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Chapter 2: Overview of the US Health Care System and Users

Chapter 2: Overview of the US Health Care System and Users. Tracey Lynn Koehlmoos HSCI 678. Outline of the Overview. Components of the System Defining Health Establishing US Health Seeking Behavior Demographics Detailed look at health status of population.

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Chapter 2: Overview of the US Health Care System and Users

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  1. Chapter 2: Overview of the US Health Care System and Users Tracey Lynn Koehlmoos HSCI 678 Intro to US Health System

  2. Outline of the Overview • Components of the System • Defining Health • Establishing US Health Seeking Behavior • Demographics • Detailed look at health status of population Intro to US Health System

  3. Snap Shot of Health System Components • Organizational: • Public: DHHS (since 1953); collection, research • Private: Health ins.; medical-industrial complex • Voluntary: Gap fillers, disease specific (AHA) • Management: • Planning, legislation, regulation • SSA of 1964, HMO Act of 1973, TEFRA Intro to US Health System

  4. Snap Shot of Health System Components • Economic Support: (2000) • 33% Private Ins., 45% Fed & State • 15% Out of Pocket, 6% Foundation/Charity • Resource: growing to meet needs • Workforce • Facility growth • Delivery System: FFS to Manage Care • Balance equity and efficiency • Access Intro to US Health System

  5. Defining Health • WHO: • Health is not merely the absence of disease, but the state of physical, mental and social well-being. Fundamental conditions for health: Peace, shelter, education, food, income, stable ecosystem, sustainable resources, social justice, equity Intro to US Health System

  6. Determinants of Health Intro to US Health System

  7. Health Status of the USA in 2000 Birth Rate: 14.7 per 1000 women • Life Expectancy: 76.9 years • Birth Weight: W, 6.5%/ B, 12.9% • Morbidity: 11.7% all ages, any disability • Mortality: • Infant: 6.9% per 1000 • Adults: 881.9 per 100,000 (1999) • Causes: Heart Disease, Cancer, Stroke Intro to US Health System

  8. Care Seeking Behavior • Injury/Illness • Chronic disease monitoring • Prenatal Care • Prevention • Palliative Care • Self assessment • Access • THE WORRIED WELL! Intro to US Health System

  9. Demographics and Use • Women • Very Young and the Old • Baby Boomers will stretch system to its limits • Race and Ethnicity: Disease and Disparity • Socio-Economic Status • Black and Hispanic below FPL 3x White Intro to US Health System

  10. Utilization Models • Aday Model • Health Belief Model • Utilization is strongly influenced by what is available (policy, delivery systems, finance) and personal beliefs and risk perception (characteristics, satisfaction). Intro to US Health System

  11. Utilization Facts • Lowest Income=Highest Physician Contacts • Most Physician Contact in Office setting • Hospital Utilization: More Blacks, More Women, More Low Income • Home Health: More Women • Nursing Home: 5% of population >65 Intro to US Health System

  12. Effects on Health of Health Services • Does Health Care make us healthier? • More prenatal care/Less low weight births • Cancer survivors, Polio survivors • Nosocomial infection, drug interactions • Influence and effects of lifestyle and environment and behavior Intro to US Health System

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