Chapter 5: Economics of Health Care Delivery

NUR 436; Comm and Population Health; MCUSON; Dr. Hall

list 5 epidemics that occurred in the 1800s-1900s

• typhoid

• smallpox

• flu

• malaria

• yellow fever

in the 1800s-1900s, health concerns were related to contaminated _____ and _____, sewage disposals, and poor housing conditions

food; water

in the 1800s-1900s, the practice of _____ was unregulated (apprenticeships and OJT)

medicine

in the 1800s-1900s, medicine was paid for by individuals who could afford it. This was also done through _____.

bartering

in the 1900s-1945, controlling infections and trauma improved _____ issues

environmental

in the 1900s-1945, there was a rapid growth of _____

hospitals

in the 1900s-1945, private and charitable financing of healthcare, city, county, and state _____ were beginning to contribute

governments

in the 1900s-1945, there were major advances in _____ and _____

childbirth; surgery

in the 1900s-1945, there was also a development of _____

pharmaceuticals

in the 1900s-1945s, _____ trained in hospitals

nurses

in 1945-1984, this was the beginning of _____ disease (heart disease, cancer, strokes). This resulted in increased wealth and lifestyle changes in the US

chronic

between 1970-1984, the number of people employed in healthcare grew ___%

90%

***in 1965, Medicare and Medicaid programs expanded

in 1984-present, there was a period of limited _____ (contain costs, restrict growth in healthcare industry, and reorganize health care delivery system)

resources

in 1984-present, healthcare became _____

corporate

_____ is the science concerned with the use of resources, including the producing, distributing, and consuming of goods and services

economics

_____ _____ is concerned with how scarce resources affect the health care industry. (Allocation of resources)

health economics

_____ _____ _____ then focuses on producing, distributing, and consuming goods and services as related to public health and where limited public resources might best be spent to save lives or cause the most increase in quality of life.

public health economics

_____ _____ _____ is a growing field of science and practice that involves acquiring, managing, and using monies to improve the health of populations through disease prevention and health promotion strategies. This field of study also focuses on evaluating the use of money and the impact on the public health system.

public health finance

***two common measures of economic growth are the gross national product (GNP) and the gross domestic product (GDP)

_____ is the total market value of all goods and services produced in an economy during a period of time (e.g., quarterly or annually).

GNP

_____ is the total market value of the output of labor and property located in the United States.

GDP

_____ focuses on the individual or an organization

microeconomics

The _____ _____ approach is a measure of macroeconomic theory. In this approach improving human qualities, such as health, is a focus for developing and spending money on goods and services because health is valued; it increases productivity, enhances the income-earning ability of people, and improves the economy.

human capital

In Fig. 5.4, the upward-sloping supply curve represents the seller’s side of the _____, and the downward-sloping demand curve reflects the buyer’s desire for a given product. As shown here, suppliers are willing to offer increasing amounts of a good or service in the market for an increasing price. The demand curve represents the amount of a good or service the consumer is willing to purchase at a certain price. This curve illustrates that when few quantities of a good or service are available in the marketplace, the price tends to be higher than when larger quantities are available.

market

The point on the curve where the supply and demand curves cross is the _____, or the point where producer and consumer desires meet.

equilibrium

***Supply and demand: when few goods or services are available, prices tend to rise; when there is plenty, prices tend to drop.

_____ refers to producing maximal output, such as a good or service, using a given set of resources (or inputs), such as labor, time, and available money.

efficiency

_____, on the other hand, refers to the extent to which a health care service meets a stated goal or objective, or how well a program or service achieves what is intended. *** know how to apply. Example: The nurse implements a teen pregnancy program and there is a decrease in teen pregnancy.

effectiveness

***Factors influencing national health care spending: ethnicity, public support, and specifically demographics, technology, and chronic illness.

The Marine Hospital Service is considered the first national health insurance plan in the United States.

Maine Hospital Service

_____ has two parts: Part A (hospital insurance) covers hospital care, home care, hospice care, and skilled nursing care (limited); Part B (noninstitutional care insurance) covers medically necessary services, such as health care provider services, outpatient care, home health, and other medical services (such as diagnostic services and physiotherapy). In 1999, a program called Medicare Advantage was added to the program (Part C). This option allowed for additional coverage, which included both Parts A and B services. The Part C plans are coordinated care plans that include health maintenance organizations (HMOs), private fee-for-service plans, and medical savings accounts (MSAs); these provide full health care coverage costs after a high deductible.

Medicare