Epidemiology of Health and Illness.
Transforming the Public’s Healthcare System. Global Health .
Read chapter 4, 5 and 7 of the class textbook and review the attached PowerPoint presentations. Once done please answer the following questions;
1. Define epidemiology and discuss how the epidemiology triad can be applied to Health issues we see in the hospital?
2. Epidemiology is not just useful for community health nurses; it is useful for all healthcare professionals. Brainstorm some ways in which epidemiology could be used in an acute care setting. What types of problems arise in acute care that might need to be measured? How could nurses use epidemiology to assess those problems and attempt to intervene? How can this data be further used in a community setting in terms of follow-up or continuation of intervention3. What are some of the causes of increases in healthcare costs in recent years, as outlined in the chapter? Brainstorm some examples that you have witnessed in the clinical setting. Can any of these factors be modified? What could nurses do to help cut down on costs related to the different factors
4. Why is it important for nurses to know about global health issues or concerns
if they are not planning to work in other countries? How can this information be used in the workplace here in the US?
As stated in the course syllabus present your assignment in an APA format, word document, Arial 12 font attached to the forum in the discussion tab of the blackboard title “week 2 discussion questions”. A minimum of 2 evidence-based references (besides the class textbook) are required. You must post 2 replies to any of your peer’s postings. A minimum of 500 words (excluding the first and references page) is required.
Chapter 5 Transforming the Public’s Healthcare Systems
Evolving U.S. Healthcare Delivery System
Healthcare delivery system
Transforms resources into essential services to meet the healthcare needs of certain populations
Settings
Hospitals
Physicians’ offices
Shelters
Specially equipped vans or shopping malls
Evolving U.S. Healthcare Delivery System (cont.)
Reimbursement
Private insurance companies
Managed care organizations
Government agencies
Foundations
Patient
Affordable Care Act (ACA) of 2010
Types of healthcare systems
Private
Public
Military
Private Healthcare Delivery
Fee-for-service
Hill-Burton Act
Tax Equity and Fiscal Responsibility Act of 1982
1983 Amendments to the Social Security Act
Diagnosis-related groups (DRGs)
Prospective payment system (PPS)
Third-party payers
Insurance companies
Health maintenance organizations (HMOs)
Preferred provider organizations (PPOs)
Managed care organizations (MCOs)
Public Health Care
Defined as the health outcomes of a group of individuals
Shattuck
1850 Report of the Sanitary Commission of Massachusetts
1872 Public Health Association formed
Social Security Act of 1935
Local health departments
Centers for Disease Control and Prevention (CDC)
Military Health Care
National Defense Authorization Act (2005)
Care provided:
Ambulatory care
Military base and regional clinics
Hospital service
Base dispensaries or sick bays
Simple hospitals services
Regional hospitals
Advanced care
Types of programs
TriCare
Veterans Administration
Healthcare Reform
Legislative initiatives were proposed seven times during the 20th century
Based on the need to control healthcare costs while providing access to quality healthcare services
Nursing and healthcare reform
ACA
Current U.S. Healthcare Delivery System
Interrelated systems
Horizontal and vertical integration of services
Levels of care
Preventive care
Primary care
Secondary care
Tertiary care
Restorative care
Healthcare Providers
Physicians
Nurses
Physician assistants
Specialized care providers
Technicians/therapists
Other providers
Pharmacists
Social workers
Healthcare Settings
Acute care facilities
Short-term specialized care facilities
Long-term care facilities
Ambulatory care sites
Daycare centers
Hospices
Retirement communities
Complementary/alternative health care
Issues Affecting the Delivery of Healthcare Services
Deregulation
Emphasis on secondary and tertiary healthcare services
Increasing consumerism
Technological advances
Increasing longevity of Americans
Defensive health care and government regulation
Managed Care
MCOs
Capitation
HMOs
PPOs
Point-of-service plans (POSs)
Integrated healthcare systems
Patient Care Outcomes
Defined as the consequences of care that the patient receives or does not receive
Outcome studies
Look for trends over time in patient status and adverse events
Data obtained used as a basis for decisions
Development of policies and procedures
Community-Based Healthcare Settings
Shelters in the community
Role of nurse
Abuse shelters
Homeless shelters
Disaster shelters
Ambulatory care centers
Ambulatory emergency/trauma
Primary care centers
Ambulatory surgery centers
Health Politics and Policy
Government policy
Healthy People
Healthy People 2020
ACA
Public opinion and special interest groups
Nursing and healthcare policy
American Nurses Association (ANA)
New Nursing Opportunities
Advanced practice registered nurses (APRNs)
Entrepreneurs
Data management and evaluation
Research
Community focused and community based
Prevention and risk reduction focus for all BSN nurses
Chapter 7 Global Health
Global Health
Population expansion
Aging population in some areas
Decrease in life expectancy in others (HIV)
High birth rates and poverty
Role of International Agencies
United Nations
Nongovernmental organizations (NGOs)
Carter Center
Bill & Melinda Gates Foundation
United Nations Children’s Fund
World Health Organization
World Bank
Global Health Issues
Disease burden
Infectious diseases
New pathogens
Human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS)
Tuberculosis (TB)
Lower respiratory infections
Chronic diseases
Obesity
Cardiovascular diseases
Cancers
Diabetes
Chronic respiratory diseases
Violence and War
Levels of violence
Armed conflict and war
Poverty
Women’s rights
Global Initiatives
Declaration of Alma Ata
Millennium developmental goals
Nursing shortages
International Council of Nurses
Nursing and human rights
Chapter 4
Epidemiology of
Health and Illness
Epidemiology
The study of the distribution and the determinants of states of health and illness in human populations
Epidemiological model or triangle
Host
Agent
Environment
Scope of Epidemiology
Demographic changes
Patterns of disease
Methods of control and prevention of health problems
Wellness focus
The Basis for the
Epidemiological Process
Identifying health problems and needs
Collecting and analyzing data to identify risk factors
Planning, implementing, and evaluating methods for prevention and control
The Epidemiological, Research, and Nursing Processes
Similarities include:
Defining the problem
Gathering data
Analyzing the data
Evaluating the data
Natural History of Disease
Prepathogenesis period
Pathogenesis period
Levels of prevention
Primary prevention
Secondary prevention
Tertiary prevention
Descriptive Epidemiology
Focuses on the frequency and distribution of states of health within a population:
– Person
– Place
– Time
Use of Rates
Incidence rates
Mortality
Prevalence rates
Morbidity
Crude rates
Specific rates
Adjusted rates
Sources of Data
Census data
Vital statistics
Centers for Disease Control and Prevention (CDC)
Morbidity and Mortality Weekly Report (MMWR)
National Center for Health Statistics
Person, Place, and Time
Who develops the health problem
Where the rates of the health problem are the highest and lowest can be determined by examining the characteristics of place
When health problems occur
Short-term
Seasonal or cyclical
Long-term
Analytic Epidemiology
Cross-sectional studies
Retrospective (case-control) studies
Prospective studies
Intervention (experimental) studies
