Flashcards in 1st Exam Deck (80):
Baylor University Experimented with what during the Great Depression?
Blue Cross Health Insurance
What happened in 1935 for healthcare?
The start of Medicaid and Medicare
What pieces does the Iron Triangle have?
Quality, Access and Cost
What legislation was passed for Medicaid & Medicare?
Legislation pays to improve access and quality.
(American Medical Association) A group of physicians focused on education
AARP & Planned Parenthood
What’s the difference between pharmaceutical companies and Medicare?
Medicare can’t buy medications in bulk.
What is one of the things public health lobbyists advocated for?
What came out of the Balanced Budget Act of 1997?
What are the requirement of Oregon end-of-life legislation?
What came out of the ACA for Idaho?
What did the Patient Protection and Affordable Care Act do?
Pay a tax for opting out of health insurance
Payments, grants and rules and regulations
How did payment shift in US health care history?
From personal payment to insurance payment
What happened to hospitals during the Great Depression?
Hospitals experimented with Insurance
What happened to insurance after WWII?
A switch to private insurance from taxable income.
What did government do in 1935?
Created aid for disabilities
What was the unintended effects of Medicare and Medicaid?
The growth of the aging population
What is the main way to reimburse hospitals?
DRGs (Diagnosis Related Groups)
Who makes decisions for hospitals?
Board of Trustees
What is horizontal integration?
(Like merging with like).
What is horizontal integration?
Incorporates everything like, rehabilitation, dr. Office, surgery etc.
be careful so you don’t monopolize.
What is CABBAGE?
It is a heart health procedure that was killing lots of people, by untrained doctors.
-Has to be joint commission approved.
What are the hazards of hospitalization?
-Congress took action.
What were the forces of reform for hospitals?
-cost, quality and action
-no anti-trust monopolies
-reimbursement: people got paid to fix their mistakes
What does the readmission reduction program state?
Readmission in the 30 days or less for the same diagnosis is bad.
What did the Hill-Burton Act do?
Funded construction and expansion of health care systems.
What type of hospitals are the majority in the U.S?
Non-governmental not-for profit hospitals
How has patient roles changed?
Patients play an active role in their health care.
What replaces the bill of rights?
The Patient Care Partnership
2. Clean and safe environment
4. Privacy protection
5. Help leaving the hospital
6. Help billing your claims
What is informed consent?
Patient understands procedure and alternatives and risk (from doctor). Patient has to consent.
What year did physicians move from solo to groups?
What are the advantages to a group practice?
-shorter on-call hours
-and group consultations
What is a patient-centered medical home?
A life-long team to help take care of you. Help schedule:
-flu shots etc.
How are patient centered medical homes (PCMH) funded?
Medicare & Medicaid
What is the GDP of healthcare?
US Spends almost double the average of gross domestic product.
What were the early forms of health insurance?
Sickness insurance, fraternal orders, and unions.
What was the key social Legislation on healthcare?
Patient Protection and affordable care act-
What Hi-teknology is used in healthcare?
Polio vaccines, birth control, anesthesia, etc.
Internet and healthcare
-data like hospital compare
-physicians have latest info.
Retrospective v Prospective DRG payments
Retrospective- Paying back, after the fact
Prospective- Paying upfront saves money from overuse of treatments
What did the Carnagie Foundations do?
Supported entrance tests to be a hospital. They thought the foundation would give them money.
What is an academic medical center?
Research oriented medical school
Teaching with high technology
What is healthcare licensure, certification and registration?
-prevents entrance into field, professional titles
-continuing education every 10 years, expensive and time consuming
-least rigorous and allows networking
What conflicts of interest can physicians have?
Sending patients to their MRI machine.
What problems do technology bring?
-extending life and right-to-die
-equal access to technology
What are the patients rights?
3. Involvement in care
5. Help leaving hospital
6. Help billing claims
Who are the health system stakeholders?
The physicians, nurses, techs, etc.
What are some terms from the colonial era?
-no medical schools
-sick treated with medicinal herbs
-European physicians came to US and apprenticed Americans
-no formal methods to testing/no regulation
-1st medical school in Philadelphia
-regulations: Medical Education-set educational improvements. JAMA- published whether schools were good or bad.
What plan does Idaho have for PCMHs?
Uses ACOs- Accountable Care Organizations: incentivize people with money, link physician teams to lower emergency visits
What type of people use FQHCs? What benefits do they get?
(Federally Qualified Health Centers)
-Sliding Fee, so they can get prescriptions cheaper
What is to err in human?
Deaths in hospitals caused by medication errors or staff incompetencies.
What injuries do Urgent Care Center take? Who works at Urgent Care?
-operate under licensed physician
Hospital use of IT
Healthcare advances in 1900s
-moved to health insurance
-Physicians moved from private practices to groups.
Who does discharge planning? Can patients appeal it?
-Social workers, physicians, insurance companies and nursing
-Yes (QIO)-Quality Improvement Organizations: protect patients rights
What is the danger with vertical integration?
What does IHI do?
(Institute of Healthcare Improvement)
1. Shorten wait times
2. Reduce smoking habits
3. Reduce cost
What does LeapFrog do?
Combines Fortune 500 companies and foundations to improve health care.
What caused Early Market Reforms? What was put in place of early market reform?
-Horizontal Integration and Vertical Integ.
What are Forces of reform?
1. Cost, quality and access
-hospital performance is exposed
-shifting accountability for “health”
2. (ACO)-accountable care organizations: coordinated care with physicians across health system
3. Reimbursement and Payment Revisions
-value-based rather than volume based
-readmission a reduction program
What is the flexner report? What did it “say”?
It published which medical schools were bad and which were good. Any doctor could be a specialist.
Are hospitalists certified? What did they specialize in?
-Improve coordination because they know the hospital system
What is capitation?
Physicians get paid for the health of their patients, not by how many times they come into the office.
Where is Idaho places for family medicine?
At the bottom.
Why do hospitals buy private practices?
So they can market share.
What is evidence-based clinical practice?
Rules by literature on how to treat patients.
What area of health care has the largest malpractice?
What are ethical issues in healthcare?
Technology keeps patients alive much longer.
What physician training do physicians need?
1. Undergraduate degree (4yrs)
2. Medical school (4yrs)
3. Residency (3-7yrs)
4. Pass board exam
Why do physicians specialize?
What is the highest level of education most NPs and PAs have?
What is podiatrist medicine?
Consult, foot doctor.
What jobs are under allied health personnel?
What jobs are under Therapeutic Science Practitioners?
-speech language pathologist
What jobs are under Behavioral Scientist?
-Rehabilitation counselors-mental health
What jobs are under Support services?
What privileges does a PA have under an MD?
-refer to specialists
When can dentists work?
Right out of dentistry school.
What is complementary medicine?
Used together with traditional medicine.