Making Health Care Decisions

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Making Health Care Decisions
B. Lee Green Texas AM University
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Objectives

• Describe the role of information in making
  decisions about health care
• Identify high-quality sources of health
  information, including reputable hotlines and
  internet sites
• Describe five advertising techniques used to
  promote health products and services
• Recognize quackery and health fraud and cite
  examples of each
• Learn how to employ several strategies when
  selecting a physician

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Objectives

• Identify a range of alternative and complementary
  health care providers
• Recognize the difference between primary,
  secondary, and tertiary care and acknowledge your
  own and your physicians responsibilities in
  regard to each form of health care
• Understand the advantages and disadvantages of
  traditional indemnity plans, HMO and preferred
  provider organizations
• Differentiate between prescription and over the
  counter drugs
• Understand the steps to take before taking a
  natural product as medicine

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Buying Health Care How Do Consumers Make
Decisions?

• Decision Making and Accurate Health Information
• Patient Package Insert an information sheet,
  required by the FDA, that warns the consumer of
  possible contraindications for use of a drug or
  medical product.
• Contraindications are circumstances that make use
  of a pharmaceutical or medical product
  inadvisable.

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Making Health Care Decisions
Table 16.1
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Making Health Care Decisions
Table 16.2
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Buying Health Care How Do Consumers Make
Decisions?

• Advertising Health Care
• Approaches to advertising
• Scientific Studies
• Bandwagon Approach
• Testimonials
• Emotional Appeals
• Comparison with other Products
• Price Appeal

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Buying Health Care How Do Consumers Make
Decisions?

• Health Fraud
• Quackery is a health claim made for a product or
  service that cannot be justified by
  scientifically derived evidence.
• Placebo a look-alike pill with no therapeutic
  value.

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How to Choose Health Care Providers

• The Right Physician for You

Table 16.3.1
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How to Choose Health Care Providers (cont'd.)
Table 16.3.2
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How to Choose Health Care Providers

• Complementary and Alternative Health Providers
• Naturopaths are the general practitioners of
  alternative medicine
• Selecting a Health Care Provider
• Referral from current physician
• Referral from student health center
• Ask a nurse if they would recommend a physician.
• Referral from a friend

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How to Choose Health Care Providers

• When to Go to the Hospital
• Primary Care routine medical care provided by a
  physician in the office or at an emergency room
  in a hospital or clinic.
• Outpatient Care care provided in a physicians
  office, emergency room, or ambulatory clinic that
  does not involve hospitalization or overnight
  stays.
• Secondary Care care involving surgery and
  nonroutine medical treatment, usually delivered
  in a hospital.
• Inpatient Care health care provided in a
  hospital.

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How to Choose Health Care Providers

• When You Go to the Hospital
• Tertiary Care special medical procedures, such
  as open-heart surgery and transplants, performed
  at medical school hospitals or at large regional
  hospitals.
• Preadmission Certification approval from a
  health plan of the need for inpatient hospital
  care prior to the actual admission.

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How to Choose Health Care Providers

• When You Go to the Hospital

Figure 16.1
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Paying For Health Care

• Uninsured having no health insurance.
• Underinsured having limited health insurance
  that compromises ones access to health care
  services and places one at significant financial
  risk.
• Medicare is coverage for people over age 65.
• Medicaid is coverage for people of low income or
  who are disabled.

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Paying For Health Care

• Indemnity (Fee-for-Service) Plans
• Indemnity (Fee-for-Service) Plan insurance
  coverage in which a person pays for most of his
  or her medical bills and then files a claim to be
  reimbursed.

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Paying For Health Care

• Managed Care Plans
• Health Maintenance Organizations (HMOs) prepaid
  plans that offer a defined set of benefits
  according to a predetermined monthly premium.
• Point-of-Service Plans (POS) HMOs having an
  indemnity-type option that lets members get care
  from physicians outside the plans network.
• Preferred Provider Organizations (PPO) a hybrid
  form of insurance that merges features of
  traditional fee-for-service insurance and prepaid
  plans.

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Paying For Health Care

• Asking Questions about a Health Plan
• What type of coverage do you need?
• How do you feel about your choice of physicians
  or hospitals?
• What is the plans policy on special areas of
  coverage?
• When does coverage take effect?
• Overall, does this plan meet your needs?

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Drugs and Natural Products as Medicine

• Prescription Drugs are drugs ordered specifically
  for a person by his or her physician and filled
  by a registered pharmacist.
• Over-the-Counter (OTC) Drugs are drugs purchased
  without a prescription.
• Generic Drugs have the same active chemical
  ingredients as brand name drugs.

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Drugs and Natural Products as Medicine

• The Correct Way to Take Medications
• Five questions to ask when given a new
  medication
• What is the name of the drug and what is it
  supposed to do?
• How and when do I take it, and when do I stop
  taking it?
• What food, drinks, other drugs, or activities
  should I avoid?
• What are the side effects, and what should I do
  if they occur?
• Is there any written information available about
  the drug?

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Drugs and Natural Products as Medicine

• The Correct Way to Take Medications

Figure 16.2
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Concluding thoughts

• You are responsible for your health
• Common sense
• Health skills
• Healthy behaviors