Quiz 5 Study Questions PDF

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Week 5 Study Questions Part 1 (Nies Ch. 10): 1. Examine the power of nursing to influence and change health policy. a. What is public health policy? ⮚ Decisions made by 3 branches of the government: judicial, executive, and legislative o Federal & state o State is entrusted with protection of public health: i. Political action ii. Authority to license healthcare professionals and institutions o Federal ■ State must comply with federal regulations to receive funds ■ Example Of legislation from the government: Patient Protection and Affordable Care Act (2010) (Obama Care) ⮚ Monitor, production, provision, and financing influence health policy o Social and political theories ⮚ Based on values ⮚ Starts with health b. How has the definition of health changed? - The current definition of health includes wellbeing (promotion). However, in the past, the definition of health included mainly the context of infectious diseases and chronic conditions. - Compete physical, mental, and social wellbeing. It is “not just the absence of disease or infirmity” (-WHO) - “improvements in peoples’ lives by accelerating health impact and reducing disparities” (-CDC’s main goal) - “paradigm shift” c. What is the focus of Public Health Policy? d. What is the focus of health policy related to the private sector? - Quick and proactive decision making influenced by the economy and business e. How can nurses influence and change health policy? 2. Discuss current health policy issues. a. What are current health policy issues according to the American Nurses Association? - Health system transformation - Health information technology

- Care coordination Important: Advocacy is the pillar of nursing b. What are current health policy issues according to Healthy People 2030? ▪ ⮚ Important: health and wellbeing for all

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c. What are current health policy issues according to the American Public Health Association? Increase and protect funding for vital public health agencies and programs and strengthen the nation’s public health infrastructure. Uphold the Affordable Care Act and expand access to health services and coverage. Address the health impacts of climate change. Advance racial equity Uphold critical public health laws and regulations and reverse damaging rollbacks. Address the nation’s gun violence epidemic.

3. Discuss the nurse’s role in political activities. a. What has stimulated more health care related legislation in the last 20 years? ⮚ Legislative actions ⮚ healthcare system b. What health care legislation has been passed related to health care coverage? ⮚ The Patient Protection and Affordable Care Act (2010-“Obama Care”) (did not majorly change healthcare reform laws) Part 2 (Nies Ch. 11): 1. Describe the organization of the public health care subsystem at the federal, state, and local levels. ➢ Federal ● The state must comply with federal regulations to receive funds ➢ State ○ entrusted with protection of the public ■ political action ■ Authority to license healthcare professionals ➢ Local ○ direct delivery of public health services

a. How is the public health care subsystem organized at the federal level?

➢ Federal policies and practices have had a significant influence on local and state governments to meet health and social problems, laws enacted to respond to changing health needs and concerns b. How is the public health care subsystem organized at the state level? ➢ Activities vary among states. ➢ The The state must comply with federal regulations to receive funds ■ Example Of legislation from the government: Patient Protection and Affordable Care Act (2010) (Obama Care) ➢ Health commissioner or secretary of health is appointed by the governor and directs most state agencies. ➢ A Health officer is usually a physician with a degree and experience in public health. ➢ State Health Department c. How is the public health care subsystem organized at the local level? Local Health Department varies based on: ➢ Community size ➢ Economic ➢ Partnerships with the private health care system ➢ Health care facilities ➢ Business support ➢ Health care needs ➢ Transportation ➢ Number of citizens requiring public health care Types of services: 1. Community health 2. Environmental 3. Personal health 4. Mental health d. What are the differences in the federal, state, and local levels of the public health subsystem? o The public subsystem focuses on the population Three categories: ❖ Federal program ➢ example: WIC ❖ State programs ❖ Local programs

➢ example: Audubon Area Clinic e. How are the public health subsystem levels similar? ● They protect, promote, and restore people’s health 2. Compare and contrast the scopes of the private health care subsystem and the public health care subsystem. a. How are the private health care subsystem and the public health care subsystems alike? ● Healthcare promotion (could not find exact similarities...could be a vague answer?) b. How are the private health care subsystem and the public health care subsystems different? ❖ Private Healthcare: ◆ health care providers integrated into the system (HMO) ◆ patient-centered medical homes (not an actual “place”---Patients go to their primary care provider, then their PCP refers them to specialists as needed) ◆ more advanced nurse practitioners and physician assistants ➔ Private subsystem 5 basic models: 1. Solo practice 2. Single specialty group model 3. multispeciality group model 4. integrated health maintenance model 5. community health center ➔ Public Healthcare: ● “promote the general welfare of citizens” ● Coordination of services under the Department of Health and Human Services ● concerned with the health of population and environment ● influence state and local ○ laws enacted to respond to changing health needs and concerns

3. Discuss the relationship of critical health care issues to the health care organization and health care providers. a. What are current critical health care issues? ● pluralistic (coexisting with 2 or more systems) and competitive system provide fragmented and uncoordinated care. b. How do the current critical health care issues relate to the health care organization?

● Fragmentation and duplication must be overcome to provide coordinated, collaborative, and accessible services to all citizens c. How do the current critical health care issues relate to health care providers? ● Private care agencies and institutions are in competition with one another for: clients, health professionals, and resources 4. Discuss future concerns for the health care delivery system. a. What are future concerns for the health care delivery system? ❖ Refers to observable or quantifiable differences in the presence of: disease, health outcomes, access to health care among different groups and populations ➢ Disparities among ethnic minorities (including African Americans, Native Americans, and Hispanics), socioeconomic status, age, mental health, cognitive, sensory, physical disability, sexual orientation or gender identity, geographic location ❖ Nursing Report future: ➢ practice full extent of education ➢ achieve higher levels of education through an improved educational system that promotes seamless progression ➢ full partners with physicians and other healthcare providers in redesigning healthcare ➢ effective workforce planning and policymaking require better data collection and improved information infrastructure b. Why are these issues concerning for the future? ➢ We need a significant change in: ○ Patient-centered care ○ stronger primary care services ○ deliver more care in the community ○ seamless, coordinated care ○ reconceptualized roles for health professionals ○ interprofessional collaboration

Part 3 (Nies Ch. 12): 1. Discuss factors that influence the cost of health care.

a. What factors influence the cost of health care? ● Public hospitals- receive public funds and served the health care needs of the entire population ● Private hospitals- cared mainly for those who have the ability to pay greater amounts of money than the general population ● For-profit hospitals- limited in numbers, received funds from investors and care for those who could definitely pay ● technological advances ● sense of entitlement ● guaranteed payer ● lifestyle and health beliefs b. Why is healthcare so expensive in the U.S.? ● preventative care is in higher demand 2. Discuss public & private financing of health care and financing trends. a. How is health care publicly financed? ● Medicare, Medicaid, government grants b. How is health care privately financed? ● Blue cross/ blue shield (monthly fee) c. What are the trends in health care financing? ❖ ACA changes- eligibility in Medicaid-covered services: ➢ Ambulatory care ➢ Emergency services ➢ Hospitalizations ➢ Pregnancy/maternity and newborn care ➢ Mental and substance abuse health/disorder ➢ Preventative measures 3. Describe the effects of economics on health care access. a. How does economics affect health care access? ● The economy shapes interactions with employment, health coverage, costs, and financial access to care and health outcomes.

4. Discuss the future of health care economics. a. What does health care economics look like in the future? Researcher: ● Nurses need to be engaged in research about the provision of efficient, cost-effective health care. ● Investigate, develop, and evaluate the effectiveness of health promotion and disease prevention.

Educator: ● Health education is the foundation of public health nursing practice. ● In the area of health care economics, the nurse needs to demonstrate the value of patient education. ● Outcome measures for health education need to be established Provider of Care: ● Services delivered by nurses need to be appropriate, necessary, and cost-effective. ● Accurate foundation for an appropriate nursing diagnosis ● Goals for care should jointly be established between members of the community and community health nurse, which will guide the choice of intervention. ● Evaluations from previously developed outcome measures will guide appropriate modifications to the plan. Advocate ● Nurses need to become more involved in the economics of health care. ● A large number of nurses gives our occupation potential political clout. ● Advocate for health promotion/disease prevention funding from both public/private sectors ● Need to plan programs, seek funding, and evaluate program effectiveness ● Constantly seek sources of funding for health programs through any available sources...