Chapter 2: Overview of the US Health Care System and UsersOutline of the OverviewSnap Shot of Health System ComponentsSlide 4Defining HealthDeterminants of HealthHealth Status of the USA in 2000Care Seeking BehaviorDemographics and UseUtilization ModelsUtilization FactsEffects on Health of Health ServicesIntro to US Health SystemChapter 2: Overview of the US Health Care System and UsersTracey Lynn KoehlmoosHSCI 678Intro to US Health SystemOutline of the Overview•Components of the System•Defining Health•Establishing US Health Seeking Behavior•Demographics•Detailed look at health status of populationIntro to US Health SystemSnap Shot of Health System Components•Organizational:–Public: DHHS (since 1953); collection, research–Private: Health ins.; medical-industrial complex–Voluntary: Gap fillers, disease specific (AHA)•Management: –Planning, legislation, regulation–SSA of 1964, HMO Act of 1973, TEFRAIntro to US Health SystemSnap Shot of Health System Components•Economic Support: (2000)–33% Private Ins., 45% Fed & State–15% Out of Pocket, 6% Foundation/Charity•Resource: growing to meet needs–Workforce–Facility growth•Delivery System: FFS to Manage Care–Balance equity and efficiency–AccessIntro to US Health SystemDefining Health•WHO:–Health is not merely the absence of disease, but the state of physical, mental and social well-being.Fundamental conditions for health:Peace, shelter, education, food, income, stable ecosystem, sustainable resources, social justice, equityIntro to US Health SystemDeterminants of HealthPhysical Environment Social EnvironmentAccess to Health Services Physical and Mental Well-BeingIntro to US Health SystemHealth Status of the USA in 2000Birth Rate: 14.7 per 1000 women•Life Expectancy: 76.9 years•Birth Weight: W, 6.5%/ B, 12.9%•Morbidity: 11.7% all ages, any disability•Mortality: –Infant: 6.9% per 1000–Adults: 881.9 per 100,000 (1999)–Causes: Heart Disease, Cancer, StrokeIntro to US Health SystemCare Seeking Behavior•Injury/Illness•Chronic disease monitoring•Prenatal Care•Prevention•Palliative Care•Self assessment•Access•THE WORRIED WELL!Intro to US Health SystemDemographics and Use•Women•Very Young and the Old–Baby Boomers will stretch system to its limits•Race and Ethnicity: Disease and Disparity•Socio-Economic Status–Black and Hispanic below FPL 3x WhiteIntro to US Health SystemUtilization Models•Aday Model•Health Belief Model•Utilization is strongly influenced by what is available (policy, delivery systems, finance) and personal beliefs and risk perception (characteristics, satisfaction).Intro to US Health SystemUtilization Facts•Lowest Income=Highest Physician Contacts•Most Physician Contact in Office setting•Hospital Utilization: More Blacks, More Women, More Low Income•Home Health: More Women•Nursing Home: 5% of population >65Intro to US Health SystemEffects on Health of Health Services•Does Health Care make us healthier?•More prenatal care/Less low weight births•Cancer survivors, Polio survivors•Nosocomial infection, drug interactions•Influence and effects of lifestyle and environment and