HSM606-CH2&CH3
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School
Rush University *
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Course
2200
Subject
Health Science
Date
Dec 6, 2023
Type
docx
Pages
6
Uploaded by AdmiralDangerCrane43
HSM- 606: Health Care Organization Chapter 2:
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Medical model (biomedical model): the absence of illness or disease.
o
Free of symptoms and does not require medical treatment. -
“A state of physical and mental well-being that facilitates the achievements of individual and societal goals.”
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Health care: a variety of services believed to improve a person’s health and well-being
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Holistic health: well-being of every aspect of what makes a person whole and complete.
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Holistic medicine: treats the individual as a whole person. 1. Why is “health,” a relatively simple thing to conceptualize, so hard to define? Why is “the absence of disease” insufficient?
A lot more cost-effective to prevent than cure. 2. What did you think about Shi and Singh’s exploration of spirituality and health?
3. In what way is “quality of life” an important element of healthcare delivery?
4. Who can describe and give a great example of the three components of the tripartite model (AKA the epidemiology triangle)?
All variables that come with different outcomes. Interplay of all three variables 5. What’s the difference between acute, subacute, and chronic care?
Acute- treatable Subacute- leave the hospital, you need to still do something for yourself and hospital Chronic care- not curable, irreversible
6. What percent of Americans have a chronic conditions? What are some of the ones
outside of the common list that Shi and Singh identified (cancer, heart disease, kidney disease, diabetes)? – will require a tiny amount of independent inquiry (i.e. a Google search) to find a list of others
60%
Ex. Cancer, addiction, hypertension, diabetes, heart disease, kidney disease
7. What are the primary reasons that we see an increase in chronic conditions and can you give some specific examples?
1.
New diagnostic methods, treatment, have improved life expectancy 2.
Newer/better screening and diagnosis are finding them more 3.
Lifestyle choices
8. What are some of the specific prevention initiatives of the “Communities Putting Prevention to Work” initiative? Bonus points if you don’t just pull from what’s listed in the
book
Bike lanes,healthy food and beverages options, walking trails 9. What are some of the public health interventions associated with behavior modification mentioned in Shi and Singh, and what are some specific examples you can
offer from your home city/state/country, undergraduate campus, culture, or other experience?
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Tobacco -
Drinking 10. What are some examples of primary, secondary, and tertiary prevention?
Primary: smoking cessation, exercise programs
Secondary: early detection, health screening Tertiary: rehab, infection control practices 11. What’s an iatrogenic illness?
12. What kind of chronic conditions might we see an increase in due to the progress identified table 2.2?
Arthritis, depression, UTI, 13. How impactful can health promotion activities such as on-site vaccinations, biometric screenings, fitness benefits, healthy food options, intervention services, etc. proven to be in terms of savings?
Approx. $3 for every $1 spend on the program
14. What are the three main distinctions between medicine and public health as outlined
in Shi and Singh?
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Medicine focuses on the individual patient and public health focuses on population. 15. Who can explain Blum’s Model of Health Determinants?
16. What are some of the different ways that Shi and Singh discuss as measures of physical health?
Morbidity (disease and disability) and mortality (death) rates Self-perceived health status is a commonly used indicator of health and well-being
Respondents are asked to rate their health as excellent, good, fair, or poor. 17. What are IADLs?
Physical function measures activities that are necessary for living independently in the community. 18. What are some of the measures of health service utilization identified by Shi and Singh?
19. What major societal values / beliefs prevalent in the American culture influence health care, health care delivery, and health care organizations in the US?
Pro-science (for good and bad)
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Pro-capitalism- thus health care is an economic good, not a public resource. Entrepreneurial spirit and self-determination Preference for free enterprise and a distrust of government. 20. With respect to healthcare, what is “Market Justice” and how is it different from “Social Justice?” What national systems have approached it differently?
21. If the political, social, and economic landscape is constantly shifting, why has the US not established a national healthcare system?
The resilience of persistent, anthro-cultural values
22. Who can describe, at a high level, the three major stages that Shi and Singh outline in the development of healthcare delivery in the US?
23. What are the main factors that Shi and Singh say explain why the profession remained so underdeveloped in the US before industrialization (small, disorganized, fragmented – insignificant)
24. Through what major social/geographic/legislative/organizational/infrastructure developments did medical care delivery become based more on a professional standard
than on independent self-declaration of competence?
25. What were some of the transformative medical breakthroughs outlined in Shi and Singh’s third chapter that led to the growth and sovereignty of medicine as a profession?
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Anesthesia -
Hand washing -
Pasteur’s germ theory of disease
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Antiseptic surgery -
Discovery of X-rays (diagnostic imaging)
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Antibiotics
26. Why did public health and the delivery of medicine emerge in the US as separate, dichotomous organizations?
Public health primarily focused on city/state hygiene as a means of protecting the community.
Physicians fear regulations.
27. How and why did private insurance (or “Voluntary Insurance”) become the standard?
28. What are the four main reasons that Shi and Singh identify as the reason why national health insurance has repeatedly failed?
29. What are the major “parts” of Medicare and Medicaid and what were major expansion efforts outlined by Shi and Singh?
30. What are Health Maintenance Organizations and how were they a major part of medical care in the corporate era?
31. What are Managed Care Organizations and how were they a major part of medical care in the corporate era?
32. How has corporatization shifted power?
33. In what ways has globalization influenced health care delivery (in the US, and abroad)?
34. What were some of the intended and actual outcomes of the ACA as outlined by Shi
and Singh?
35. In what ways does the Blumenthal article underscore some of the societal values outlined in Shi and Singh’s Chapter 2?
Tax burden 36. Blumenthal identified that healthcare expenditures in the US climbed from $27B in 1960 to $888B in 1993 and $1.9T in 2004. What are some more recent numbers?
4.7 million 37. If employer sponsored health insurance makes employers a major decision-maker (or at least player) in healthcare coverage/quality/delivery in the US – then why haven’t they been powerful enough to direct a fix?
No employer is big enough. 38. Who can explain the effect of ERISA legislation exempting those who self-insure from certain requirements and the FASB’s decision regarding the accrual of future benefit payouts?
Made it more expensive
39. Why assign a supplemental article to outline the evolution of the industry in addition to Shi and Singh’s third chapter?
40. Who can explain what Exhibit 1 in Anderson, et al, (2003)?
41. What does Exhibit 2 in Anderson, et al, (2003) illustrate?
42. How do Exhibits 4, 5, and 6 in Anderson, et al, (2003) explain the capacity of services provided through this immense spend?
43. What are the major conclusions of the Anderson, et al (2003) article as it relates to
whether efforts to preclude governmental monopsony have been effective at driving improved outcomes/delivery?
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