Term Paper on "Determining the Healthiness of a Foreign Country's Healthcare System"

Term Paper 10 pages (2794 words) Sources: 1+

[EXCERPT] . . . .

Healthcare systems across the world are experiencing critical problems.

The purpose of this research is to focus on the healthcare system of Puerto Rico. We will investigate Population characteristics, the economy, health status parameters, Financial Parameters, Access and Availability, Accountability, Planning, Patient Autonomy and Satisfaction. We will determine how these factors influence the effectiveness of the overall healthcare system on the island of Puerto Rico.

Population Characteristics

Total Population of State

Puerto Rico is an island located east of the Dominican Republic. As a result of the Spanish American War Puerto Rico is a territory of the United States and its citizens were granted U.S. citizenship in 1917. The island has been at the forefront of political and economic debate for quite some time. The island was inhabited by aboriginals but after 400 years of colonial rule, the original people group that inhabited the island was nearly extinct.

As of July 2004, the total population of Puerto Rico was 3,897,960. The World factbook reports that 22.4% of the population is 14 and younger;

446,474 in this age group are male and 426,585 are female. Sixty five percent of the population is between the ages of 15 and 64, 1,220,721 are male and 1,329,936 female. Those 65 and older compose 12.2% of the population 205,933 are male and 268,311 are female.

The median age is 33.8 and population growth is estimated at.49%.

Population by Ethnic group

The island of Puerto Rico is mainly inhabited by whites of Spanish Origin who make up 80% of the population. In addition, 8% of the population is black, 0.4% are Amerindian 0.2% are Asian and 10.9% are mixed or other. Eighty five percent of the population is Catholic and Spanish and English are the primary languages that are spoken on the island.

Do population characteristics play a role in the overall health status?

Over 80% of the population of Puerto Rico is under the age of 65 and the median age is 33.8. Therefore, most of the population is relatively young. The health status of the population is impacted by the traditional meals and eating habits of the people. The consumption of traditional Latin dishes contributes to higher rates of diabetes and other health problems.

The Economy

What is the state of overall economy?

According to the CIA worldfactbook the Puerto Rico has a unique economy. The factbook reports that the Puerto Rican economy thrives on the industrial sector. The factbook contends that the industrial sector has surpassed the traditional agricultural sector. The economy thrives on duty free access to America and benefits by certain tax incentives. In addition, many American companies are invested in Puerto Rico.

In addition, Puerto Rico has the same minimum wage laws as the United States. Within the agricultural sector, dairy production and livestock products are the primary source of income. The production of sugar has declined and been replace with the former. In addition, tourism is an extremely important sector of the economy. The factbook reports that an estimated 5 million tourist visited Puerto Rico in 1999. The factbook also reports that economic growth declined in Puerto Rico from 2001 until 2003; this decline was due to the decline of the American economy.

The factbook also explains that the overall GDP of Puerto Rico is a little over $65 billion and the per capita GDP is $16,800. The inflation rate was 6.5% at the end of 2003 and the unemployment rate was 12%. The main agricultural products include livestock, coffee, sugarcane, plantains, bananas, chickens and pineapples. The prominent industries in Puerto Rico include food products, electronics, apparel, pharmaceuticals, and tourism.

Does the state of the economy, or the type or kind of industry, or lack thereof, play a role in the overall health status?

As you can see from the previous paragraph, the unemployment rate in Puerto Rico is relatively high. In some ways, a high unemployment rate can decrease the ability of an individual or a family to afford healthcare. When people cannot afford healthcare they do not have the ability to purchase healthcare the status of the health of the population can decline. The types of industries that exist in Puerto Rico do not appear to influence the overall health status of the population.

Health Status Parameters

Mortality and morbidity of major illnesses and conditions

The Henry Kaiser Family Foundation asserts that the number of Puerto Ricans living with HIV / AIDS was 10,560 in 2002. According to the CDC Hispanics born in Puerto Rico are more likely to contract HIV / AIDS through drug use than Hispanics born elsewhere. The Kaiser Family Foundation also contends that 17,269 people died of AIDS through the end of December 2002.

The number of adults diagnosed with Diabetes is 282,000. The Death rate from diabetes is not published. Puerto Ricans most likely to have diabetes are between the ages of 45 and 64.

The infant mortality rate

The infant mortality rate in Puerto Rico is 8.37 deaths per 1,000 live births. The factbook asserts that the rate for male infants is 9.7 deaths per 1,000 live births and 6.98 deaths per 1,000 live births among females.

According to the Centers for Disease Control (CDC) infants in Puerto Rico are more likely to have Low Birth Weights (LBW) and Preterm Delivery (PTD). The CDC explains

Puerto Rico -- born infants are at greater risk for LBW, PTD, and death than Puerto Rican infants born on the mainland. From 1989 -- 1991 to 1998 -- 2000, the overall infant mortality declined approximately 24% for Puerto Rican infants; however, the disparity in rates between infants born in Puerto Rico and those born on the mainland remained constant. Disparities in LBW and PTD rates emerged during this period because of large increases among Puerto Rico -- born infants."

The CDC also reports that Puerto Rican mothers were "less likely than mothers of mainland-born infants to report certain maternal risk factors." These factors include having less than 12 years of education, including receiving late/no prenatal care, not being married, tobacco use and having plural births.

Life expectancy at birth

According to the world factbook the average life expectancy at birth is 77.49. The life expectancy at birth for men is 73.49 and the life expectancy for woman is 81.68.

Number of Hospitals, Nursing Homes, clinics

According to Kaiser as of August 2004 there were six federally qualified health centers in Puerto Rico. The Keiser foundation reports no rural healthcare clinics. In addition, the data about the number of hospitals in Puerto Rico is lumped together with the number of hospitals that are in the United States, this number is 4,927.

Utilization of Healthcare Services

According to Kaiser 74% of Puerto Rican women between the ages of 18 and 64 reported having a pap smear within the last three years. Seventy two percent of women ages 50 to 69 reported having a mammogram in the past two years. In addition, the percentage of Puerto Ricans between the ages of 18 and 64 ever tested for HIV is 44.4%.

Loss of Time from Work

This information was unavailable.

Length of Stay in Acute Care Facilities, and Use of Emergency Rooms

None of this information is available for Puerto Rico.

Utilization of Prescription and over the counter drugs

The total number of prescription drugs filled in 2003 in the United States was 3,083,903 (in thousands).

Number of Patients with inadequate health insurance, Number of uninsured

This information is not available as it pertains to Puerto Rico Specifically. However, it is lumped together with the mainland United States. These figures assert that an estimated 46% of Americans do not have health insurance through their employers. In addition, 5% have individual health plans.

Thirteen percent have health insurance through Medicaid and 12% have insurance through Medicare. The percentage of uninsured Americans is 16%.

Doctor to Patient Ratio

Fifty percent of doctors in Puerto Rico are primary care physicians. There are more than 10,000 nonfederal doctors in Puerto Rico. For the United States, there are 280 doctors for every 100,000 people.

Financial Parameters

Total Expenditures

The total healthcare expenditures for the United States are $1,015,988,000,000. The per capita expenditure is $3,759.

Expenditures by type

The following graph taken from the Keiser foundation website, expenditures by type are as follows.

Health expenditures as a percentage of GNP, Expenditures by age group

None of this information is available for Puerto Rico. As it relates to Medicaid spending in the United States children compose 16% of the recipients while adults are 10% of the recipients.

Cost Control Mechanisms

Because Puerto Rico is a territory of the United States it is subject to many of the same healthcare standards as the 50 American States. However, some healthcare programs are unique to Puerto Rico and are designed to minimize healthcare cost.

One such plan was the expansion of Medicare beneficiaries that took place in 2002. This expansion allowed Medicare benefits to be expanded to people living in 26 Puerto Rican municipalities. Today this cost control mechanism… READ MORE

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