Chapter 3: Health Policy, Politics, and Reform

1. You Have learned about health information technology (HIT) in this chapter. Give a few examples for the application of HIT in the clinical practice. Explain the main barriers of using HIT in the healthcare system.

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Chapter 2: Public Health Systems

 

 

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1

Chapter Highlights #1

Public health and healthcare systems as a complex organization of institutions and structures

National and international perspectives on public health structure, function, and outcomes differ by fiscal support and philosophical attitudes concerning health

 

 

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Chapter Highlights #2

Public health administration as a reflection of health, politics, economics, and social structures

Influences of history, resources, financing mechanisms, interest groups, and environmental conditions on public health

Governmental and nongovernmental organizations and public health

 

 

 

 

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Question #1

Is the following statement true or false?

Nongovernmental organizations use endowed funds or private fund-raising to address the needs of individuals, families, and populations.

 

 

 

 

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Answer to Question #1

True

Rationale: A nongovernmental organization (NGO) is an agency that acquires resources from private (vs. public) sources to help others. A philanthropic organization is one that uses endowed funds or private fund-raising to address the needs of individuals, families, and populations.

 

 

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Importance of Understanding How Public Health Systems Are Organized

Public health involves organized efforts to improve the health of communities rather than individual people.

The central goal of public health is the reduction of disease through prevention and the improvement of health in the community, both nationally and internationally.

 

 

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Structure of Public Healthcare in the United States

Governmental Agencies and Public Health

U.S. Department of Health and Human Services

State and local health departments

 

 

 

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Functions of Public Health in the United States

Healthy People 2020

Funding for the healthcare system in the United States comes primarily from privately owned health insurance companies.

 

 

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Trends in Public Health in the United States

Health status and its determinants

Utilization of healthcare resources

Expenditures and health

Vulnerable populations and healthcare

 

 

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Question #2

Is the following statement true or false?

The United States has found the most efficient and effective ways to care for all by decreasing health disparities and giving access to care equally.

 

 

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Answer to Question #2

False

Rationale: Despite the economic strength of the United States and other industrialized nations, many countries have found more efficient and effective ways to care for all by decreasing health disparities and giving access to care equally.

 

 

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Healthcare Systems in Selected Developed Nations

Identifying indicators of health

Being committed to providing healthcare professionals and the public with a system that works

Generating policy that allows for the production of positive outcomes

 

 

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Question #3

The International Council of Nurses is a federation of more than how many national nurses associations?

100

110

120

130

 

 

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Answer to Question #3

D. 130

Rationale: The International Council of Nurses (ICN) is a federation of more than 130 national nurses associations, representing more than 13 million nurses worldwide.

 

 

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National and International Public Health Systems

The United States healthcare system includes structures and functions to support assessment, assurance, and health policy related to the health of populations.

Other industrialized nations have found more efficient and effective ways to care for all by decreasing health disparities and giving equal access to care.

 

 

 

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Public Health Commitments to the World: International Public Health and Developing Countries

World Health Organization

Refugee and disaster-relief assistance

Multilateral, bilateral, and nongovernmental organizations as international organizations of health

International Council of Nurses

 

 

 

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Question #4

Is the following statement true or false?

Bilateral agencies and organizations conduct their services in two specific countries.

 

 

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Answer to Question #4

False

Rationale: Bilateral agencies and organizations conduct their services within one specific country.

 

 

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Chapter 3: Health Policy, Politics, and Reform

 

 

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Chapter Highlights #1

Healthcare policy and the political process

Healthcare finance and cost–benefit in relation to health policy

Access to healthcare and insurance facts in the United States

Healthcare workforce diversity and its effects on the quality of healthcare

Nursing’s role in shaping healthcare policy

 

 

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Chapter Highlights #2

Quality of care and evaluation

Information management facts

Equity in healthcare access

Ethical consideration in health policy

Political advocacy, how to be politically active and advocate

 

 

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Chapter Highlights #3

Health advocacy and healthcare reform

Affordable Care Act (ACA) overview and updates

Community-based services and healthcare reform

Health services research application to healthcare policy

 

 

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Healthcare Policy and Political Process

Policies: set of principles that govern an action to achieve a given outcome, or guidelines that direct individuals’ behavior toward a specific goal

Public health policy: decisions made in regard to the health of the individual and the community

Health policies: impact on the health of an individual, a family, and a population or community

 

 

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Question #1

Is the following statement true or false?

Health policies impact on the health of an individual, a family, and a population or community.

 

 

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6

Answer to Question #1

True

Rationale: Health policies impact on the health of an individual, a family, and a population or community.

 

 

 

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Involving Politics

Process of influencing the allocation of resources needed to enable policy and involves the strategies needed to achieve the desired goals.

Policy-making takes a great deal of effort, time, and commitment.

Setting an agenda

Policy formulation

Policy adoption

Policy implementation

Policy assessment

Policy modification

 

 

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Healthcare Finances and Cost-Benefit

Economics is the study of how individuals, groups, organizations, and society allocate and utilize resources.

When a policy is evaluated for its effectiveness, there is an interest in keeping the cost of a specific health program within reason, and it is critical to consider the overall costs and benefits of an existing program when a more efficient and effective service is identified and adopted.

 

 

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Access to Care and Health Insurance

The U.S. healthcare system is a unique system of both independent and collaborative power and action by both federal and state governments.

 

 

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Question #2

Is the following statement true or false?

The U.S. healthcare system is a unique system of both independent power and action by the federal government.

 

 

 

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Answer to Question #2

False

Rationale: The U.S. healthcare system is a unique system of both independent and collaborative power and action by both federal and state governments.

 

 

 

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Nursing’s Role in Shaping Healthcare Policy

Nursing has a rich history as a unique profession, with its own values, ethics, respect, integrity, and responsibility. Nurses’ contributions to the policies are unlimited; there is a need for greater coordination of action to ensure that nursing is actively supported and involved in influencing and shaping health and healthcare policies.

 

 

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Historical Highlights on Nursing Political Involvement

Mid-‘70s and early ‘80s: Political involvement of nurses

1976: Important year of advocacy

1990s: Nurses included in healthcare policy formation

 

 

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What Does It Mean to Be Politically Active?

Personal and professional political involvement of nurses

Nurses must be knowledgeable about issues, laws, and policy

Why is nurse-informed political involvement?

Direct caregivers

Awareness of patient safety and satisfaction, access to services, clinical outcomes, and health disparities

Positioned to see impact of policy on individuals

 

 

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Nursing Advocacy and Policy Participation

Patient advocacy

Political advocacy

 

 

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How to Be Politically Involved?

Evidence-based practice examples

Nurses’ milestones in policy development have contributed to:

Quality outcomes

Decreases in cost

Expanded access

Major differences to the health of the nation

 

 

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Advocacy Activities of Professional Nursing Organizations

Role of professional nursing organizations

ANA

NLN

ICN

 

 

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Current Situation of Nursing Involvement: Challenges and Barriers

Not enough time to get involved

Heavy workloads with understaffing

Perception of powerlessness

Gender issues

Political action breaching family time

Anxiety with public speaking

Lack of knowledge in legislative process

Fear of retaliation

 

 

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Quality of Care

Safety

Effectiveness

Patient centeredness

Timeliness

Equality

Quality of care is defined by the Institute of Medicine (2001) as the degree to which health services for individuals and populations increase the likelihood of desired outcomes, and are consistent with current knowledge.

It is extremely difficult to evaluate the complexities of the quality of care for the U.S. population.

 

 

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Information Management

U.S. policy-makers have made the adoption of health information technology a priority so that health records can be kept electronically, assisting patients, providers, and insurers.

 

 

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Equity and Equality in Healthcare Access and Quality

Because of the vast disparities in healthcare access and quality, President Obama has made healthcare his top priority, promising affordable and adequate healthcare insurance for all Americans.

 

 

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Question #3

Is the following statement true or false?

Equality is healthcare that does not vary in quality because of gender, race, ethnicity, geographic location, or socioeconomic status.

 

 

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Answer to Question #3

True

Rationale: Equality is healthcare that does not vary in quality because of gender, race, ethnicity, geographic location, or socioeconomic status.

 

 

 

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Community-Based Services Association with Healthcare Reform

Federally qualified health centers

Patient-centered medical home

Accountable care organizations

Meaningful use

 

 

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Ethical Considerations

ANA Code of Ethics with Interpretive Statements

Code of Ethics for Nurses

Social Policy Statement

Scope and Standards of Practice in Nursing

 

 

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Health Advocacy and Healthcare Reform

Advocacy is collaborating with colleagues and engaging in conversations with decision-makers

Healthcare systems are dynamic

 

 

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Overview of the ACA Prior to the End of Obama Presidency

Patient Protection and Affordable Care Act

Health Care and Education Reconciliation Act

 

 

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Health Services Research

Research continues to be an influencing power by documenting the need for accelerated reform in order to achieve quality care, proper information management, insurance for all, and equity of access.

 

 

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