Usp 143: Part 2

What were hospitals before the 1880s?

Infirmaries; mostly charitable; focused on caring for sick people rather than curing them; primarily served poor populations.

Who was Florence Nightingale?

Nurse, statistician, and social reformer who founded modern professional nursing.

Why is Florence Nightingale important?

Professionalized nursing, improved sanitation and hygiene, and used statistics to improve patient care.

What happened between 1880-1920?

The rise of curative medicine with vaccines, X-rays, and scientific medicine; hospitals became places of cure.

Why did healthcare spending increase after 1880?

Curative medicine became effective, so people were willing to pay for treatments that improved health.

What was the Flexner Report?

A 1910 report that standardized medical education and promoted science-based medicine.

What model did the Flexner Report promote?

The Biomedical Model.

What is the Biomedical Model?

The belief that illness has a biological/scientific cause and can be treated through medical intervention.

What does the Biomedical Model focus on?

Physicians, hospitals, procedures, and scientific cures.

What does the Biomedical Model tend to ignore?

Social determinants of health.

What happened to many HBCU medical schools after the Flexner Report?

Most were closed.

What happened to physician authority after the Flexner Report?

Physicians became the primary decision-makers in healthcare.

What is a modern echo of the Flexner Report?

O-Chem requirements, physician dominance, scope-of-practice debates, and emphasis on science-based training.

What is physician professionalism?

The idea that physicians determine what care is necessary, which services are provided, and how care is delivered.

Who traditionally decides what care is medically necessary?

Physicians.

Why is physician professionalism important?

It shaped the physician-centered healthcare system that still exists today.

What percentage of healthcare interactions involve primary care?

80-90%.

What percentage of healthcare spending goes to primary care?

Approximately 5-10%.

Why is primary care important?

It provides some of the greatest health improvement per dollar spent.

Why is primary care often underfunded?

Specialty services receive higher reimbursement.

What is the primary care spending gap?

Primary care handles most patient interactions but receives a small share of healthcare spending.

What was the Hill-Burton Act?

A 1946 federal law that funded construction of hospitals and clinics.

Why was the Hill-Burton Act important?

It expanded healthcare infrastructure throughout the United States.

What obligation did Hill-Burton facilities have?

Provide community benefit and some free/subsidized care.

What is a public good?

A good that benefits society and is often non-rivalrous and non-excludable.

What is a private good?

A good that is rivalrous and excludable.

Why is healthcare both a public and private good?

It benefits individuals directly while also benefiting society through a healthier population.

What is an example of healthcare acting as a public good?

Vaccinations.

What is an example of healthcare acting as a private good?

Cosmetic surgery.

What is police power?

Government authority to protect health, safety, welfare, and morals.

What are examples of police power in healthcare?

Vaccination requirements, insurance regulations, Medicare laws, Medicaid laws, and taxation.

A city builds more hospitals but health outcomes do not improve. Why?

Clinical care is only one contributor to health outcomes; social determinants also influence health.

A healthcare system invests heavily in specialty procedures but neglects primary care. What problem might occur?

Reduced efficiency and missed opportunities for prevention.

Why does primary care often improve health outcomes more efficiently than specialty care?

It focuses on prevention, early intervention, and chronic disease management.

What is one major criticism of the Biomedical Model?

It underemphasizes social determinants of health.

What course concept explains housing, food, and transportation affecting health?

Social determinants of health.