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ECONOMICS OF HEALTH CARE. BASIC DEFINITIONS. Amount of Medical Care Spending. Uses of Medical Funds. Uses of Medical Funds. the data in the figure show that great strides have been taken in terms of more people insured in the United States. Medical Care Quality.
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Uses of Medical Funds Uses of Medical Funds
the data in the figure show that great strides have been taken in terms of more people insured in the United States.
Health care is extremely labour-intensive, perhaps more than any other public sector activity. With more than six million workers, health and welfare constitute one of the most significant sectors of the economy in the EU, providing employment for 9.7% of the EU workforce (European Commission 2002). While health care consumes between 7% and 11% of the gross domestic product (GDP) in western European countries, approximately 70% of health budgets are allocated to salaries and other charges related directly to employment. In CEE and the NIS of the former USSR the health sector has an even greater role in employment due to the relative underinvestment in capital, resulting in a labour-intensive model of service delivery.
Mapping the future of HRH in Europe: analysing the factors affecting the health care workforce While the different approaches to analysing trends in health and HRH explored in the previous section may contribute usefully to exploring future trends in Europe, it is clear that no single discipline can address all aspects of human resources using these three perspectives simultaneously. Instead, a multidisciplinary approach is required to examine the full array of forces affecting HRH and to gain insights about how and why they are changing.
Demographic trends Demographic trends pose one of the most fundamental challenges to optimizing HRH, shaping the future health labour market directly, by impacting on the supply and composition of the health care workforce, and indirectly, by influencing the demand for products and services.
the data in the figure show that great strides have been taken in terms of more people insured in the United States.
Direct effects Across Europe, the ageing of populations - a consequence of persistently low fertility rates coupled with substantial gains in life expectancy - has emerged as a critical policy issue with important implications for both the nature of health care and the workforce that will provide it. The United Nations predicts that the population of Europe (including the Russian Federation) will fall from 726 million in 2003 to 696 million in 2025, resulting in a decline of the European share of the world's population from 11.5% to 9% (United Nations 2003). Within the 15 countries belonging to the EU before May 2004, the average age of the population is predicted to rise from 38.3 years in 1995 to 41.8 in 2015, with consequences for the available labour force. Thus, the working-age population, which increased consistently until the early 1990s, is estimated to decline over the next 25 years (European Commission 2000).
Trends in the share of the female workforce as a percentage of the total health workforce in selected countries in the 1990s
Lisbon Strategy set out in 2000, the Stockholm European Council in 2001 recommended that Member States increase significantly the number of older people (aged 55-64) remaining in the workforce and the Barcelona European Council in 2002 proposed increasing the age of retirement by five years by 2010 (currently it averages 58 years). Yet, in 2001, the employment rate of older workers was only 38% in the 15 Member States of the EU pre-2004 and 37% in the enlarged EU (European Commission 2002). This figure is substantially lower in, for example, France, Italy, Belgium and Luxembourg, mainly because of advantageous early-retirement schemes that contrast with the lack of employment opportunities in CEE. In general, there seems to be a trend towards early retirement. As a result, the length of retirement compared to the duration of working life has increased in all parts of Europe. It seems increasingly obvious that any increase in workforce participation by older workers will thus require fundamental changes in pension schemes and in employers' policies on recruitment and retention, including organizational practices and working conditions.
Female practising physicians as a percentage of all practising physicians in selected countries in the 1990s
Provider-patient relationship At the same time, the Internet is becoming an increasingly popular source of information on health (Larner 2002; Panes et al. 2002; Tuffrey and Finlay 2002). A better-informed public may elicit enhanced responsiveness from health service providers as individuals demand packages of care that are more suited to their perceived needs. In summary, technological change is having an important impact on HRH by determining the types of services that health workers can perform, the settings in which they deliver them and their practice structures. However, technology is not a monolithic force and its influence is complex. It may reduce or increase costs, promote or inhibit coordination of care, enhance or diminish access to care and improve or worsen patient outcomes.
Historical Development • Dental Hygiene as Forerunner to the Prevention Movement • Dr. Alfred Fones • Founder of Dental Hygiene School and First Author of Dental Hygiene College Textbook
Globalization and trade liberalization Intensification of the interdependence of global processes and markets emerges as an almost universal feature of economies in contemporary societies. These developments have an important impact on health care and the human resources that deliver it.
Factors Affecting Dental Health • Access to Care • Restriction of dental hygiene services • Shortage of Medicaid providers • Financial Situations • Insurance • Medicaid • Transportation
Department of Health and Human Services • Public Health Service Operating Division • Human Services Operating Division
National Institutes of Health Food and Drug Administration Centers for Disease Control and Prevention Agency for Toxic Substances and Disease Registry Indian Health Services Health Resources and Services Administration Agency for Health Care Policy and Research Substance Abuse and Mental Health Services Administration Public Health Service Operating Division
Public Health Service • PHS works toward improving and advancing the health of our nation. • U.S. Surgeon General • Dental Hygienists work as Public Health Officers.
Agriculture Defense Education Justice Labor State Treasury Veteran’s Affairs United States Peace Corps (which is an executive branch agency) Other Federal DepartmentsInfluencing Dental Care
Individual State Influence • State Dental Divisions • Medicaid • S-CHIPS • Prisons • Tribal Clinics • Institutions • Community Clinics
Dental Health Care Personnel • Need • Demand • Utilization • Supply • Dental Hygiene Shortages • Dental Hygienist to Dentist Employment Ratio = 1:2
Fee-for-Service • A dental practice sets a fee, and a patient and/or third party pays for the fee. • UCR: usual, customary and reasonable fee • Indemnity plans pay fee-for-service. • Discounted coverage available and sliding scales for certain patients in certain clinics
Capitation Method • Dental Managed Care • A certain amount is paid to a dental practice for a certain number of patients. Payment is received whether treatment is provided or not. • Many times employees will state that they are not paid for “cleanings” provided; however, this is not an accurate statement.
Encounter and Barter • Encounters are for an arrangement paid for each visit. • Barter system is used when the dental provider negotiates payment by exchanging goods and services.
Dental Billing • Claim Form • ADA CDT • Payment Plans • Dental Credit Cards • Explanation of Benefits
Government’s Role • U.S. PHS • Federal Block Grants • State Governments • Local Governments
