov/2008 from http://www.thewellspring.com/wellspring/introduction-to-wellness/357/key-concept-1-the-illnesswellness-continuum.cfm,[object Object]

Jean Watson’s 10 carative factors,[object Object],The formation of a humanistic-altruistic system of values,[object Object],The instillation of faith-hope,[object Object],The cultivation of sensitivity to one’s self and to others,[object Object],The development of a helping-trusting relationship,[object Object],The promotion and acceptance of the expression of positive and negative feelings,[object Object]

Jean Watson’s 10 carative factors cont’d,[object Object],The systematic use of the scientific problem-solving method for decision making,[object Object],The promotion of interpersonal teaching-learning,[object Object],The provision for a supportive, protective, and (or) corrective mental, physical, sociocultural, and spiritual environment,[object Object],Assistance with the gratification of human needs,[object Object],The allowance for existential-phenomenological forces (Watson, 1985, p. 9-10),[object Object]

Non-caring,[object Object],1986 study by Riemen found three themes emerging from patients descriptions of non-caring nurse behaviors:,[object Object],Physically present—emotionally distant,[object Object],Belittling and inhumane actions,[object Object],Devaluation of the patient as a unique individual,[object Object]

Patient satisfaction,[object Object],Care is the human service quality that makes health consumers either satisfied or dissatisfied with health services and it is the care not the cure that consumers really value.,[object Object],Question for Class: Do we value (health care provider) professional satisfaction? Where does it come in?,[object Object]

Health Services versus Health Care,[object Object],Service: Work done by one person or group that benefits another (Retrieved 6/22/09 from wordnet.princeton.edu/perl/webwn),[object Object],Health care: Implies enactment of caring theory, patient satisfaction,[object Object],Health care services: implies combination of services and caring,[object Object]

Health care system,[object Object],Illness industry: a capitalist institution,[object Object],Focus on illness and injury versus prevention of problems and maintenance and promotion of health,[object Object],Care versus service versus profit,[object Object],Non-profit out-of-date term, now not-for-profit because business management same as for-profit,[object Object]

Health Maintenance,[object Object],=Health Protection,[object Object],Activities that preserve present health,[object Object],Primary prevention,[object Object],Health supervision,[object Object],Monitoring and surveillance,[object Object]

Health Promotion,[object Object],Risk Reduction,[object Object],Health Education: nutrition, physical activity, injury prevention, sleep, OTC medications, when to call MD and use of health care system, immunizations,[object Object],Anticipatory Guidance,[object Object],Physical G&D,[object Object],Psychological and emotional G&D,[object Object],Socialization, interactions, behavior,[object Object]

Public Health,[object Object],(One) Definition of public health: effort organized by society as a whole to protect, promote, and restore health,[object Object],Focus is on what requires group effort to accomplish as opposed to individual effort,[object Object],In U.S., mixed knowledge, attitudes, and beliefs about government, role of society in individual life,[object Object]

Economics, Politics, and Policy,[object Object],Economics: Study of distribution of scarce resources,[object Object],Politics: Study of power over the distribution of scarce resources; social relations involving authority or power,[object Object],Policy: A policy is typically described as a deliberate plan of action to guide decisions and achieve rational outcome(s). Retrieved 6/22/09 from http://en.wikipedia.org/wiki/Policy,[object Object]

Public Health Policy,[object Object],http://www.cdc.gov/nceh/ehs/EPHLI/core_ess.htm,[object Object],Policy Development as one of the Core Functions of Public Health: Assessment, Policy Development, Assurance,[object Object]

Public Health Core and Essential Functions (from webpage previous slide),[object Object],Assessment,[object Object],Monitor environmental and health status to identify community environmental health problems,[object Object],Diagnose and investigate environmental health problems and health hazards in the community,[object Object],Policy Development,[object Object],Inform, educate and empower people about environmental health issues,[object Object],Mobilize community partnerships to identify and solve environmental health problems,[object Object],Develop policies and plans that support individual and community environmental health efforts,[object Object],Assurance,[object Object],Enforce laws and regulations that protect health and ensure safety,[object Object],Link people to needed environmental health services and assure the provision of environmental health services when otherwise unavailable,[object Object],Assure a competent environmental health workforce,[object Object],Evaluate the effectiveness, accessibility and quality of personal and population-based environmental health services,[object Object],Conduct research for new insights and innovative solutions to environmental health problems and issues,[object Object]

Questions for Class,[object Object],Given the definitions of politics and policy, what is the relationship between them?,[object Object]

Health Care System,[object Object],Providers: Hospitals, physicians (those who can bill third party payers directly for their services),[object Object],In-patient/Out-patient: Hospital as basis of orientation; where does ED fall?,[object Object],Clinic, out-patient surgery, free-standing birth center,[object Object],Urgent care center, doc-in-the-box,[object Object]

Hospitals,[object Object],Public: Federal, state, county, city,[object Object],Community=voluntary=not-for-profit,[object Object],Proprietary=for profit,[object Object]

Questions for Class,[object Object],What is missing from this consideration of the health care system? (hint—who are we?),[object Object],What/who makes the decision for in-patient care/admission to the hospital?,[object Object]

Medical therapeutics,[object Object],MDs: Diagnose and treat. How treat?,[object Object],Prescription of medications: Drugs and herbs,[object Object],Drug categories: Legend (scheduled and non-scheduled); OTC,[object Object],Surgery: historically done by barbers until discoveries of anesthesia and antisepsis,[object Object],Counseling: lifestyle advice and recommendations,[object Object]

Prevention,[object Object],Primary Prevention: prevention of occurrence of disease or injury. Code word—prevention.,[object Object],Secondary Prevention: prevention of progression of disease to symptoms. Code word—screening. Also early diagnosis and treatment.,[object Object],Tertiary Prevention: prevention of sequelae or severe consequences of disease. Prevent disability and death. Code word—rehab.,[object Object]

Public Health Allegory,[object Object],A man, walking along a riverbank, suddenly sees a person flailing his arms and hears him pleading for help as he bobs in the water while being pushed downstream. The man on the bank dives into the water, swims to the victim and rescues him by pulling him ashore. When the man turns toward the river, once again he hears someone screaming for help. Then another. And another. One after the other, the man pulls victims from the river.Exhausted, and pulling yet another victim to shore, he notices a woman walking by. “Help me!” he pleads. “All these people are drowning and I have to do something to save them. More people are falling in and need help. Look!” he says, pointing to the river where more victims are in the water and needing help.,[object Object]

Allegory cont’d,[object Object],Immediately, the woman starts to run upstream along the bank.“Where are you going?” he screams at the woman. “I need help now!”“I am helping right now,” says the woman. “I’m going upstream to find out how they’re falling into the river and to prevent that!” (Retrieved 6/22/09 from http://www.miph.org/blog/upstream-thinking),[object Object]

Health and Health Care,[object Object],Given the definitions of health care and health, how are they connected?,[object Object],What does the research show is the connection between health care and health?,[object Object],Social and economic determinants of health: standard of living,[object Object]

Example: Tuberculosis,[object Object],http://ajrccm.atsjournals.org/cgi/content-nw/full/169/11/1181/FIG1,[object Object]

Historical Trends in Mortality,[object Object], From infectious disease and injury,[object Object],To chronic diseases,[object Object],Length of life has increased, quality of life now a concern for the old-old (> 85 y. o.),[object Object],Premature death now more of a concern,[object Object]

Primary causes of death in U.S.,[object Object],0-28 days: congenital anomalies,[object Object],29-365 days: SIDS,[object Object],1 year – 45 years: unintentional injuries, esp MVA (MVC),[object Object],45-65 years: 1. Cancer 2. unintentional injuries,[object Object],65+: 1. cardiovascular disease 2. cancer,[object Object]

Week 1 health and health care system

Week 1 health and health care system

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Week 1 health and health care system