Intro & health system
What are the key principles of global health?
A focus on the public good; Belief in a global perspective; A scientific and interdisciplinary approach; The need for multilevel approaches to interventions; The need for comprehensive frameworks for health policies and financing
____adjusts overall life expectancy by the amount of time lived in less-than-perfect health, weighted according to the type of disease and the severity of the disease.
Health-adjusted life expectancy (HALE)
Fee-for-service payment and per diem payment are __ reimbursement.
Retrospective reimbursement
What is disease surveillance?
The ongoing systematic collection, analysis, interpretation, and dissemination of specific health data for use in public health practice.
Wide variations in health outcomes and access to health care services between segments of the population.
Definition of health disparity
Global perspective on public health problems;a collective goal of nations and promoted by the world’s major health organizations; manifests itself in the diversity of culture, geography, demography, epidemiology, economics, and gender.
How are disability-adjusted life years (DALYs) calculated?
DALY= years lost due to premature death (YLLs) + years lived with disability (YLDs)
What are Diagnosis Related Groups and the Resource-Based Relative Value Scale?
Types of Prospective Reimbursement
agent, host, envrionment
Air quality index, minimum wage, and concentrated poverty are examples of ___
Structural SODHs
____ _ is the largest cause of death from one infectious agent globally; the leading killer of people with HIV
Tuberculosis (TB)
One of the goals for public and global health is to minimize the gap between health-adjusted life expectancy and life expectancy. True or False?
True
What are Publicly Funded Insurances?
Medicare, Medicaid, CHAMPUS, Tricare, CHIP
What is case definition for a notifiable disease?
It may include clinical symptoms, lab values, and epi criteria, and classification of cases
Which county should receive more public health resources? County A [Social Vulnerability index (SVI)=2] vs county B (SVI=10)
B
What are the purposes of the United Nations Children’s Fund?
Advocate for the health needs of women and children under the age of 5
What are the most common global causes of DALYs lost?
ischemic heart disease, respiratory infections, cerebrovascular disease
How are Health Services Organized?
National health service (government pays for healthcare and owns most of the health facilities): UK
National insurance scheme
Pluralistic
Passive system vs active system
passive: case reports are sent to local health department by healthcare providers or labs
active: outreach to potential reporters
What are wrap-around services?
–Comprehensive, family-centered services
–Social and economic services
What are the key components of a well-functioning health system?
health financing, leadership/governance, health information system, Human resources for health, Essential medical products and technologies, Service delivery
Global health program A is estimated to avert 10 DALYs/person; program B is estimated to avert 5 DALYs/person on average, which one is more effective?
A
What are the differences between Indemnity Plans and Managed care organizations?
Indemnity: retrospective reimbursement; any healthcare provider; pay for services, but do not provide them
MCO: prospective reimbursement for providers; both pay for and provide services; limited to network providers; referrals for specialists required?--Health maintenance organizations (HMOs, yes), Point of Service plans (POS, needs referrals, allowing out-of-network visits at a higher cost), Preferred Provider Organizations (PPOs, no referrals and allowing out-of-network visits at a higher cost)
Patterns of occurrence: point source vs. propagated outbreak vs. intermittent
Propagated: spreads person-to-person over multiple incubation periods--cases occur in waves, with progressively increasing peaks. TB.
Point source: A group of people are exposed to the same source at a single point in time. All cases occur within one incubation period of the pathogen.
Intermittent: sporadic or irregular exposure, leading to a fluctuating case pattern. E.g., contaminated water supply that is periodically exposed to pollutants.
High-risk diseases for women and girls
unintended pregnancies and repeat pregnancies, STIs (including HIV), malnutrition, depression, intimate partner and sexual violence