PHAR 321- EXAM #1

Characteristics of Adults Aged 18-64 Who Did not take medication as prescribed to reduce Costs

(1 assessment Q)

1. Women were more likely than men to not take medication as prescribed

2. adults with disabilities were more likely to not take medication as prescribed to reduce cost

3. uninsured adults were more likely than adults with other health coverage, Medicaid, or private health insurance to not take medication as prescribed due to cost

4. adults without prescription drug coverage were more likely to not take medication compared with those with public or private prescription coverage

Definition of Health (WHO)

a state of complete physical, mental and social wellbeing, and not merely the absence of disease and infirmity

(health encompasses physical, mental, and social aspects and not just absence of illness

Define Care

efforts mad to maintain or restore physical, mental, and emotional wellbeing, by trained and licensed professionals

Primary care

the general first care provider (MD, DO, PA, RPH)

-PCP, clinic

Secondary care

hospital, internist

tertiary care

specialty hospital, children’s hospital, cancer center, specialist

Define system

a whole composed of several interdependent parts that have differentiated roles, are interconnected by 3 processes (input, throughput, and output), to create one overall unified and designed purpose

-a system must be connected, these connections are primarily the points where failures occur between patient, provider, payor

How Healthcare does not demonstrate free market attributes

1. low degree of consumerism

2. third parties usually separate buyer and seller

3. third parties are often the initial “payer”

4. government regulation

5. power of professionals

6. nonprofits dominate the provider landscape

7. lack of price transparency

8. lack of information technology and data flows

9. asymmetric information

10. local markets: “all healthcare is local”

11. totally different language

free market

actively ship for healthcare services

Who are the players in the system?

1. payers: consumer or their agent, insurance plans, government, employers

2. providers: pharmacists, doctors, nurses

3. producers: Pharma companies, IT, Medical Device Manufacturers

4. consumer: the direct patient that is provided healthcare for

How much of illness is induced by lifestyle?

51% of illness is lifestyle induced

-smoking

-obesity

-stress

-nutrition

-blood pressure

-alcohol

-drug use

20% human bio, 19% environment, 10% healthcare

What are the four basic modes of paying for healthcare?

1. out of pocket payment

2. individual private insurance

3. employment-based group private insurance

4. government financing

Out of pocket payment

in the first half of the twentieth century, out of pocket cash payment was the most common method of payment. this is the simplest mode of financing-direct purchase by the consumer of goods and services

-money from patient or their human payor directly to the provider (you pay or mom, dad, loved one pays for your visit to the provider)

-made directly from patient to provider

individual private insurance

-a third party, the insurance plan (health plan), is added dividing payment into a financing component and a payment component. The ACA added an individual coverage mandate for those not otherwise insured and federal subsidy to help individuals pay the insurance premium.

-you or someone tha is a human tha cares for o.