Health Care Systems

Health: hard to define: state of complete physical, social + metal well-being, not merely absent of disease the enjoyment of the highest attainable health is fundamental right Textbook definition:"a connection betewen, body-mind + spirit"healthy= more than just visibleHealth Impacts: genetics: family inheritance (cancers, diabetes) behaviours: food, hygiene (smoking, drinking, brush teeth) environment: diseases, pollution, access community + society: school, teachers, (people around) = school standard for food etc. The Canadian Health Care Concept: A significant Canadian Health FIeld concept was presented in 1974 that included lifestyle + environment Lalonde FrameworkHealth--> Environment--> Lifestyle--> Healthcare Organization--> Human Biology Health Care 'Systems' Canada has a government sponsored public plan available to all citizens that covers almost all elements of healthcare (NOT meds) --- US only some government sponsoring WAIT TIMES: excessively long -- US athlete can get ASAP- b/c US based on access + money--- wait times decrease by urgenct: cardiac bypass: 65 days vs. hip surgery 210 days Access to Care- Canada promises all citizens get care - no one uninsured no matter what -- Canada has longer wait times: fewer MRI + CT machine per capita than in US Patients are ranked on 'urgency' Canada's Healthcareall territories and provinces have interlocked insurance plans "universal coverage" for medically necessary healthcare services basis of needs, rather than ability to pay- (medicare) publicly funded OHIP: Ontarian "Canada Health Act" -- fund hospital, medical or primary care, assisted living, chronic care, covers mental health, prescriptions if 65+ National Health Service - (UK + Canadian approach) Healthcare is the diagnose, treatment + prevention of disease, illness, injury + other physical and medical implications 3. Specialists- in hospital w/ advanced facilities for medical investigation (cancer management. pediatrics) 2. Focused Scope: medical specialists, typically hospitals (cardiologists) 1. Wide-scope: first point of consultation Population: 500 000 to 5 mil tertiary care: region50 000 - 500 000 secondary care: district5000 - 50 000 primary care: locally Healthcare Money US spends double Canada money = better, therefore need balance but where take from: edu/roads? Riddell thinks 10% is good on healthcare US may be considered Superior more doctors/equipment, rich go first employers can cover costs unless wealthy your family is one serious illness away from bankruptcy, unless employer support and doesnt fire you Canada may be considered Superior EVERYONE regrdless of wealth gets similar high quality care- access guarenteed less spending on healthcare. longer life expectancy doctors, not insurance companies who decide medical attention Canadas Current Health Care Status improved status of health for both genders HOWEVER depends on definition of 'good health' CVD leading causes of deah major concern: obesity and diabetes related deaths MAIN CHALLENGES: aging population prevalence of avoidable diseases caused by poor health habits financing long term care/ expensive tech and drugs shortage/unbalanced geographic distribution of healthcare professionals Models of Health Care + how to Implement Health Care ChangePRECEDE - PROCEED Models: framework that helps analysis of current health care situatoin used to help design new programs that can effectively implement a health change for a community PRECEDE: planning: Predisposing, Reinforcing, Enabling, Constructs, Educational, Diagnosis, EvaluationPROCEED: implementation+ evaluation: Policy, Regulatory, Organizational, Constructs in Educational Environmental Development PLANNING PHASE: what can be achieved/changed?PRECEDE/PROCEED model: green + colleagues 1970. Precede: phase 1: Social Diagnosis, 2: Epidemiological, Behavioural + Environmental Diagnosis, 3: Educational + Ecological Diagnosis, 4: Admins + policy DiagnosisPROCEED: Phase5: implementation, 6: process evaluation, 7: impact eval, 8: Outcome eval.