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87 Cards in this Set
- Front
- Back
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How did people die in early settlement in Aus? 4 |
- infections disease and inadequate treatment - at childbirth - disease (diptheria, whooping cough, scarlet fever) - injuries |
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Who had better care than the poor? |
The rich |
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Where was care delivered in early Aus? 4 |
- community hospitals - private hospitals - church run hospitals - public hospitals (teaching - gov finances) |
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What is the international trent? |
- for organised medicine (doctors) to be hostile towards state intervention |
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What was the conditions medically speaking for doctors in 1900? 3 |
- doctors were paid fee for service and in private practice - hospitals were independently administered with govt. subsidies - after federation, fed governments attempted to introduce welfare type systems + compulsory contributions |
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Who are the political players in health? 4 |
- doctors (aus medical association is the most successful union in aus) - politcal parties (liberal - free enterprise, small gov contribution, user pays) - beauraucrats who advise gov, implement gov policy, are "experts" - consumers (sick people vote) |
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What happened in 1996 for health planning in relation to politics? |
Howard privatised system - 2 tier - private insurance or very long waiting lists + a run down public system |
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What happened in 1983 politically speaking for health? |
Hawke (labor) reintroduced compulsory scheme (medicare) |
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What happened in 1947 to health politically speaking? |
labor gov legislated a free system - failed - 90% of doctors refused to cooperate |
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What happened in 1952 politically speaking to health? |
liberal gov - page system introduced |
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What happened in 1970 politically speaking to health? |
Voluntary scheme restructured |
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How much of our income goes to health? |
2% |
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When was medibank introduced? |
1970s whitlam government |
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What did Howard introduce re: taxes? |
Private health insurance rebate |
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What was the health program in 1973? |
Community health program - local community involvement |
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When did community health become a state responsibility? |
1980 |
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Why did commenwealth/fed gov intervention come more involved in sate matters over time? 2 |
- the health budgets were large during ww2 - the states gave the rights to income taxes to the federal gov - the fed government developed a hospital system for returned servicemen |
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What are the levels of service delivery? |
primary seconardy tertiary |
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What do primary services include? |
- general practice, usually in private practice, allied health and community health |
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What do secondary services include? |
- general hospital care - private and public - specialist services - mental health services |
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What are tertiary services? |
Specialist services e.g. nursing homes, transplant services, long term mental health services |
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How many hospital beds in Aus are private? |
1/3 |
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What are examples of private non-inpatient services? |
- medical practitioners (GPs and specialists) provide most out-of-hospital medical services - most dental and allied health services are provided by private practitioners (e.g. physio + psychology) |
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What is the new focus of health in Aus? |
Primary health care |
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What is planned to increase in Aus? What is this plan called? |
primary HC - increase GPs and community clinics National Preventative Health Strategy |
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What is the AHCS? |
Australian Health Care System |
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What are the two features of the AHCS? |
1. federal structure: operation of national government in parallel with six states 2. public/private division of responsibility |
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How much health funding is led by the federal gov in the AHCS? |
44% |
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How much health funding led by state and local government? |
23% |
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How much health funding in AHCS led by private? |
30% |
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Under the current liberal gov the move is to a more free enterprise system with more user pays... list three points |
1. Subsidies for Private Health insurance ‐ you need private insurancebecause queues for public services are too long 2. increased GP payments – but increased gap (user pays) 3. Reduced no. of bulk billing GPs |
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Who visits private hospitals? |
Visiting medical officers provide private medical services to patients in a private hospital |
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The Government subsidises private health care costs andprovides incentives for people to maintain privateinsurance: list two incentives: |
1. 1/3 of fees are reimbursed 2. deduction in annual fee if you join under 30 years old and maintain insurance |
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What exists for high income earners who don't have private health insurance? |
Levy (cost) |
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What is the private sector health expenditure ? |
Private sector expenditure on health accounts forabout 1/3rd of total health expenditure |
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How is the revenue generated in private health insurance? |
60% of revenue are fees generated from individuals out of pocket expenses |
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Do private hospitals get money from the federal government? |
Not at all |
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How many private hospitals in Australia, and what is the break down? |
556 - 289 acute or psychiatric - 175 for - profit - 124 not-for-profit -271 day surgery |
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What are the 2 largest multinational health organisations in Aus? |
Ramsay Health Care and Healthscope |
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When and by who was Ramsay Health Care established? |
Paul Ramsay, SYD, 1964 |
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What is the scope of Ramsay Health care? |
Grown to become a global hospital group operating 116 hospitals and day surgery facilities across Australia, UK, France, Indonesia. |
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What does Ramsay healthcare offer? 4 |
-day surgery - complex surgery - mental health - rehab |
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How many beds, jobs and patients does Ramsay Healthcare have? |
Beds 10,000 Staff 30,000 1 million PTs |
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What is the largest not-for-profit health care system in Aus? |
Catholic services |
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What do catholic services offer scope wise to health care? |
Largest grouping of health, community and aged care services in Aus 9500 beds in 75 (private and public) healthcare facilities including 7 teaching hospitals |
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What are 2 elements of Catholic healthcare that are different? |
- providing a wider range of services (palliative care) - some catholic hospitals are located in geographic regions which are not appealing to for-profits |
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How much do Australians spend on complementary and alternative medicine? |
1.8 billion from personal budget |
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What do alternative healing and complementary medicine promote? 3 |
agency, self determination and subjectivity |
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What is a limitation of complementary and alternative medicine ? 3 |
-socially constructed -weak research - promote hyper-positivity & self-responsibility to the terminally ill |
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What does complementary and alternative medicine include? |
Homeopathy, natropathy, herbs, chiro, osteopathy, massage, reiki, therapeutic touch |
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What is unique to Australia and founded in 1928? |
Remote Aus Royal Flying Doctor Service |
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What does the royal flying doctors provide? |
24h 364 aeromedical emergency and health care service to people in Aus remote areas |
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What is the scope of the royal flying doctor service? |
21 bases 47 aircrafts 22million km/year 35,000 need transport each year 12,00 health clinics / year |
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What does AHPRA stand for? |
Australian Health Practitioner Regulation Agency |
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What is AHRPA responsible for? |
The registration and accreditation of 10 health professionals across Australia |
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What is AHRPA governed by? |
The health practitioner regulation national law act 09 - nationally consistent legislation for 10 professions |
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Who does AHPRA work with? |
Health Complaints commissions in each state to make sure the appropriate organisation investigates community concerns about individual, registered health practitioners |
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What does AHPRA support? |
The boards in the development of registration standards, codes and guidelines |
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Who does AHPRA provide advice to? |
Ministerial Council about the administration of the national registration and accreditation scheme |
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Why is health care an issue? (2) |
Inequality (refers to unequal distribution in politics of power and resources) Inequity (refers to unfairness: injustice by virtue of not conforming with rules or standards) |
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What is the life expectancy of indigenous disadvantage ? |
Males and females at birth were on average going to live 11.5 to 9.7 years less than non-indigenous Australians |
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Where is most people's first presentation to health care? |
via their GP |
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What is the social disadvantage regarding GPs? |
Access is variable depending on locality |
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How does primary health care link with the social model of health? 5 |
1- Multidisciplinary in nature 2- base on community needs 3- integration of health, welfare, private, public, not for profit - a partnership approach - tensions can emerge 4- social context 5- data traditionally not collected in a consistent manner |
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What has changed about the original ideals of primary health care according to WHO? |
HFA = Health for all declaration The original ideals in 1978 have changed, in an attempt to make them more achievable e.g. from "comprehensive PHC" to "selective PHC" |
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What do Braum and Germov consider PHC as? |
The philosophical underpinning of community health services which began with the community health policy in 1973 in Aus |
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What is the view of health under comprehensive PHC and selective PHC? |
C = positive wellbeing S = absence of disease |
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What is the view of locus of control over health in comprehensive and selective PHC? |
C = communities and individauls S = health professionals |
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What is the major focus in comprehensive PHC and selective PHC? |
C = Health through equity and community empowerment S = medical solutions for disease eradication |
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What is the difference between health care providers in comprehensive and selective PHC? |
C = Multi-disciplinary teams S - medical doctors |
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What is the difference in strategies for health between comprehensive PHC and selective PHC? |
c = multi-sectoral collaboration s = medical interventions |
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What are the 5 strategies of the ottawa charter for health promotion/central ideals of "health for all" ? |
1. develop healthy public policy 2. create supportive environments 3. encourage community action 4. develop personal skills 5. reorient health services |
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What do health care systems in any country correlate with? |
the economic/political systems in that country |
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When did the NHS (national health scheme) start and what are 3 elements of it? |
1948 - free system - doctors employed by gov - small private sector fee for service component |
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What is NHS the largest of ? |
Employers in Europe (.75 million people) |
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What are the inherited problems of the NHS? 2 |
- inequity due to distribution of resources - measurement and coordination due to variation in local practice |
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What is currently happening with the NHS? |
Increasing demand causing financial strain - people living longer, diseases of old age, increased expectations |
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What healthcare system does the USA have (before Obamacare)? |
Free enterprise = user pays |
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When was health insurance available to americans? |
Via employment - limited health insurance available via your job - often people will not leave a bad job for fear of losing health cover (they wait to retire) |
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What are welfare socialist/decentralised systems like? |
Government control, funding and policy making at a high level Doctors are salaried in the public sector Western EU, UK, Sweden, NZ, Japan |
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What are 3rd world healthcare systems like? 3 |
- low level of resourcing - limited access - generally a private sector exists for a wealthy minority |
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What are socialist HC systems like? |
almost 100% state run e.g china, cuba, canada |
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What are the 4 principal features of the Australian health care system? |
- private, for profit component (GPs, pharmacists, dentists, private hospitals, private specialists and alt practitioners) - public component (com health centres, maternal + child health) - a NGA (non-gov organisation) not for profit - a domestic component (carers) |
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What are the 3 key health policies and programs of the Aus HC system? |
1. Commonwealth national health act 1953 - universal health ins scheme and creation of the pharmaceutical benefits scheme 2. medibank 1975/medicare 1984 3. Council of Australian Governments (1995) |
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What are the missions of Australia's health care policies ? 5 |
1. universal access to basic health care 2. services should be of high quality 3. financing of health care should be equitable 4. services are delivered through a mix of private/public 5. accountability and efficiency |
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What are 8 problems with the current HC system in Aus? |
- bed shortage - hospitals need upgrades - staff shortage (med, nurses, allied) - increasing tech - increasing costs + expectations of access to certain tech - lack of funding - lack of rural services - reduced no. of private GPs who bulk bill - duplication of funding and poor coordination of services e.g. state and fed funding available for similar service which operate independently |
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What are the 7 strategic directions of the national preventative health strategy? |
- shared responsibility - developing strategic partnerships at all levels of government, industry, unions etc - act early and throughout life - working with individuals, families and communities - engage communities - influence markets and develop coherent policies e.g through tax - reduce inequity through targeting disadvantage - indigenous aus - close the gap - refocus primary HC towards prevention |
