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Lecture

HE302 February 26th, 2013.docx

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Department
Health Sciences
Course
HE302
Professor
Renee Mac Phee
Semester
Winter

Description
th Tuesday, February 26 , 2013 Frank Model of Public Health  The model was developed as a means of developing a more integrated and coordinated public health system  Identifies the structural components of the present system as a means of synthesizing data collection and reporting  Regardless of where the information comes from, it ensures that planning and service delivery are based on the same “pieces”  Five components of the model: 1. Health Surveillance: The tracking and forecasting of any health event or determinant through continuous collection of high quality data, integration, analysis and interpretation of the data into reports, advisories, alerts and warning, and dissemination to those who need to know (ex. influenza, gastroenteritis). Can track it by looking at how many people are coming to the hospital for it, look at lab results, etc. 2. Disease and Injury Prevention: involves a range of interventions, including: vaccine programs, infectious disease investigation and outbreak control, workplace health and safety regulations, cancer screening, programs to encourage healthy behaviors. 3. Health Protection: involves inspections of restaurants, child care centers, nursing homes and other public facilities - Monitoring and enforcing of water and air quality standards - Federal government PH legislations – Federal Quarantine Act 1872 (oldest piece of PH legislation) - Environmental Protection Act, Food and Drug Act, Tobacco Act 4. Population Health Assessment: responsible for evaluating and comparing overall trends and changes in population health status, evaluations are used to develop new and review existing health policies and programs, determines effectiveness of health programs, guide future policy and program decision making. 5. Health Promotion: involves strengthening community health services, establish joint partnerships between governments and communities to solve pressing health problems, advocate for healthy public policies including those that address the social determinants of health Public Health Units in Ontario  PH unit – an official health agency established by a group of urban and rural municipalities to provide a more efficient community health program, carried out by full time, specially qualified staff  36 PH units in Ontario  Administer health promotion and disease prevention programs  Each unit is governed by the board of health, which is an autonomous corporation under the Health Protection and Promotion Act  Administered by the medical officer of health who reports to the local board of health  The board is largely made up of elected representatives from the local municipal boards  The MOHLTC cost-shares the expenses with municipalities Community Based Health Services  Can include: - Doctor’s offices - Walk-in clinics - Labs - Blood donor clinics - Cancer screening centers - Home-based care - Hospice care (ex. palliative care)  Home care: can be defined as an array of services provided to individuals who are incapacitated so as to enable them to live at home - Services vary but can include personal care (ex. assistance with bathing, dressing, grooming), meal preparation, household cleaning, transportation, therapeutic care, the th administering of medications and other treatments 19 Century:  Virtually everyone was cared for at home, particularly those with limited financial resources – family members helped to provide care  Doctors made house calls  Middle-class and wealthy individuals were able to secure privately paid care  The very sick, regardless of SES, were often cared for in the hospital 20 Century  Emergence of doctor’s offices, hospitals, clinics, etc. saw care of individuals being moved from the home into the community 1950’s  Change in direction…formalized, public home care programs were being introduces 1980’s  Home care programs available in all provinces and territories  Responsibility for home care services rests with the provinces and territories  Consequently services, policies, and delivery varies considerably from one area to another 21 Century th  Significant push to have people cared for at home… much like the 19 century… without the house calls from doctors  Services for nursing, homemaking, personal care, meal services are covered by the province  Some therapeutic services (ex. physiotherapy, occupational therapy, speech, respiratory) may be covered depending on where the client lives  Other items that may be covered include: medical equipment, supplies, minor home repairs, home maintenance, social services (ex. friendly visiting program), respite care, palliative care  Some provinces (NFLD and PEI) require a physician referral in order to access services  Some programs will limit the age of the individuals eligible to receive services (ex. 65+)  Some programs are restricted to those in financial need Who uses home care?  Figures for community care are difficult to access particularly for privately paid services  Use of publicly funded or subsidized home care services in the previous year - 65+ = 10%, 18+ = 2.5%  Female, older (65+), not married or childless, relatively poor health status, more likely living in rural than urban settings, risk for use increases with low SES and living alone Why do we need home care?  Decreased costs (r
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