Midterm- Mikaella Cayanan

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California State University, Chico *

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HCSV 435

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Medicine

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Jan 9, 2024

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pdf

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7

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1. What are 6 basic characteristics that differentiate the U.S. health care delivery system from that of other countries? There is no central governing agency because healthcare is funded publicly and privately by organizations, which leads to little integration and coordination. The U.S. focuses on acute care and relies heavily on technology because it is the center of medical technology innovation and much money is spent on research and development. Health care delivery is largely in private hands, but it is only partially governed by free market forces, which is why it is under imperfect market conditions. The American tradition of individual responsibility and a commitment to minimizing government power has resulted in the private sector playing a prominent role instead of the government in the country. The presence of multiple players makes the system ineffective and disrupts the balance of power, and that balance of power among the players prevents any single entity from controlling the system. Access to health care services is selectively based on insurance coverage; it is exclusive to individuals who have health insurance, are covered under a government program, or can afford to pay for treatments privately. 2. Most Western European countries have national health care programs that provide universal access. How does the National Health Insurance system, such as the one adopted by the country of Canada differ from the National Health system, such as the one structured in Great Britain? The majority of healthcare in Canada is provided by the private sector, with government funding for health insurance. The provinces handle insurance. The employers of many Canadians provide them with extra private insurance. The National Health Service (NHS) in the United Kingdom is a fully socialized health care system where the government not only finances but also provides care. Although there is a private system that works alongside the public one, most services are provided free of charge to individuals, and the system is supported by taxes. 3. List the 4 health determinant categories and provide an example of how the government is improving help in each determinant. Environment : The EPA is a federal agency responsible for protecting human health and the environment. It sets and enforces regulations to reduce pollution, promote sustainable practices, and ensure the safety of air, water, and land. Behavior and Lifestyle : Launches public health campaigns to raise awareness about the importance of healthy behaviors such as regular exercise, a balanced diet, and tobacco cessation. These campaigns provide information, resources, and support to encourage individuals to adopt healthier lifestyles.
Heredity : Supports programs that offer genetic testing and counseling services. These services help individuals understand their genetic risks, identify potential hereditary conditions, and make informed decisions about their health and family planning. Medical Care : Provides healthcare financing through programs such as Medicare and Medicaid. These programs help ensure that individuals who qualify, such as the elderly, low-income individuals, and people with disabilities, have access to necessary medical care. 4. Explain how the U.S. has both market & social justice aspects of healthcare. While individuals in the U.S. have the freedom to choose their private health insurance and pay out-of-pocket for services under market justice, there is also a social justice component in which government programs such as Medicare and Medicaid ensure that certain essential services are covered for those who cannot afford private insurance or meet specific eligibility requirements. 5. Describe what healthcare providers and institutions were like before the Industrial Revolution. Before the Industrial Revolution, hospitals were low in number and located only in big cities. Few people were able to practice or pursue studies to become healthcare practitioners due to the scarcity of medical schools. Many of the institutions were of poor quality and were not properly sterilized. Anyone was allowed to practice medicine due to the outdated processes, resulting in unprofessional practices. There was no systematic or scientific medical education. Many asylums operated for patients who had untreatable, chronic mental illnesses. Pesthouses also operated to isolate people with contagious diseases. 6. Discuss some of the advancements that changed healthcare and the switch from a “traditions” approach to a scientific approach because of these groundbreaking medical discoveries. Ignaz Semmelweis implemented the policy of hand washing around 1847. Semmelweis noticed the high puerperal fever mortality rate among postpartum women and concluded that there was a link between the puerperal fever and the widespread practice among medical students of not washing their hands prior to childbirth and immediately after performing dissections. Around 1860, Louis Pasteur is credited with inventing the germ theory of disease and microbiology. Pasteur demonstrated various sterilizing methods, including boiling to destroy bacteria and limiting air exposure to prevent contamination.
7. Describe the differences between an allopathic physician (MD) and a holistic physician (DO). MDs and DOs mainly differ in their philosophies and approaches to treatment. Holistic physicians practice osteopathic medicine, which focuses on the body's musculoskeletal system. Allopathic physicians are trained as such, which means that their views include medical treatment as an active intervention in treating or curing the effects of diseases. 8. In the U.S. we have an imbalance of specialty care and primary care. What are the major medical care distinctions between these two majors? Explain the negative consequences of specialty maldistribution. The major distinction between primary care and specialty care lies in the scope of care and services provided to patients. The first point of contact for individuals seeking medical attention is primary care, which focuses on treating the person as a whole. It consists of a wide range of services such as disease prevention, health promotion, diagnosis, and treatment for acute or chronic illnesses. On the other hand, specialty care usually follows primary care and has a more narrowed focus. It may concentrate on specific diseases, organ systems, or body parts. Specialty care tends to be more in-depth due to its focused nature. Specialty maldistribution causes a high volume of intensive, expensive, and invasive medical services as well as to the rise in health care costs. The underprivileged communities will suffer the most without primary care providers because they tend to seek them out the most. Also, primary care plays a crucial role in disease prevention, health promotion, and managing chronic conditions effectively. When there is an imbalance between primary care providers and specialists, it can result in inadequate attention being given to preventive measures or holistic approaches towards patient well-being. 9. Describe the training of and discuss the important role that advance practice nurses and physician’s assistants (Non-Physician Practitioners) play in providing high quality, cost effective medical care. Advance practice nurses and physician's assistants play an important role in providing high-quality, cost-effective medical care due to their extensive education and training. Unlike the average nurse, these healthcare professionals have undergone additional schooling and certification, which enables them to provide a wider range of services. This expanded scope of practice allows them to deliver comprehensive care to patients, addressing not only their immediate medical needs but also other aspects of their well-being. NPPs work helps alleviate some problems created by the geographic maldistribution of physicians. By leveraging their advanced knowledge and skills,
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advance practice nurses and physician's assistants contribute significantly to the overall quality of healthcare delivery while also helping to control costs. 10. What impact does the growth of technology have on healthcare costs? How has technology impacted access to medical care and why aren’t new treatments, medications, modalities and machines available to everyone? The rise in medical technology was a factor in rising healthcare costs. This is due to the cost of both purchasing and maintaining technological equipment. Access to medical care has been significantly impacted by technology. It has enhanced the effectiveness and efficiency of the delivery of healthcare. However, despite the advancements in medical technology, not everyone has equal access to new treatments because they come with a high cost and limited availability. 11. What is HIPPA and what role does it play in protecting patient privacy when it comes to electronic medical records? It is a law that sets guidelines and regulations for the use and protection of personal medical information. The main purpose of HIPPA is to ensure patient privacy and give individuals more control over their health information. HIPPA plays a crucial role in protecting patient privacy when it comes to electronic medical records by regulating their usage and release, allowing patients more control over their health information. 12. Discuss some of the examples of new, cutting-edge medical technology and its impact and implications for society, politics and religion. Remote monitoring and telemedicine have a huge impact on society. It eliminates the need for travel and shortens wait times by enabling people to obtain healthcare services from the convenience of their own homes. People who reside in remote or underserved locations with little access to medical services would especially benefit from this. Telemedicine has the potential to address political concerns about healthcare access and cost. The load on hospitals and clinics can be lessened by offering remote consultations, thereby cutting healthcare expenses for both individuals and governments. Telemedicine poses moral questions from a religious standpoint about the nature of doctor-patient relationships. Some religious organizations could worry about whether or not virtual consultations uphold a personal connection between doctors and patients or if they compromise conventional conceptions of care.
13. Explain how public and private financing of health care affects the demand for healthcare services and products. The demand for health services and goods is shaped by both public and private health care financing. Private finance gives consumers more freedom to make their own decisions, which can increase demand. Public finance tries to increase access, cover certain demographics, and possibly boost demand within those communities. 14. Explain the significance of Gatekeeping in regards to primary care and keeping healthcare costs down. Gatekeeping regarding primary care plays an important role in keeping healthcare costs down by reducing unnecessary expensive specialist consultations, controlling prescription costs, minimizing assessment expenses through streamlined evaluations, and promoting improvements in the services provided by primary care physicians. Additionally, primary care offers a more thorough picture of a patient's health, and more visits encourage enhancements in the services they offer. 15. Discuss the four principles of insurance and the nature and purpose of cost sharing in private health insurance. The first principle states that risk is unpredictable for the insured individual. This means that no one can predict with certainty when they will suffer a loss or need to use their insurance policy. The second principle states that risk can be predicted with a reasonable degree of accuracy for a group or population. While predicting when a person will experience a loss may be challenging, predictions about the chance of losses happening among a wider group or population are possible. The third principle explains that insurance provides a mechanism for transferring or shifting risk from an individual to the group through the pooling of resources. Insurance firms can distribute the cost of covering losses across all policyholders by combining the premiums from numerous individuals. The fourth principle states that actual losses are shared on an equitable basis by all members of the insured group. This means that the cost of a claim made by an insured member for a loss is split among all other members in the form of premiums. Due to the nature of insurance, cost sharing is necessary. The purpose of cost sharing is to decrease the misuse of insurance benefits.
16. Discuss Medicare; when and how it was developed (parts A and B) and, how it has changed since its inception, i.e., Part C and D, managed care and the Affordable Care Act Medicare covers medical expenses for the elderly. In Medicare Part A, Hospital insurance is paid for by taxes that employers pay and withheld from employees' paychecks; this allows the use of Social Security money to pay for hospital care. Services that physicians determine to be medically necessary may be covered by Medicare Part B. Part C lowers a beneficiary's expense while providing coverage that goes beyond that of parts A and B. Medicare Part D requires individuals to pay an extra premium but provides coverage for prescription drugs. The implementation of the Affordable Care Act has also had an impact on Medicare. The ACA has allowed more people to acquire healthcare insurance overall, including those who are eligible for Medicare. 17. What are Diagnostic-Related groups (DRG’s), Ambulatory Payment Classification (APC), Outpatient Prospective Payment System (OPPS), Resource Utilization Groups (RUG), and Home Health Resources Groups (HHRG) and how are “codes” like this utilized to try to control cost? DRG’s are used to pay for inpatient services, and it was created to ensure that people receive the services they require and that their bill isn't bloated with extra charges. APC is associated with Medicare's Outpatient Prospective Payment System and is a payment method for services provided by hospital outpatient departments, and it helps determine how much to pay healthcare providers for outpatient services under the Medicare program. The OPPS was implemented to pay for facility services such as nursing, anesthetics, etc. RUG is a system used to categorize nursing home patients into groups based on their clinical and functional state as determined by a facility's minimal data set. HHRG runs Medicare Certified Home Health, Hospice, and Home Care organizations. All of the codes are used to maintain stability between providers and patients on the costs of services delivered. 18. Based on the information in your text, how were the National Health Expenditures were spent and what impact did this have on the Gross Domestic Product (GDP) and the Consumer Price Index (CPI)? The National Health Expenditures were spent on health services, supplies, health-related research, and construction activities in a country during a calendar year. In 2015, the U.S. GDP was a little more than $18 trillion. Thus, 17.8% of the total economic output in the United States in 2015 was consumed by health care. The rapid rise in health care expenditure and cost inflation exceeded the growth in GDP and CPI.
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19. Describe the types of Outpatient Care, and discuss why it has grown so quickly the impact this has had on society. Clinical services include regular check-ups, screens for chronic conditions, diagnostic procedures, and treatment for such conditions. Primary care doctors or specialists may offer these at outpatient clinics or private offices. Surgical services comprise procedures that can be carried out without a hospital stay on an outpatient basis. Examples include simple procedures like minor surgery or the excision of moles. Acute care emergency services are accessible in outpatient settings like urgent care facilities. These institutions offer fast medical care for non-life-threatening conditions that need to be treated right away but do not necessitate a trip to the emergency room. Home health care entails offering medical support and help to patients in their own homes. People who have trouble getting to medical facilities owing to mobility problems or chronic illnesses can benefit greatly from this kind of outpatient therapy. Community health clinics provide comprehensive primary healthcare services to marginalized people as outpatient facilities. They frequently offer free or inexpensive medical and dental care, mental health counseling, testing for early disease, and other crucial healthcare resources. Several variables have fueled the expansion of outpatient treatment. First of all, it enables patients to receive required medical care without the hassle and expense of overnight hospital stays. For people without insurance or who are unable to pay for conventional hospital-based treatments, it also offers more affordable primary healthcare options. 20. Distinguish between primary, secondary, and tertiary care. Primary care is the initial level of medical attention that people receive for routine medical conditions. It focuses on providing general medical services and preventive care, such as routine check-ups, vaccinations, and screenings. Primary care is typically provided by general practitioners or family physicians. Secondary care is the next level of healthcare that involves specialized medical services provided by healthcare professionals who have expertise in a specific area. For additional assessment or treatment, primary care professionals frequently refer patients to secondary care. This level of care includes services like hospitalization, routine surgeries, and rehabilitation. Tertiary care is the most complex level of care and is required for relatively uncommon conditions. It often involves highly specialized medical teams and facilities, such as trauma centers or transplant units. These services may include complex surgeries, long-term management of chronic conditions, and intensive rehabilitation programs.