Primary Principles for Health Care Reform-final

7/26/2019 Primary Principles for Health Care Reform-final

1/25

+

PRIMARY PRINCIPLES FOR HEALTH CAREREFORM


2/25

+Drag picture toplaceholder orclick ico to addHEALTH CARE REFORM

- i! a geeral ru"ric u!ed#or di!cu!!ig $a%or healthpolic& creatio or chage!'#or the $o!t part(go)er$etal polic& that

a*ect! health care deli)er&i a gi)e place+


3/25

+

,OALS

Health care re#or$ t&picall& atte$pt! to-

.roade the populatio thatrecei)e! health care co)eragethrough either pu"lic !ector

i!urace progra$! or pri)ate!ector i!urace co$paie!

E/pad the arra& o# health carepro)ider! co!u$er! $a& choo!ea$og

I$pro)e the acce!! to health care!peciali!t!

I$pro)e the 0ualit& o# health care

,i)e $ore care to citi1e!

Decrea!e the co!t o# health care


4/25

+PRINCIPLES- ALMA ATA

DECLARATIONA !erie! o# "a!ic priciple! ideti2ed i the Alma AtaDeclaration 3hich !hould "e #or$ulated i atioalpolicie! i order to lauch ad !u!tai Pri$ar& Health

Care 4PHC5 a! part o# a co$prehe!i)e health !&!te$ad i coordiatio 3ith other !ector!-

A. Equitable distribution of ealt care

!. Communit" #artici$ationC. Healt %or&force De'elo$ment

D. (se of A$$ro$riate Tecnolo)"

E. Multi-sectional A$$roac


5/25

+E67ITA.LE DISTRI.7TION OF

HEALTH CARE

Pri$ar& care ad other !er)ice! to $eet the$ai health pro"le$! i a co$$uit& $u!t"e pro)ided e0uall& to all idi)idual!irre!pecti)e o# their geder( age( ca!te( color(ur"a8rural locatio ad !ocial cla!!+


6/25

+COMM7NITY PARTICIPATION

I order to $ake the #ulle!t u!e o# local(atioal ad other a)aila"le re!ource!+

Co$$uit& participatio 3a! co!idered!u!taia"le due to it! gra!! root! ature ade$pha!i! o !el#9!u:ciec&( a! oppo!ed totargeted 4or )ertical5 approache! depedeto iteratioal de)elop$et a!!i!tace+


7/25

+HEALTH ;OR


8/25

+7SE OF APPROPRIATE

TECHNOLO,Y

Medical techolog& !hould "e pro)ided that i!acce!!i"le( a*orda"le( #ea!i"le ad culturall&

accepta"le to the co$$uit&+

E/a$ple! o# appropriate techolog& icludere#rigerator! #or )accie cold !torage+

Le!! appropriate could iclude( i $a& !ettig!("od& !caer! or heart9lug $achie!( 3hich"ee2t ol& a !$all $iorit& cocetrated i ur"aarea!+ The& are geerall& ot acce!!i"le to thepoor( "ut dra3 a large !hare o# re!ource!+


9/25

+M7LTI9SECTIONAL APPROACH

Recogitio that health caot "e i$pro)ed "&iter)etio 3ithi %u!t the #or$al health !ector>other !ector! are e0uall& i$portat i pro$otig

the health ad !el#9reliace o# co$$uitie!+ The!e !ector! iclude( at lea!t-

agriculture 4e+g+ #ood !ecurit&5>

educatio> co$$uicatio 4e+g+ cocerig pre)ailighealth pro"le$! ad the $ethod! o# pre)etig ad

cotrollig the$5> hou!ig> pu"lic 3ork! 4e+g+ e!urig a ade0uate !uppl&

o# !a#e 3ater ad "a!ic !aitatio5>

rural de)elop$et> idu!tr&> co$$uit& orgai1atio!4icludig Pacha&at! or local go)er$et!( )olutar&

orgai1atio!( etc+5+


10/25

+.AREFOOT DOCTORS

The ?.are#oot doctor!? o# Chia 3ere a di)er!e arra&o# )illage health 3orker! 3ho li)ed i rural area! adrecei)ed "a!ic health care traiig+

The& !tre!!ed rural rather tha ur"a health care(ad pre)eti)e rather tha curati)e !er)ice!+

The& al!o pro)ided a co$"iatio o# 3e!ter adtraditioal $edicie!+

The& had clo!e co$$uit& tie!( 3ere relati)el& lo39co!t( ad perhap! $o!t i$portatl& the& ecouraged!el#9reliace through ad)ocatig pre)etio adh&giee practice!


11/25

+

CRITICISMS

The Al$a Ata Declaratio it!el# 3a!critici1ed #or "eig too @ideali!tic ad@ha)ig a ureali!tic ti$e ta"le+

More !peci2c approache! to pre)et adcotrol di!ea!e! 9 "a!ed o e)idece o#pre)alece( $or"idit&( $ortalit& ad#ea!i"ilit& o# cotrol 4co!t9e*ecti)ee!!5 93ere !u"!e0uetl& propo!ed+ The "e!tko3 $odel 3a! the *electi'e #HCa$$roac


12/25

+SELECTI=E PHC

The idea o# Selecti)e Pri$ar& Health Care 3a!itroduced a! a !trateg& to co$ple$etco$prehe!i)e PHC+

It 3a! "a!ed o a paper "&Bulia ;al!h ad


13/25

+,O.I9FFF

Selecti)e PHC approach co!i!t! o# techi0ue! ko3collecti)el& uder the acro&$ ?,O.I9FFF?+

It #ocu!e! o !e)ere populatio health pro"le$! icertai de)elopig coutrie!( 3here a #e3 di!ea!e! arere!po!i"le #or high rate! o# i#at ad child $ortalit&+

The target! ad e*ect! o# Selecti)e PHC are !peci2cad $ea!ura"le+


14/25

+,O.I9FFF

The approach ai$! to pre)et $o!t health ad utritiopro"le$! "e#ore the& "egi-

ro3th $oitorig- the $oitorig o# ho3 $uch i#at! gro33ithi a period( 3ith the goal to uder!tad eed! #or "etterearl& utritio+

Oral reh&dratio therap&- to co$"at deh&dratio a!!ociated3ith diarrhea

!rea!t#eedig

,$$ui1atio

Fa$il& plaig4"irth !pacig5

Fe$ale educatio

Food !upple$etatio- #or e/a$ple( iro ad #olic acid#orti2catio8!upple$etatio to pre)et de2ciecie! i

pregat 3o$e+
https://en.wikipedia.org/wiki/Oral_rehydration_therapyhttps://en.wikipedia.org/wiki/Oral_rehydration_therapyhttps://en.wikipedia.org/wiki/Breastfeedinghttps://en.wikipedia.org/wiki/Breastfeedinghttps://en.wikipedia.org/wiki/Vaccinationhttps://en.wikipedia.org/wiki/Vaccinationhttps://en.wikipedia.org/wiki/Family_planninghttps://en.wikipedia.org/wiki/Family_planninghttps://en.wikipedia.org/wiki/Family_planninghttps://en.wikipedia.org/wiki/Female_educationhttps://en.wikipedia.org/wiki/Female_educationhttps://en.wikipedia.org/wiki/Female_educationhttps://en.wikipedia.org/wiki/Female_educationhttps://en.wikipedia.org/wiki/Family_planninghttps://en.wikipedia.org/wiki/Family_planninghttps://en.wikipedia.org/wiki/Family_planninghttps://en.wikipedia.org/wiki/Vaccinationhttps://en.wikipedia.org/wiki/Vaccinationhttps://en.wikipedia.org/wiki/Breastfeedinghttps://en.wikipedia.org/wiki/Breastfeedinghttps://en.wikipedia.org/wiki/Oral_rehydration_therapyhttps://en.wikipedia.org/wiki/Oral_rehydration_therapy


15/25

+=ISION FOR THE GSTCENT7RY

.a!ed o the Health9For9All Polic& i A#rica Regio "&

It call! #or health de)elop$et policie! that are cetered o the#ollo3ig )alue! ad priciple!-

*olidarit""a!ed o parter!hip( tra!parec& ad !haredre!po!i"ilit&(

Equit""a!ed o ui)er!al acce!! to health care( icludigidi)idual care( ad o the eed to guaratee ui)er!al acce!! tohealth(

/ Etics "a!ed o achie)e$et o# ad cotri"utio to glo"al adatioal progre!! i health(

0 Cultural identit" 3hich re!pect! ethic di*erece! ad!peci2citie! o# coditio!(

1 ender equit" 3hich e!ure! e0uit& "et3ee 3o$e ad $e ideci!io9$akig ad utili1atio o# health !er)ice!+


16/25

+

STRATE,IES TO ADOPT

+ e)iro$et! #or health(

+ udertakig health !&!te$ re#or$ "&dra3ig upo PHC priciple!(

+ e$po3er$et ad !upport at idi)idual(#a$il& ad co$$uit& le)el!(

+ creatio o# the coditio! that 3ill ea"le

3o$e to participate( "ee2t ad lead ihealth de)elop$et+


17/25

+FINANCIN, ISS7ES IN HEALTH CARE

Patiet!

I!urer!

Ho!pital!

Health care pro#e!!ioal!

E$plo&er!

,o)er$et!JCo!i!tet 3ith the cocept o# patiet9cetered care( thepatietK! "a!ic $edical eed! $u!t "e the 2r!t priorit& ia& pa&$et82acig !&!te$+

Health care 2acig re#or$ !hould egage all!takeholder!-


18/25

+

.EATIN, THEISS7ES

#atient Em$o2ermentand #ersonal

Res$onsibilities

Idi)idual! ha)e a per!oalre!po!i"ilit& ad a right to choo!ead !elect the health care pla ad

"ee2t! o# their choice++ Idi)idualchoice! !hould "e e/paded "e&odtho!e de)eloped "& go)er$et"ureaucracie! or e$plo&er!+Idi)idual! 3ho $ake health& li#e9!t&le choice! !hould "e a"le to

"ee2t #ro$ tho!e choice! "&pa&ig lo3er pre$iu$! or recei)igother 2acial re3ard!+


19/25

+

.EATIN, THEISS7ES

Findin) Alternati'es tote 3Medical Home4

Conce$t

Polic& $aker! $u!t a)oid thecreatio o# e3 health care deli)er&$odel! that i$pede( dela&(

3ithhold( or de& acce!! toece!!ar& !pecialt& care+ A! thepractice o# $edicie ha! "eco$eicrea!igl& !peciali1ed( it i!i$portat to e!ure that patiet!ha)e acce!! to ti$el&( high 0ualit&(

a*orda"le !pecialt& care( icludigthe ph&!icia o# their choice+


20/25

+

.EATIN, THEISS7ES

Ensurin) #atient Accessto *$ecialt" *er'ices

;hile the iitial pa!!age o# la3!"aig ph&!icia !el#9re#erral 3a!3ell9itetioed( uitededco!e0uece! ha)e placed

cotiuit& o# patiet care at ri!k+Re!po!i"le ph&!icia o3er!hip o#!er)ice! ad #acilitie! ha! "eede$o!trated to i$pro)e patiet!a#et&( acce!!( 0ualit&( e:ciec&ad the deli)er& o# co!t9e*ecti)e

!er)ice!( ad it !hould ot "eprohi"ited+


21/25

+

.EATIN, THEISS7ES

uaranteein) ,ndi'idualste Ri)t to Enroll in a

Healt Care #lan of Teir

Coice

Idi)idual! !hould to "e a"le tochoo!e a health pla 3ith the

"ee2t!( pro)ider!( ad patietco!t9!harig arrage$et! o# theirchoice+ It i! i$portat that polic&$aker! e!ure that health pla!co)er "a!ic health care "ee2t!(icludig acce!! to !pecialt& care(

3hile a)oidig the te$ptatio toi$po!e e/ce!!i)e $adate! thatdri)e up the co!t o# $edicali!urace+ Thi! 3ill e!ure that"a!ic health care eed! are $et(3hile gi)ig health pla erollee!

greater choice! ad e/i"ilit&+


22/25

+

.EATIN, THEISS7ES

#ro'idin) E5cient Careand Co'era)e

6Cost7E5cienc" 's.

8ualit"79alue7*afet":

I recet &ear!( !e)eral iitiati)e!ha)e "ee itroduced to either

cotrol co!t! or i$pro)e 0ualit&- @Pa&9#or9per#or$ace

,ai9!harig

=alue9"a!ed purcha!ig

JPatiet! de!er)e the highe!t 0ualit&treat$et ad a& co!t9cotrol$echai!$ $u!t "e i$ple$eted ia $aer that i! i the "e!t itere!to# the patiet+ Patiet !a#et& ad the3ell9"eig o# the patiet $u!t al3a&!

"e the 2r!t co!ideratio+


23/25

+

.EATIN, THEISS7ES

Medical Liabilit" Reform

Patiet! 3ho !u*er a i%ur&"ecau!e o# the egligece o# ahealth care pro#e!!ioal !hould "e%u!tl& co$pe!ated+ Yet the highco!t o# de#e!i)e $edicie itoda&K! puiti)e ad ad)er!ariale)iro$et ha! a detri$etale*ect o a*orda"ilit& ad acce!!#or all patiet!+


24/25

+

.EATIN, THEISS7ES

Healt ,nformationTecnolo)" 6H,T:

Adoptio o# HIT $a& reduceco!tl& ie:ciecie! "&ehacig ph&!icia!K acce!! to

$edical te!t! ad reducig theeed #or duplicati)e !er)ice!+ Iti! critical that iteropera"le!tadard! "e e!ta"li!hed i ati$el& $aer to e!ure $orerapid adoptio o# HIT+


25/25

+

9END9

THAN< YO7+

Primary Principles for Health Care Reform-final

Documents

Transcript of Primary Principles for Health Care Reform-final