Chapter Fourteen

Chapter Fourteen - Health Care System: Function Chapter 14...

Info iconThis preview shows pages 1–15. Sign up to view the full content.

View Full Document Right Arrow Icon
Health Care System: Function Chapter 14
Background image of page 1

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Introduction This chapter includes: How consumers obtain health care services How health care services are paid and who is paying the bill Issues of concern: Access, quality, cost Potential solutions
Background image of page 2
Health care services not accessible to all Even when accessible there are racial & ethnic disparities Major problems of system represented in Kissick’s (1994) cost containment, access, & quality triangle
Background image of page 3

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Health Care Triangle Cost containment Access Quality Cost containment Access Quality 0 A change in 1 will change all 3
Background image of page 4
Access to Health Care - 1 In 2005, 46.6 million Americans were uninsured; millions more lacked coverage for shorter periods of time Likelihood of being uninsured greater for those who: are younger, are less educated, have lower incomes, are not white, are not U.S. citizens, 8 in 10 uninsured persons were members of working families
Background image of page 5

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Health Insurance Coverage among people < 65 years
Background image of page 6
Access to Health Care - 2 Medically indigent: unable to receive health care because they cannot afford health care Working poor: have a job but unable to afford health insurance; 30 million Most Americans pay for health care 3 or 4 times
Background image of page 7

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Access to Health Care - 2 Why People Do Not Have Health Insurance? © Adams, P. F., and P. M. Barnes (2006). Vital and Health Statistics, 10(229).
Background image of page 8
Quality of Health Care WHO measures with disability-adjusted life expectancy (DALE) U.S. government measures with National Healthcare Quality Report (effectiveness, Accreditation JCAHO– facilities National Committee on Quality Assurance– health care plans
Background image of page 9

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Paying for Health Care - 1 Cost in 2006 $2+ trillion $7,129 per capita More than any other nation 16.2% of GDP; expected to reach 20% in 2015 4 primary sources of payment
Background image of page 10
Paying for Health Care - 1 Personal Health Care Expenditure by Source of Funds © National Center for Health Care Statistics
Background image of page 11

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Paying for Health Care - 2 Arrangements for payment: fee-for-service (fee schedule) Fee-for-service: patient (first party), provider (second party), health insurance company or government (third party) Prepaid health care found mostly in managed care plans; set price on per-member, pre-month basis– capitated fee, capitation system
Background image of page 12
Health Insurance - 1 Like other insurance– risk & cost spreading process Paid for in “equitable fashion;” some pay more if at high risk (e.g., smoking) The greater the risk the greater the premium 1911: First health insurance
Background image of page 13

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
Health Insurance - 2 State Children’s Health Insurance Program (SCHIP) Enacted in 1997 & authorized in 1997 for $40 billion To cover uninsured children: 11.3 million Voluntary grants to states; can be part of Medicaid In 2005, 6.1 million children were enrolled Up for re-authorization in 2007
Background image of page 14
Image of page 15
This is the end of the preview. Sign up to access the rest of the document.

This note was uploaded on 02/16/2011 for the course NURS 231 taught by Professor Hickey during the Spring '10 term at South Carolina.

Page1 / 42

Chapter Fourteen - Health Care System: Function Chapter 14...

This preview shows document pages 1 - 15. Sign up to view the full document.

View Full Document Right Arrow Icon
Ask a homework question - tutors are online