Week 1.pdf

FOUNDATION OF HEALTHCARE FINANCIAL AND ECONOMIC Dr. Emanuel Díaz Ortiz, MSE., MSN., AMC., DHA ENFE 4700 Anesthesia Program Objectives Define concepts related to economics and finance in the health system. Review the Theoretical Economic Framework o...

FOUNDATION OF HEALTHCARE FINANCIAL AND ECONOMIC Dr. Emanuel Díaz Ortiz, MSE., MSN., AMC., DHA ENFE 4700 Anesthesia Program Objectives Define concepts related to economics and finance in the health system. Review the Theoretical Economic Framework of Healthcare. Identify the social determinants of health. Discuss the historical context of health reform in Puerto Rico and the United States (U.S.). GENERAL CONCEPTS HEALTH Health A state of complete physical, mental, and social well-being and not merely the absence of illness. OMS(1974) Health Lener Monroe sees health as a qualitative characteristic because it has to do with the quality of life. It is high if: – the individual functions at an optimal level. – free of mortality or disability. – high vitality. – performs his main social roles in accordance with his values and those of his group. – evaluates his morale positively. – is emotionally healthy.  Public Health El Valor en la Salud La OMS ve la salud como un bien para cada ser humano. Hernan San Martin nos dice que la interpretación que una persona le dé a su salud y enfermedad se basa en gran medida en su sistema de valores. Los gobiernos le ven un valor instrumental para alcanzar la vida plena. Para los individuos, el valor de la salud dependerá de su deseabilidad. El trabajador de salud deberá estar atento a cómo valoran la salud los individuos y grupos con quienes trabaja. Existe una compleja acción recíproca entre las condiciones socio-económicas, la salud poblacional y las condiciones biomédicas.  Public Health “It is the science and art of preventing disease, prolonging life, and promoting physical health and efficiency, through the organized efforts of the community.” Winslow(1920)  ECONOMIC THEORETICAL FRAMEWORK OF HEALTH CARE  - a daim as a true A truth Postulates - An existence - Products and services provided in the healthcare field are not homogeneous. Health care is filled with imperfect information, with providers having better information about a patient's condition than the patient himself or herself. In the healthcare market, there are no free entries or exits. Often there are few buyers or sellers in a health care market. Social Determinants of Health  Social Determinants of Health The World Health Organization defines social determinants of health (SDH) as "the circumstances in which people are born, grow, work, live and age, including the broader set of forces and systems that influence the conditions of everyday life.” They emerge from how money, power, and resources are distributed at global, national, and local levels, which are determined by the policies that are implemented. (Commission on Social Determinants of Health (CSDH), 2008) Conceptual Framework of Social Determinants of Health (OMS) REFORM AND FINANCES OF THE HEALTH SYSTEM IN THE UNITED STATES AND PUERTO RICO Historical Context in Puerto Rico and the United States 1898 1965 1990s 2010 The American invasion of P.R. Medicaid plan approved by President Clinton again Approval of the Obamacare occurs. President Lyndon B. Johnson proposed a mandate for Plan (Affordable Care Act), the in the U.S.. employers to address unequal uninsured population was access to healthcare and other markedly reduced. changes to control healthcare costs in the U.S. President Nixon proposed a Dr. Guillermo Arbona national reform mandating that established the regional health employers offer health system in the country. insurance to employees in the Health Reform is Puerto Rico U.S. implemented in P.R. 1960 1972 1994 Finance and Economics in Health  Finance/Health Economy/Health It is a function of the health system that Discipline that analyzes the focuses on the mobilization, efficient use of resources accumulation, and distribution of allocated to health care and resources to meet individual or population health needs. promotion. A set of practices and strategies It focuses on how to optimize these intended to manage the costs, resources to increase the efficiency expenses, and investments associated of the organization and promote the with the operation of a health services well-being of the population taking institution or organization. into account effectiveness, efficiency, and equity. (OPS) Characteristics of the Financial System in the U.S. Health Sector El enfoque de Estados Unidos esta determinado por ideas fundamentadas en el pacto social entre los ciudadanos y el gobierno. – “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. That to secure these rights, governments are instituted among men, deriving their just powers from the consent of the governed, that whenever any form of government becomes destructive of these ends, it is the right of the people to alter or to abolish it, and to institute new government…” División entre los derechos y responsabilidades del gobiernos estatal vs gobierno federal. – Decima Enmienda de la Constitución: “The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.” – La mayoría de los programas gubernamentales de salud han sido históricamente responsabilidad del gobierno estatal. – Dado al pacto social que existe, la financiación del cuidado de la salud ha sido históricamente una responsabilidad privada con cierto grado de implicación del estado enfocado en los grupos vulnerables. Financial Goals and Objectives in the Health System General Health for the Population – Tax expenditures on health services. – Better educational level of society, better environment, and economic development to alleviate poverty = better social health compared to the provision of health services. – Financial allocation conflicts. – Political pressure and dilemmas in the allocation of public funds. (Paterson, 2022) (Waxman & Knighten, 2023).  (Waxman & Knighten, 2023). others sid party out of innance pocket Mech said primarane Medicare CONTEXT OF HEALTH ECONOMICS Marginal Utility Utility is the satisfaction a consumer gets from the goods or services he or she purchases. The marginal utility of a good/product refers to the increase in total satisfaction experienced by consuming an additional unit of that good/product (service). – Decreasing Marginal Utility ↳ meaning a second Marginal utility describes consumer behavior. Purchal or sale  a it win Marginal Cost You can only get Indicates the increase/change in production costs when producing additional units of a product, also known as marginal costs of production. It allows us to understand how an increase in production affects costs and, therefore, profits. Production costs include: corporate expenses, employees, and supplies. +production quantity = - marginal costs the more production = less marginal cost) lessprofitempany Marginal Income Hotel income or not income It is the increase/change in total income when one more unit of product is sold. – Higher price = Lower demand must be – Lower production = Higher price The product uniquelgood to get this. – Higher production = Low marginal income Equilibrium- is the optimal point of production where the production function and demand are in balance (you manage to sell the same amount as you spend). Production and Market Production function- is the relationship between quantity and cost of production. It can affect price, supply and demand of the product and as a result marginal revenue. Market - It is a set of systems with exchanges of goods and services between sellers and buyers that determines the product or service and the price – Perfect Market- High prices signal potential sellers. Low prices encourage potential buyers to come in and consume more of the product or service. – Labor market - refers to the set of employers, who are those who offer jobs, and people looking for paid work (offerors). Conclusion The economics, structure, and financing of health care significantly impact the work of health care professionals. In the United States, the disorganized payment system has made it difficult for policymakers or funders to address the root causes of healthcare costs. Nursing offers numerous opportunities to improve both the quality and efficiency of health care, playing a crucial role in defining and evaluating these changes. QUESTIONS? Assignment Divide into groups of 4 to work on all the academic activities of the course that are done as a team during the semester. For the next class, find a recent example of a debate between the state government and the federal government regarding health care. This could be a court case involving states' rights or an administrative action between the state government and the federal government.  References Anwar, S., Bachtiar, N., & Fahmy, R. (2023). Economic Debate on Financing Model of the National Health System. Devotion: Journal of Research & Community Service, 4(2), 648–657. Bartlett, J., Lynn, P. & Taylor, C. (2022). Fundamentals of nursing: The art and science of person-centered care (10th ed.). Philadelphia, PA: Lippincott Wilkins & Wilkins Co. Departamento de Salud de Puerto Rico. (28 de agosto 2023). Planes de Salud. Recuperado de: https://www.salud.pr.gov/ Elola, J., Daponte, A., & Navarro, V. (1995). Health indicators and the organization of health care systems in western Europe. American Journal of Public Health, 85(10), 1397–1401. https://doi.org/10.2105/ajph.85.10.1397 Michael, J (2023). Financial management for nurse managers: Merging the heart with the dollar (5th ed). Burlington, MA: Jone & Bartlett Learning. Mulligan, J. (2007). Managed lives: Privatizing public health in Puerto Rico [ProQuest Information & Learning]. In Dissertation Abstracts International Section A: Humanities and Social Sciences (Vol. 68, Issue 5–A, p. 2027). Rector, C. (2022). Community and public health nuring: Promoting the public’s health. (10th. ed.). Philadelphia, PA: Wolters Kluwer. Waxman, KT., & Knighten, M.L. (2023). Financial and business management for the doctor of nursing practice (3rd ed). New York: Springer Publishing Company.