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PUH 202 FINAL EXAM WITH COMPLETE SOLUTION

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PUH 202 FINAL EXAM WITH
COMPLETE SOLUTION

What makes up a health system? - ANSWER all actors, institutions, and
resources that undertake health actions where the primary intent is to
improve health

What are the 3 main goals of health systems? - ANSWER good health,
responsiveness to population expectations, fairness of financial contribution

4 main functions of health systems - ANSWER provide health services, raise
money that can be spent on health (resource generation), pay for health
services (financing), govern and regulate health system (stewardship)

how are health systems organized? - ANSWER has much to do with history,
politics, and values of individual countries

national health insurance scheme system - ANSWER offer health insurance to
all people for an agreed package of services, sometimes through the
government

national health service system - ANSWER government is sole player for
health care and owns most of the facilities (UK)

pluralistic systems - ANSWER public sector, private, for-profit sector,
non-for-profit sector all play roles

levels of care - ANSWER primary, secondary, and tertiary

examples of primary care - ANSWER well baby care, maternal health care,

,family planning

examples of secondary care - ANSWER some emergency care, adult illnesses,
surgical care, treatment of sick kids

tertiary care examples - ANSWER complicated pediatric and adult cases,
treatment of HIV, specialist surgical services, advanced emergency care

Declaration of Alma-Ata - ANSWER speaks of health as a human right and
the people's right to participate in the planning and implementation of
health care

public sector - ANSWER first actor in most health systems. could be at
national, state, or municipal level. responsible for stewardship or governing
of health system. also responsible for managing and financing public health
functions

private, for-profit sector - ANSWER health services that can be purchased for
profit. involved in the provision and financing of health systems in many
countries. in LMIC's- often medicine men, healers, etc.

private, non-for-profit sector - ANSWER NGOs. a lot of community based
efforts, can also offer health services with their own financing or help from
private or gov sector

poorer countries have the ______ private expenditure, while better-off
countries spend relatively ____ out of pocket. - ANSWER highest, less

Germany's HC system - ANSWER first to have universal health insurance in
1880s. based on "sickness funds" that are insurance funds financed by equal
parts employer and employee based on the salary of the worker. government
makes contributions for unemployed and retired. there are over 200 sickness

, funds based on region an occupation regulate by the government. Sickness
funds are on a non profit basis. Sickness funds cover 90% of population,
while 10% has private insurance. Most high income countries are based on
Germany's "social insurance scheme"




US HC system - ANSWER combination of public and private financing, mostly
private provision of care. Close to 50% of financing related to 4 public
programs: Medicaid (income), Medicare (65+ age and disability), Veterans
Administration (military), and Worker's Compensations (illnesses and
disabilities related to job). Another 50% comes from individuals and
employers. Most insurance are for-profit. Health providers work
independently of HC system, besides the VA. Only high income country that
not based on healthcare is a right. until recently, 40 million (15%) have been
uninsured.




Costa Rica HC System - ANSWER federal government controls most of health
sector directly. Costa Rican Social Security Administration owns most
hospitals. People who work in formal sector of economy have to participate
in CCSS. Most doctors employed by public practices, even if they have private
practices.CCSS is funded from wage taxes and funding from governments tax
revenues. Members of CCSS receive most services for free, but do have some
copays. People outside of formal sector can join CCSS too, with fees based on
their salary. The government has divided the country into Health Areas each
of with has 9 health teams to serve 4000 people. The focus on primary care.

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