22139077 health care economics

8/14/2019 22139077 Health Care Economics

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(AN EXPRESSION OF CARING FOR ALL CITIZENS)

HEALTH CARE ECONOMICSA Learning Packageby:

Mrs. Marilyn D. Junsay, MSN., RN. presented by: Ms. Leviene V. Divinagracia, MM


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Health care is something that touches our lives. Everybody visits the doctor, dentist,


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Why do people demand health care? This desire to be healthy has led to the demand for health care

People want to be healthy

All health care providers must have a clear understanding of the economics of care.


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Economics deals with the efficient allocation of scarce resources It determines which of the alternatives in health care represent the most efficient use


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ECONOMICS and HEALTH ECONOMICS ECONOMICS - The study of the distribution of scarce resources across a population. It is the science concerned with the ways society allocates scarce resources commonly kn

HEALTH ECONOMICS The study of the distribution of health care.


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Examples of health care economic environmentsIndividual consumers Insurance companies Employers State and federal governments

Examples of resource inputsLabor Capital technology


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Resources are considered scarce when society demands more resources and goods than are g It cover all inputs used to produce goods and services.

Scarcity has two sides:The infinite nature of human wants The finite or limited nature of resources available t


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MACROECONOMICS In healthcare, the macroeconomic market is the entire countrys health care system inclu Spending for employment and other aspects of health as part of the economy. Biological


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MICROECONOMICS This is about how individuals choose, minimize costs or maximize profits or wealth or ut

ECONOMIC POLICY The course of action intended to influence or control the behavior of an economy. It i

FINANCING The amount of money that flows from payors to an insurance plan, either private or gover

REIMBURSEMENT The flow of money from the insurance companies to providers or hospitals.


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The Health Care Market System Market a place, situation, or a procedure. It is a mechanism by which buyers and selle Demand is the buyers willingness to purchase a particular product or service. Supply


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A market for health care involves two groups: the buyers and sellers who interact to trapreventive medical treatment or who wanted information about their health. The sellers a


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Price is the quantity of something that is required in exchange for something else. It i Supply of healthcare refers to the availability of resources for the delivery of health Health care facilities, Human resources and Financing

Healthcare facilities while hospitals

continue to be the primary facility for the delivery of healthcare, economic pressures hav


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Human Resources health personnelhave grown substantially in the past years, still distribution inequities continues to per

Financing

this is primarily provided by either private or commercial insurance companies or by publi


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Healthcare Economic Terms Capitation amount established to cover the cost of healthcare services delivered to a person for a sp

Case Management


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Co-payment

is a cost sharing arrangement whereby the person who is insured pays a specified charge. p

Diagnosis-Related Groups (DRGs)

Fee for service


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Managed Care

the external monitoring and comanaging of an ongoing provider-client relationship to ensur

Can Health Care Costs be Contained?


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Cost containment

means to keep costs within

acceptable limits. It involves cost awareness, monitoring, management, and incentives to

Four (4) Major Contributors to Escalating Medical Costs Overcapacity of hospitals Su


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Hospitals

confinement to tertiary private hospitals is a nightmare.

An ordinary influenza with no complications with confinement of 5 days without Medicare

The surplus of highly specialized providers (Physicians influence on healthcare costs): Although fees charged by physicians for services account for only 20% of medical costs

FACTORS contributing to the escalating costs of health care:


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The financing of Healthcare Services Who will finance? The patient, the patients family, Medicare, Medicaid, the Health Main

Medicare is a federal government sponsoredhealth insurance for the elderly and other clients with chronic illnesses.

Medicaid is a federal state cooperative healthinsurance plan for the financially indigent. In the Philippines, once you are a governme


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The Role of the Health Care Consumer A consumer is a person who uses a commodity or a service. All of us are consumers of hea


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The cost of new technology Construction of new facilities Growth in specific populat

Other Factors Causing the Upward climb of Health care:


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Incidents or variances that may delay the patients discharge, increase cost or alter Examples of the most common forms of fraud: Billing service not furnished Misrepresenting the diagnosis to justify payment S

System variance due to omission in the hospital system. (e.g. when the patient has to


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Health Service Organizations Health Service Organizations are formed to deliver care through varied organizations cre


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Public Health System It is intended to protect the community against the hazards of group living. Some exam Public health and primary health care services Mental health hospitals and health


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Primary Health Care System Primary health care as an organization movement officially began at the 30th world healt


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Ambulatory care is a care delivered in an office or other setting and at the time an Nursing homes Hospice care is a specific type of care designed for terminally ill patients who choos

Health Care Delivery Settings Hospitals


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22139077 health care economics

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