Introduction to US Health Care

• Text by Dennis D. Pointer,

Stephen J. Williams, Stephen L. Isaacs &

James R. Knickman with Tracy Barr

• PowerPoints by Robin Pickering Eastern Washington University

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Introduction to US Health Care

Chapter 14

Public Health Policy

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Public Health ServicesProtection of the nation’s public health is a government responsibility.

Public Health Agencies Three core

functions are

Assessment

Policy Developm

ent

Assurance

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The Department of Health & Human Services (DHHS)

The DHHS and various federal agencies perform several public health functions.

•Data gathering and analysis, and surveillance and control: The CDC

•Conducting and sponsoring research: The NIH

•Providing programmatic assistance to state and local governments

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The Department of Health & Human Services (DHHS)

The DHHS and various federal agencies perform several public health functions.

•Ensuring the safety of food and drugs: The FDA

•Ensuring access to health services by aged and poor

people: The CMS

•Providing direct services to special populations14-5

State Health Agencies

The state’s role in public health:

Licensing health care

professionals

Inspecting and licensing

health care facilities

Collecting vital statistics

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The state’s role in public health (contd.)

Investigating and analyzing the epidemiology of disease

Epidemiology study includes three factors:

1.Incidence2.Distribution

3.Control14-7

The state’s role in public health (contd.) • Observing and managing

communicable diseases in the community

• Registering diseases and tumor information

• Providing laboratory services• Formulating health policy and

legislation• Analyzing health policy and

legislation’s impact• Providing community health education

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• Food safety inspection• Sanitation services• Investigation and control

of STDs• Drinking water purification

Local Health Agencies

Most front-line public health services are provided locally.

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Private Health Care Providers

Private health care providers contribute to the public health by:

• Engaging in surveillance and monitoring of diseases

• Administering immunizations• Screening for communicable diseases• Offering patient education• Coordinating the provision of private

and public health services14-10

Federal & State Statues and Regulations

• Title 21, Federal Food, Drug, and Cosmetic Act

•OSHA Laws•The Hazard Communication Standard•The Medical Waste Tracking Act•The Occupational Exposure to Bloodborne Pathogen Standard

•The Health Insurance Portability and Accountability Act

State laws differ from state to state, i.e. abortion laws

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Researchers conduct surveys comparing the U.S. population to populations in other developed countries. Key indicators are:

CostAccessResponsiveness Infant mortalityFairness of financing

Health Indicators

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To classify health systems researchers look at a number of factors.

Degree of primary care regulation Type of financial access to health care Whether the health system relies on generalists or

specialists to provide primary care

Characteristics of the Health System

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To determine if a the foundation of a country’s health system is primary or specialty care researchers look at the following factors:

Extent to which the PCP acts as the point of entry into the systemExtent to which the physician provides continuous care over timeComprehensiveness of the care providedExtent of coordination of services by the PCP

Primary Care or Specialty Care

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Check Your Understanding

• 1. Public health services focus on preventing disease and promoting health in populations.

• True or False?

Check Your Understanding

• 2. Federal, state, and local governments are responsible for public health because private organizations lack the resources and infrastructures to perform functions associated with public health.

• True or False?

Check Your Understanding

• 3. Which of the following is not one of the three core functions performed by public health agencies?

• A. assessment (understanding community health needs)

• B. policy development (creating laws regarding public health)

• C. assurance (implementing laws and analyzing their effect)

• D. absorption (combining all public health functions into a single agency within individual communities

Check Your Understanding

• 4. Federal and state laws prohibit the participation of private health care agencies to perform public health functions.

• True or False?

Check Your Understanding

• 5. Federal health law generally focuses on:

• A. specific regulations regarding delivery of health care to individuals

• B. the activities of the U.S. Department of Health and Human Services

• C. delivery of health care to veterans and members of the Armed Services

• D. embryonic stem cell research

Check Your Understanding

• 6. The primary concern of OSHA laws is workplace safety.

• True or False?

Check Your Understanding

• 7. States, in order to meet the requirements of federal regulations, often have the same health laws and regulations.

• True or False?

Check Your Understanding

• 8. Which of the following are true about health policy in the United States?

• A. it involves federal, state, and local government agencies

• B. it includes health initiatives created and implemented by private health care agencies

• C. it requires enormous expenditures and is funded by various sources.

• D. a and c only• E. all of the above

Check Your Understanding

• 9. The U.S. has no national health policy; all health policies are determined at the state level.

• True or False?

Check Your Understanding

• 10. Who makes health policy in the U.S.?

• A. congress• B. state legislatures• C. federal and state judiciary• D. all of the above

Check Your Understanding

• 11. Although the U.S. spends more on health care than any other industrialized country, it also has the highest ranking for all health indicators, including quality of care and infant mortality.

• True or False?

Check Your Understanding

• 12. The primary physician in the U.S. health system is the:

• A. specialist• B. generalist• C. primary care physician• D. all of the above