U.S. Healthcare system quiz 1

what is the definition of health according to WHO (1947)

a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity

what is healthcare?

the specific things that people do: see a patient or prescribe a medication

what is the healthcare industry defined as

the system by which people get the health care they need

healthcare is generally defined to encompass those __ & __ whose primary purpose is to improve or prevent deterioration in health

goods and services

all health systems require a __ financing mechanism

robust

demand for healthcare is a derived demand for __

health

uncertainty in healthcare is common in both the __ & __ side of the market

demand & supply

when does informational asymmetry occur between providers and patients?

when one party in the transaction has more information than the other party which may allow the better informed party to exploit the less informed part

uncertainty in healthcare markets leads to the presence of

insurance

what can information asymmetry be exacerbated by?

limited time to shop/seek information, individuals are vulnerable or cognitively impaired, and inability to learn from experience

__ occur when someone external to the market transaction- neither the buyer or seller- is affected by the transaction and not compensated

externalities

positive externalities result in __ effects

beneficial

negative externalities result in __ effects

negative

herd immunity is an example of a __ externality

positive

smoking and pollution are examples of __ externalities

negative

demand for health care is a derived demand for

good health

what do economists and policymakers usually think about competitive markets?

they praise them

why do economists and policymakers praise competitive markets?

competition leads to price reduction which help improve well-being of consumers

what are examples of practices in healthcare markets that restrict competition and entry into the sector?

Patent protection in Pharmaceutical Industry, Licensure requirements for providers, Restrictions on product advertising

what are examples of US government subsidies for healthcare?

medicare, medicaid, affordable care act

what area of the healthcare system accounted for the largest portion of health spending in the US?

hospitals

what are the key factors that influence life expectancy

lifestyle, preventative care

what was the number one ranked pharma company in Rx sales and R&D spending

pfizer

what is an pharmacoeconomic analysis

cost analysis of a pharmaceutical product or service, and the clinical outcomes

cost analysis includes what entities

imput cost, and pharmaceutical product or service

what are the entities of a clinical or outcome study

pharma product or services and the outcomes

are clinical or outcome studies economic studies?

no, they do not include the cost

in 2023 how much was the total national health expenditure

4.9 trillion

how does America compare to other countries in health expenditure and life expectancy

higher expenditure and lower life expectancy

What is scarcity?

Limited quantities of resources to meet unlimited wants

Health care economics & value of technologies + clinical and humanistic outcomes =

pharmacoeconomics

what is the cost-minimization outcome measurement unit

same therapeutics outcomes

what is an example of cost-minimization analysis

brand drug versus generic drug

what is an example of cost-effectiveness analysis

diabetes medications and cancer medications

what is an example of cost-benefit analysis

pharmacy providing a service and comparing the cost of the service versus the cost of the service it would prevent

what is the cost-effectiveness outcome measurement unit

natural effectiveness units (mmHg, mg.dL, years of life gained)

what is the cost-benefit outcome measurement unit

dollare or other currency

what is the cost-utility outcome measurement unit

quality adjusted life years (QALY)

what are examples of direct costs?

drugs, hospitalization, outpatient services, laboratory services. transportation, accommodation

what are examples of indirect costs

short-term disability

what are examples of intangible costs

pain, suffering, anxiety

most evaluations include what type of cost

direct

what is the most comprehensive perspective

society

what is considered in the society perspective

all costs and consequences in the evaluation of a technology

what is considered in the providers perspective

Hospitals, private-practice physicians or managed-care organizations, Direct medical costs

what is considered in the patients perspective

All costs borne by the patient for any services not covered by insurance, Direct, indirect, and out-of-pocket cost

what is considered in the third party payers perspective

Insurance companies, employers and government, Primarily direct medical costs (but indirect costs can also be include

what is an example of a micro application to individual patients?

clinical decisions

what is an example of a macro application with society

resource allocation

what is public health

organized community efforts aimed at the prevention of disease and promotion of health that focus on society as a whole, the community and the aim of optimal health status

what is the mission of public health?

Collective effort to identify and address disease prevention and health promotion including quality of life

what are social determinants of health

economic, race, gender, ethnicity, sexual orientation, social suppor

what are health determinants

- Physical environments people live/work

- Political conditions people live in

- Human biology and genetics

- Social factors

- Behavioral choices

- Cultural norms

what are the three core public health functions

assessment, policy development, assurance

what is the assessment function

collect and analyze data to define population health status and quantify existing/trending health problems

what is the policy development function

Developing recommendations from data to address public health problems by mobilizing public and community organizations through plan implementations

what is the assurance function

Public health agency responsibility to ensure basic components of the health care delivery system are in place

what services are under the assessment function

- Monitor health status to identify community health problems

- Diagnose and investigate health problems/ hazards in the community

what services are under the policy development function

- Inform, educate, and empower people about health issues

- Mobilize community partnerships to identify and solve health problems

- Develop policies and plans that support individual/community health effort

what services are under the assurance function

- Enforce laws protect health and ensure safety.

- Link people to needed personal health services and assure its availability

- Assure a competent public health/personal health care workforce

- Evaluate effectiveness, access and quality of pop.-based health services

epidemiology is defined as

the study of the distribution of a disease or a physiological condition in human population and of the factors that influence this distribution.

what is the purpose of epidemiological inquiries?

-explain etiology (cause) of a disease by combining epidemiology and microbiology, genetics, biochemistry

-provide the basis for developing and evaluating preventative procedures and public health practices

what is an experimental study?

random assignment of sample or population to treatment or control group

what is a natural experiment

observational study which naturally approximates experimental design with no randomization

what are observational studies

observation of occurrence of diseases and correlating that with factors

most epidemioligy studied are __ studies

observational

in a case control study what can be derived of the conclusion of the study

1>>2>>3 strength of conclusions

what type of study would a dental cavities and flouride study be

experimental

what type of study would tobacco use and cancer be

natural experiments

what is the purpose of experimental studies

study preventions and treatments for diseases

what is the key feature of experimental studies

investigator assigns individuals to two or more groups that either do or do not receive a preventive or therapeutic agent and follows the groups for incidence of outcome

what is prevalence a measure of

burden of disease; all individuals affected by the disease at a particular time

what does prevalence mean

term that means being widespread

what is incidence a measurement of

risk; the number of new individuals who contract a disease during a particular period of time

Example 1.1:

If D=3yrs and I=10 cases per

1,000 persons per yr, what is P?

Express the prevalence rate per 1000.

1. 0.03

2. 0.3

3. 3

4. 30

30

Example 1.2: If D=3yrs and I=10 cases per 1,000 persons per yr, what is P as a percentage?

1.3%

2.100 per 3 yrs

3. 3 per 1,000

4. 30 per 1,000 per year

3%

Example 1.3: If D=3yrs and I=10 cases per 1,000 persons per yr, what is P? Express the prevalence rate per 100.

1. 0.03

2. 0.3

3. 3

4. 30

3

Example 2.1: If D = 40 yrs and

I= 5.225 cases/1,000 persons/yr

1. 2.09%

2. 40 cases per 1,000 persons

3. 209cases per 1,000 persons

4. 20.9 per 1,000 per yr

3. 209 cases per 1,000

persons

prevalence is useful for __ conditions

chronic

incidence is useful for __ conditions

acute

prevalence is used in planning

medical care services

incidence is useful in evaluating

development of disease in different populations

Several recent federal policy changes underscore the need for measuring ____ to supplement public health's traditional measures

health related quality of life (HRQOL)

health related quality of life (HRQOL) is rapidly gaining acceptance as a __ outcome

measurable

what is the cdc mission

to promote health and quality of life by preventing and controlling disease, injury, and disability

what are the 2 overarching goals of HP2010

1. Improving the quality and years of healthy life

2.Eliminating health disparities

what goals were added to HP2020

3. Focus on creating social and physical, and economic environments that promote good health

4. Focus on emphasizing quality of life and good health behavior over the entire span of life

what goal was added to HP2030

5.Engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all

what is quality of life

an overall sense of well-being, including aspects of happiness and satisfaction with life as a whole

what is health related quality of life (HRQOL)

An individual's or group's perceived physical and mental health over time

Measuring ____ can help determine the burden of preventable disease, injuries and disabilities

HRQOL

Measuring HRQOL will help monitor progress in achieving the nation's ___

health objectives

HP 2010 Report: ___ % of Americans report "frequent mental distress

10

what group has the most mental health distress

younger americans 8-24

what group has the most poor physical health and activity limitation

older adults

what group reported the highest levels of unhealthy days

native americans and alaskan natives

Adults with the lowest income or education: more ___ days than did those with higher income or educatio

unhealthy

Americans with chronic diseases or disabilities: ___ levels of unhealthy days overall

high

what does healthy people 2030 measure?

self-reported health status, life expectancy, physically and mentally unhealthy days, participation in daily activities

healthy days is used to

-identify health disparities

-track trends in the population