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dynamics of healthcare > Midterm > Flashcards

Midterm Flashcards

1
Q

Affordable Care Act

A

Legislation passed in 2010 requiring US citizens and permanent residents to have minimum essential health insurance coverage
the most significant change in the past 10 years

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2
Q

Healthcare costs

A

Expenses related to medical treatment and services

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3
Q

Medicaid

A

Government program providing health coverage to low-income individuals and families

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4
Q

Medicare

A

Government program providing health coverage to individuals aged 65 and older, and certain younger individuals with disabilities

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5
Q

Private insurance

A

Health coverage provided by private companies

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6
Q

Reasons for rising healthcare costs

A

Factors contributing to the increase in expenses related to medical treatment and services-technology medication aging increased prevalence of chronic diseases

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7
Q

Decline in mortality

A

Reduction in the number of deaths due to improvements in hygiene in the 20th century

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8
Q

Highest cause of deaths in the U.S.

A

heart disease

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9
Q

Health professionals needed for opioid addiction

A

Medical practitioners required to treat individuals suffering from opioid addiction will need more behavioral health and social workers

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10
Q

Projected population by 2050

A

⅓ Hispanic, ⅓ White, ⅓ African American

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11
Q

Downside of improved healthcare and longevity

A

People will live longer with more chronic disease

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12
Q

Preventive services included in ACA

A

Mammography colonoscopy and immunizations

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13
Q

chronic diseases are associated with

A

personal lifestyle

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14
Q

Telehealth

A

Delivery of healthcare services remotely using technology-became common during pandemic

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15
Q

Virulent antibiotic resistant bacteria strain

A

MRSA (methicillin resistant staph aureus)

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16
Q

Health IT

A

Use of computers to store and exchange health information

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17
Q

Social determinants of health

A

Factors that influence health outcomes, including birthplace, living conditions, education, and employment

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18
Q

Blue Cross/Blue Shield

A

Health insurance company offering coverage to individuals and families(private insurance

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19
Q

direct health services provided by the federal government

A

Tricare, ACA, Indian Health Service, Medicaid, Medicare

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20
Q

US DOES NOT HAVE

A

CENTRALIZED healthcare delivery systems

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20
Q

Health Promotion Service

A

Services aimed at promoting and maintaining good health(prenatal nutrition)

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21
Q

Disease Prevention Service

A

Services focused on preventing the occurrence of diseases (smoking cessation)

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22
Q

Diagnosis and Treatment

A

Services involved in identifying and addressing medical conditions (x-ray and lab) most used

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23
Q

Chronic Care

A

Services for managing long-term medical conditions (diabetes care

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24
Q

Rehabilitation

A

Services aimed at restoring physical or mental abilities ( head injury and stroke

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25
Q

National Association of Free clinics

A

Organization providing free healthcare services to underserved population

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26
Q

Federally Qualified Health Centers

A

Largest comprehensive safety net of primary and preventative care. Healthcare facilities offering comprehensive primary care services to underserved populations

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27
Q

free medical clinics

A

privately funded non for profit community organizations that provide healthcare at little or no costs to low income individual

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28
Q

Federally funded health centers

A

Healthcare facilities receiving financial support from the federal government-established for those in financial need. Offer comprehensive prenatal, dental, pharmacy, and behavioral health. The ACA provides funds to expand the health centers.60% receiving these services are members of a minority population

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29
Q

Free clinics receive little or no state funds

A

Free clinics do not receive significant financial support from state governments

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29
Q

Free clinics are necessary

A

after establishing ACA

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30
Q

The majority of people who are uninsured and would use Free medical clinics

A

Individuals who do not have health insurance through their employer and have incomes below the federal poverty level

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31
Q

Community Hospitals

A

Medical facilities providing long-term care and specialized services non for profit -include OB GYN
majority of hospitals

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31
Q

Public hospitals

A

Medical institutions owned by local, state, or federal agencies

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32
Q

Community Hospitals

A

Medical facilities providing long-term care and specialized services

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32
Q

CHIP

A

Government insurance program for children from low-income families

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33
Q

Tricare

A

Government healthcare program providing services to veterans and active duty military personnel

34
Q

Major breakthroughs in the treatment of mental illness

A

Development of Pharmaceuticals and National Institute of Mental Health.medications and research institution focused on mental health

35
Q

created through social security act

A

Medicaid and Medicare

36
Q

Hospitals

A

2nd largest business in the US

36
Q

Certified Community Behavioral Health Clinics (CCBHCs)

A

mental health and substance abuse

36
Q

Major Forces Affecting the Development of Hospitals

A

Transformation of nursing into a profession requiring training
Development of specialized technology
Patients needing acute care
advances in Medical education

36
Q

Proprietary hospitals

A

For-profit medical institutions operated for the financial benefit of corporations

36
Q

Medications for the treatment of opioid abuse

A

Naloxone, methadone, suboxone

36
Q

ACA requires all health insurances to include

A

mental health

37
Q

Private Hospitals

A

Medical institutions owned and operated by churches, businesses, corporations, and physicians

37
Q

Informed consent

A

patients most important legal rights

37
Q

Patient Care Partnership

A

Replacing the AHA’s Patients’ Bill of Rights, this plain language brochure informs patients about what they should expect during their hospital stay with regard to their rights and responsibilities.
High quality care
help with billing
autonomy(make your own decisions)
privacy

38
Q

1 in 8 ER visits are due to

A

mental health disorder

38
Q

more than 1/2 patients with mental and behavioral health disorders do not get treatment because

A

they do not know where to get help

38
Q

NIH

A

abbreviation for National Institutes of Health; the federal agency that funds and conducts biomedical research

39
Q

Capitation

A

fixed amount for each service

39
Q

HHS (Health and Human Services) is responsible for

A

Medicare, Medicaid, public health, biomedical research, food and drug safety, disease control and prevention, Indian health, and mental health services.

39
Q

nations largest public health insurance

A

Medicaid

39
Q

Public health focus

A

on community

40
Q

Mandatory Medicaid Services

A

home health, hospitals, ambulatory care, mental health services

40
Q

Example of capitation

A

HMO

41
Q

HMO

A

cheaper, fixed rate, only in network providers, need a referral for a specialist

41
Q

Premium

A

Amount you pay monthly, quarterly, semiannually or annually to purchase different types of insurance

42
Q

PPO

A

more expensive premium, can see out of network providers, do not need a referral

43
Q

ADL

A

activities of daily living (bathing toileting eating)

43
Q

elderly population growth

A

50% by 2030

43
Q

EPO

A

like an HMO but do not need referrals to see a specialist

43
Q

Chronic conditions

A

any disease or condition that lasts a long time (usually longer than six months or a year). It usually can’t be cured and therefore requires ongoing treatment and management. Examples include arthritis and asthma

44
Q

IADLs

A

instrumental activities of daily living preparing meals, housekeeping, managing finances

44
Q

Medicare B

A

Covers outpatient hospital stays and diabetic supplies, DME (durable medical equipment), patients on long term disabilities, X-rays, dialysis, vaccines, and respiratory nebulizers

44
Q

Medicare D

A

Prescription drug coverage

44
Q

Alzheimer’s disease

A

most common form of dementia progressive and irreversible brain disorder characterized by gradual deterioration of memory, reasoning, language, and, finally, physical functioning

44
Q

Medicare C

A

Medicare Advantage Plan pay a premium -private medical insurance

44
Q

health literacy

A

the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions
lack of literacy causes medical errors

44
Q

Adult day care

A

care given at a facility during day time hours; generally for individuals who need some assistance and/or supervision but are not seriously ill or disabled; usually reside outside of the facility

44
Q

Dementia

A

a slowly progressive decline in mental abilities, including memory, thinking, and judgment, that is often accompanied by personality changes

44
Q

Hospital Readmission Reduction Program

A

A program under the affordable care act to improve quality and reduce cost of care for patients readmitted to the hospital for pneumonia, congestive heart failure, or accurate myocardial infarction. Medicare reduce his perspective payments to hospitals that failed to meet the criteria for readmission for these three diagnosis

44
Q

The Tax and Jobs Act of 2017 impacts the Affordable Care Act by…

A

took away the individual mandate

44
Q

Medicare A

A

hospital insurance

44
Q

most common ADL in long term care

A

Bathing

44
Q

NHE

A

National Health Expenditures slowed between 2010-2014

44
Q

Medicaid expansion

A

An expansion of the Medicaid program under the ACA gives states the ability to expand Medicaid to cover all adults living up to 138 percent of the federal poverty level.
Not all states

44
Q

ACA disparity

A

in states that did not expand Medicaid

44
Q

Master Patient Index (MPI)

A

A list or database created and maintained by a healthcare facility to record the name and identification number of every patient who has ever been admitted or treated in the facility

44
Q

medical technology

A

refers to the procedures, equipment, and processes by which medical care is delivered

44
Q

Hospice

A

providing end of life care

44
Q

assisted living facility

A

a facility that generally provides housing, group meals, personal care, support services, and social activities in a community setting

44
Q

ACA young adults

A

can stay on parents coverage until 26

44
Q

ACO (Accountable Care Organization)

A

create incentives for hospitals and healthcare providers to coordinate patient care

44
Q

primary payer of long term services

A

Medicaid

44
Q

Coverage gap

A

people who do not qualify for Medicaid but do not make enough money to buy insurance

44
Q

HIPAA (Health Insurance Portability and Accountability Act)

A

confidentiality

44
Q

Essential Health Benefits

A

A list of health care services mandated to be covered in insurance plans offered by American Health Benefit Exchanges
Ambulatory care prescription maternity care rehabilitation lab service

44
Q

Bar coding technology

A

scanner technology and machine-readable bar codes such as UPC

44
Q

Interoperability

A

mechanism of electronic communication among organizations so data can be incorporated from one system to another

dynamics of healthcare (5 decks)

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