Workbook Compilation 1 PDF

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School of Public Health

ASSIGNMENT COVER SHEET Every piece of written work you submit for assessment must have this cover sheet attached

COURSE DETAILS Course Code: PUBH1103

Course Name: Health Systems & policy

Course Coordinator:

Assignment No: 1 Assignment Due Date: 02/Sep 2:00pm

STUDENT DECLARATION TO ACCOMPANY INDIVIDUAL STUDENT ASSIGNMENT I declare that I have read the UQ Academic Integrity and Plagiarism policy including the approved use of plagiarism detection software, the consequences of plagiarism and the principles associated with preventing plagiarism. * (http://ppl.app.uq.edu.au/content/3.60.04student-integrity-and-misconduct ) I declare that the material contained in this assignment is my own work and that where I have used the ideas or writing of other authors that this has been acknowledged according to accepted academic guidelines. I further declare that the material contained in this assignment has not been submitted in whole or substantial part, to meet the assessment requirement in another course at this, or any other, university. I have kept a copy of this assignment. *Wo r ks u b mi t t e dma yb es u b j e c t e dt oap l a g i a r i s md e t e c t i o np r o c e s s .I f t h i sp r o c e s si su s e d , t h e nc o p i e so f t h i swo r kwo u l db er e t a i n e da n d u s e da ss o u r c ema t e r i a l f o r c o n d u c t i n gf u t u r ep l a g i a r i s mc h e c k s .

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Workbook Week 1 1. I believe that a Health care system is a system designed to help the population to care for their health, cure diseases and maintain a healthy life. I think the key components of a health care system consist of organizations, people and actions that promotes good health. 2. WHO defines that a health system includes “all the activities whose primary purpose is to promote, restore or maintain health” (WHO, 2000, p5). The Some of the key components that make up this system include fFormal health services, which are the professional delivery of personal medical attention. Also, traditional public health activities as health promotion and disease prevention, and other health enhancing interventions like road and environmental safety improvement, are also part of the system (WHO, 2000,p6). In summary, Health systems consist of all the people, organizations and actions whose primary purpose is to improve health. WHO’s definition of health system is very similar to minehow I defined it. WHO outlined the most important parties in a health system, but . (it dDidn’t mention rural areas, and didn’t give details foradd preventions) 3. From WHO, it is known that activities whose primary purpose is something other health is not included in the definition of health system. (WHO, 2000, p. 5) This excludes activities whose have secondary, health-enhancing benefit. For example, general education system, while specifically health-related education is included. 4. I’m going to describe three factors that have a major effect on our health. How old we are – According to Australian Institute of Health and Welfare in “Australia’s Health 2016” (2016), the average life expectancy of a male born in 2012 is 80.3 years, while on average females live longer for an average of 84.4 years. When theour age affects the health of our body, as people gets older, they tend to get more diseases. The average age of a population increase, it can also reflectshave a negative effect on the health of the population. As older people tend to be sick more often. Income - In 2015–16, average disposable household income was $1,009. The weekly income for low-income households was $421; for middle-income households it was $856 and for

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high-income households, $2,009. Economy also have an impact on people’s health, as rich people tends to have more time and money to invest on their health. Where we live - 71% lived in Major cities— 17.2 million people 18% lived in Inner regional areas— 4.4 million people 8.6% lived in Outer regional areas— 2.1 million people 1.3% lived in Remote areas— 308,000 people 0.8% lived in Very remote areas— 194,000 people (ABS 2017f). It is important to know where people live. This is because people who live in rural areas find it more difficult to access health facilities and actions needs to be taken so everyone is equal in accessing health care.

References: 

World Health Organization. (2000). The World Health Report 2000: Health systems: improving performance. World Health Organization. p1-11.

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Australian Institute of Health and Welfare (2018). Australia’s Health 2018. Australia’s health series no. 15. Cat. no. AUS 221. Canberra: AIHW.

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Workbook 2TOPIC 2: HISTORICAL AND POLITICAL CONTEXT Question 1: The term “ideology” refers to Ideology is the common belief of values that a particular social group share. (Germov & Belcher, 2018). It shapes judgments about fairness and justice often shifts between the right to ' do as I choose' and the need to ensure that societal benefits are given to everyone. (can talk more about typical aspect of ideology) Question 2: Source for table: (Belcher, 2014). Description

Health care

Economic liberalism

A political philosophy based on small government and marketoriented policies. Promotes deregulation, privatisation, reduced government spending, and lower taxation. (Belcher, 2014, p. 370).

Individuals 'earn' access to goods and services. The poor are left to rely on charity.

Social liberalism

Based on individual freedom but acknowledges the need for state intervention, which can act to limit the freedom of individuals fully to participate in society.

Everyone has the freedom to benefit from health care.

Insurance

Politics

Selective coverage, only the poor receives benefits. It also assumes that most people are responsible for their own health care needs. Universal coverage provides benefits for the whole population. People pay tax regardless they use the insurance or not.

It requires the cutting back of government responsibilities, the introduction of private sector competition, and the promotion of independence. Opt for the expansion of state intervention in the belief that this will allow citizens to benefit and contribute to society.

Question 3: Source for the table (Baum 2008 & Belcher 2014)

Time period 1. Era of Indigenous control 2. Colonial

Common health problems/conditions

Dominant views of health and ways to manage it.

DiseasesEmphasis on spirituality and integration of health and life Infectious disease

Strong links with land, traditional healers Community health Quarantine acts.

Health Care and Insurance Arrangements

Ideological Drivers (social or economic, and how?)

Oral tradition uses natural products

Social liberalism Proactive part of accepted culture.

British

Emphasis on sanitary

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era

Provision of clean water and sanitation

3. Nation building era

Improve health of the nationpoor living conditions lack of sanitation

4. Affluence, medicine and Infrastructure era

Improve the quality of life, “conquer diseaseDeadly diseases such as tuberculosis

5. Lifestyle era

Focus on affluence in terms of chronic disease that resulted from unhealthy lifestyle. Focus on prevention

6. New public health

Increased risk factor for many diseases, e.g. smoking Focus on collective measures, especially policy. Poverty and social justice. Calls for public health

7. Global new public health

Exercise programs to improve national physique, medical inspection of children, hygiene advice to the population. Health services associated with more and more sophisticated medical technology. Growth of hospitals and expanding health service budgets – little focus on public health. Epidemiological methods developed. Population surveys of risk factors. Act by prevention to control costs of health services

Development of health public policy. Public health promotions

practices.Colonial administration Friendly societies Commonwealth department of health.

measures influenced by British practices

Considerable state intervention in areas that have an impact on health, such as housing and education Economic affluence and interventionist governments.

Considerable state intervention in areas that have an impact on health, such as housing and education,Economic affluence and interventionist governments.

Introduction of MedicareLifestyle programs modelled on north American heart health programs, such as the North Coast lifestyle programs, ‘Life-be in it’ campaign. World Health organization policies Medicare Private health insurance

desire to control costs of health services.Social liberalism

Medicare Private Against terrorism measures, preparation health insurersPractices of for diseases and international financial intervention calls. institutions on health.

Health linked to the ideas of vitality efficacy, purify and virtue.economic liberalism belief in self-help

Social and economic liberalism since it is a mixed system Health promotion

Social and economic liberalism since it is a mixed system Increased recognition of the impact of the policies, shrinking of the state

References Baum, F. (2015). The New Public Health, (4th ed). South Melbourne: Oxford University Press. (Chapter 2 - A history of public health.).

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Germov, J & Belcher, H. (2018). Power, politics, and health care. In Germov, J. (2014). Second Opinion: An Introduction to Health Sociology, (6th ed). South Melbourne: Oxford University Press.

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Patient journey Workbook 3 1. The patient, Yarran, is a 45-year-old man with an indigenous background. His highest education qualification was high school and worked as a laborer. He is currently unemployed and receives Newstart allowance. He also holds a low-income health care card. He currently lives in transitional shelter in an outer city suburb, Greenslope, located in Queensland. Yarran is unmarried, he has one brother who also lives in Brisbane gives him social support. Since he’s unemployed, he depends on Centrelink unemployment benefits to provide the financial needs for himself. Receiving new start support from Centrelink. 2. Yarran is a 45 years old male with cardiovascular disease. For a long period of time, he had been experiencing Chest pain, shortness of breath and lightheadedness. He is also a long-term smoker, this increases the risk of cardiovascular diseases. 3. Because of the symptoms he was experiencing, it has led him to see a bulk-billed general practitioner at their local medical centre about his concerns. As an Australian citizen, Yarran holds a Medicare card. This means that he can claim rebates from the sessions he had with his family doctor (Biggs 2003). He also holds a Low-Income Health Care Card that can cover the Medicare gap (Department of Health Services 2013). Because of his situation, his appointments are fully subsided by the federal government (Biggs 2003). His general practitioner diagnosed him with cardiovascular disease and Yarran was told to have a balanced diet and to quit smoking. He was also given prescribed drugs to help him with his condition. While Pharmaceutical Benefits Scheme (PBS) pays the most parts of the drugs, but Yarran do have to pay a small amount of out of pocket fee. (http://www.pbs.gov.au, 2019) 

One morning, Yarran is walking back from the grocery shop, he suddenly felt acute chest pains and shortness of breath. He started to feel faint and numbness in parts of the body. He realised that he had forgotten to bring the medicine with him, a few moments later, he passed out. A pedestrian called the ambulance and he was suspected to be having a heart attack. The ambulance took him to the nearest public hospital, Princess Alexandra PUBH1103

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Hospital, where he received treatment for his condition. When he was conscious, his brother was notified of the situation. Once stabilised, he was admitted for several days of further treatment and his brother came to take care of him. In Queensland, the state government was able to cover the entire cost of the ambulance services (Queensland Ambulance Service 2013). Additionally, as a public patient at a public hospital, Medicare, through federal funding, covered the costs of hospitalisation (Department of Human Services 2013). 

Since Yarran cannot afford to pay for private health insurance, so therefore he relies on public facilities and bulk-billing general practitioners to restore his health. Once Yarran was released from the hospital, he was referred to a cardiovascular rehabilitation team whom can give him more information about his condition and recovery. Since Yarran live alone, someone is needed to stay with him during his recovery time. Yarran can also get help from a home care agency.

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Cardiologist refers him to a six-week free program that he can do at home to improve his health, provided with indigenous health worker, free of charge. With prescription meds, he can get (research)

References: Biggs, A 2003, Medicare - Background Brief, Parliament of Australia, viewed 22 August 2013, http://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library /Publications_Archive/archive/medicare. Carrington, MJ, Retegan, C, Johnston, CI, Jennings, GL & Stewart, S 2009, 'Cholesterol complacency in Australia: time to revisit the basics of cardiovascular disease prevention', J Clin Nurs, vol. 18, no. 5, pp. 678-86. Department of Human Services 2013, Medicare Services, Australian Government, viewed 22 August 2013, http://www.humanservices.gov.au/customer/subjects/medicare-services.

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Department of Health and Ageing 2006, Supplement to the Medicare Benefits Schedule (Pathology amendments), Australian Government. Falk, E, Shah, PK & de Feyter, PJ 2007, Ischaemic Heart Disease, Manson Publishing Ltd, London. Hand, MM 2004, 'Act in time to heart attack signs: update on the National Heart Attack Alert Program's campaign to reduce patient delay', Crit Pathw Cardiol, vol. 3, no. 3, pp. 128-33.

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Workbook 4 Question 1. Drawing on Buse, Mays and Walt (2012), but in your own words, outline the difference between a policy, public health policy and health policy? 

Policy according to Palmer & Short (2014) is broad statement of goals, objective and means that govern the framework for activity. It is often thought of as decisions taken by those with responsibility for a given policy area, this area is not specific, it may be in health or the environment, in education or in trade.

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Public policies usually refer to government policy or the policies of government agencies. Health policy is the policies regarding the public and private sectors of health. But because health is such a broad area of interest, health policies also applies to organizations external to the health system whose actions also has an impact on health. Some examples can be the Ministry of Transport or the food, tobacco or pharmaceutical industries. (Buse, Mays & Walt, 2012)

Question 2: the following refers to There is a large body of literature that attempts to understand the policy making process. Walt and Gilson (1994, cited in Bused, Mays & Walt, 2012) provide a simplified model of an extremely complex set of relationships. Identify and describe the four critical components of the Walt and Gilson Model as outlined in Buse et al (2012). You should include a description of the three contextual factors (please ignore international/exogenous factors) and the key components of the policy making process. The health policy triangle consists of four critical components: 

Actors are individuals or people that can may try to influence the policy process at the local, national, regional or international level

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Context – the circumstances that surrounds the process of health policy making; and the o Situational factors can be one-off events that affect health policy o structural factors are the relatively unchanging elements of the society o cultural factors - a multi-ethnic population, language barriers, varying ideological approaches to health

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Process of policy making – how issues get on to policy agendas. Policy making processes: And the PUBH1103

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o Problem identification and issue recognition o Policy formulation: explores who is involved, how policies are formed and communicated o Policy implementation o Policy evaluation: identifies what happens once a policy is put into effect 

Content - what considered in the health policy and the actions the policy aims to implement

Contextual factors that affect policy include: situational factors, structural factors and cultural factors. Situation factors are more or less transient or idiosyncratic conditions which may influence policy; structural factors are the relatively unchanging elements of the society; and lastly, the cultural factors relates to societies where formal hierarchies are important, it may be difficult to question high officials or elder statesmen, also relates to the actions of religious groups. Key process of policy making: the most common approach to understanding policy processes is to use the ‘stages heuristic’, which are: Problem identification and issue recognition Policy formulation: explores who is involved in formulation policy, how policy are arrived at, agreed upon, and how they are communicated Policy implementation Policy evaluation: identifies what happens once a policy is put into effect content Question 3: In your description of Actors, provide 3 examples of health policy actors. Often, they become parts of network to consult and decide on policy at all these levels. At the local level, for example, community health workers may interact with the environmental health officers, teachers in local schools, or local businesses in the implementation of health policy. (Buse, Mays & Walt, 2012). One other exampleAt the national or regional level, actors may be linked with others across the state of borders. They may be members of inter-governmental networks. One example can be (i.e. government officials in one department of government in one country. (Buse, Mays & Walt, 2012).

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Last exampleAt the international level, actors may government officials of different country that be part of policy or epistemic communities – networks of professionals who get together at scientific meetings or collaborate on research projectstogether for health purposes. Question 4:  The situation context is the incidents caused by alcohol. The structural context is the problem of alcohol drinking in Australia, official data says 1 in 6 of us are at risk of alcohol related diseases like cancer because of how much we drink. The cultural context is the problem of binge drinking and social drinking in Australia.  Key actors driving the policy are government and state government, state and territory ministers.  One of the key content areas being debated is that the governments need to distance health policy decisions from profit-making industries like alcohol.  key values include challenging the alcohol drinking behaviour of Australians, improving the overall health of the population. References Buse, K., Mays, N., and Walt, G. (2012). Making health policy. Ope...