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Flashcards in 1st Exam Deck (80):
1

Baylor University Experimented with what during the Great Depression?

Blue Cross Health Insurance

2

What happened in 1935 for healthcare?

The start of Medicaid and Medicare

3

What pieces does the Iron Triangle have?

Quality, Access and Cost

4

What legislation was passed for Medicaid & Medicare?

Legislation pays to improve access and quality.

5

AMA

(American Medical Association) A group of physicians focused on education

6

Consumer Groups

AARP & Planned Parenthood

7

What’s the difference between pharmaceutical companies and Medicare?

Medicare can’t buy medications in bulk.

8

What is one of the things public health lobbyists advocated for?

Preventative health

9

What came out of the Balanced Budget Act of 1997?

CHIP

10

What are the requirement of Oregon end-of-life legislation?

Terminal
Sound Mind

11

What came out of the ACA for Idaho?

Health Idaho

12

What did the Patient Protection and Affordable Care Act do?

Pay a tax for opting out of health insurance
Improving Quality
Lowering costs
More accessible
Payments, grants and rules and regulations

13

How did payment shift in US health care history?

From personal payment to insurance payment

14

What happened to hospitals during the Great Depression?

Hospitals experimented with Insurance

15

What happened to insurance after WWII?

A switch to private insurance from taxable income.

16

What did government do in 1935?

Created aid for disabilities

17

What was the unintended effects of Medicare and Medicaid?

The growth of the aging population

18

What is the main way to reimburse hospitals?

DRGs (Diagnosis Related Groups)

19

Who makes decisions for hospitals?

Board of Trustees

20

What is horizontal integration?

(Like merging with like).

21

What is horizontal integration?

Incorporates everything like, rehabilitation, dr. Office, surgery etc.
be careful so you don’t monopolize.

22

What is CABBAGE?

It is a heart health procedure that was killing lots of people, by untrained doctors.
-Has to be joint commission approved.

23

What are the hazards of hospitalization?

(IOM)
The systems.
-Congress took action.

24

What were the forces of reform for hospitals?

-cost, quality and action
-hospital performance
-no anti-trust monopolies
-reimbursement: people got paid to fix their mistakes

25

What does the readmission reduction program state?

Readmission in the 30 days or less for the same diagnosis is bad.

26

What did the Hill-Burton Act do?

Funded construction and expansion of health care systems.

27

What type of hospitals are the majority in the U.S?

Non-governmental not-for profit hospitals

28

How has patient roles changed?

Patients play an active role in their health care.

29

What replaces the bill of rights?

The Patient Care Partnership
1. Quality
2. Clean and safe environment
3. Involvement
4. Privacy protection
5. Help leaving the hospital
6. Help billing your claims

30

What is informed consent?

Patient understands procedure and alternatives and risk (from doctor). Patient has to consent.

31

What year did physicians move from solo to groups?

1960

32

What are the advantages to a group practice?

-shorter on-call hours
-more vacation
-and group consultations

33

What is a patient-centered medical home?

A life-long team to help take care of you. Help schedule:
-eye exams
-shots
-flu shots etc.

34

How are patient centered medical homes (PCMH) funded?

Medicare & Medicaid

35

What is the GDP of healthcare?

US Spends almost double the average of gross domestic product.

36

What were the early forms of health insurance?

Sickness insurance, fraternal orders, and unions.

37

What was the key social Legislation on healthcare?

Patient Protection and affordable care act-

38

What Hi-teknology is used in healthcare?

Polio vaccines, birth control, anesthesia, etc.

39

Internet and healthcare

-data like hospital compare
-physicians have latest info.
-Apps

40

Retrospective v Prospective DRG payments

Retrospective- Paying back, after the fact
Prospective- Paying upfront saves money from overuse of treatments

41

What did the Carnagie Foundations do?

Supported entrance tests to be a hospital. They thought the foundation would give them money.

42

What is an academic medical center?

Research oriented medical school
Teaching with high technology

43

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

44

What conflicts of interest can physicians have?

Sending patients to their MRI machine.

45

What problems do technology bring?

-extending life and right-to-die
-equal access to technology
-technology overuse

46

What are the patients rights?

1. Quality
2. Environment
3. Involvement in care
4. Privacy
5. Help leaving hospital
6. Help billing claims

47

Who are the health system stakeholders?

The physicians, nurses, techs, etc.

48

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.

49

What plan does Idaho have for PCMHs?

(SHIP)
-Welfare funded
Uses ACOs- Accountable Care Organizations: incentivize people with money, link physician teams to lower emergency visits

50

What type of people use FQHCs? What benefits do they get?

(Federally Qualified Health Centers)
Primary care
-Sliding Fee, so they can get prescriptions cheaper
-uninsured

51

What is to err in human?

Deaths in hospitals caused by medication errors or staff incompetencies.

52

What injuries do Urgent Care Center take? Who works at Urgent Care?

-acute illness
-operate under licensed physician

53

Hospital use of IT

-EHS
-reduce cost

54

Healthcare advances in 1900s

-moved to health insurance
-Physicians moved from private practices to groups.

55

Who does discharge planning? Can patients appeal it?

-Social workers, physicians, insurance companies and nursing
-Yes (QIO)-Quality Improvement Organizations: protect patients rights

56

What is the danger with vertical integration?

Anti-trust monopolies

57

What does IHI do?

(Institute of Healthcare Improvement)
1. Shorten wait times
2. Reduce smoking habits
3. Reduce cost

58

What does LeapFrog do?

Combines Fortune 500 companies and foundations to improve health care.

59

What caused Early Market Reforms? What was put in place of early market reform?

-Closed Hospitals
-Horizontal Integration and Vertical Integ.

60

What are Forces of reform?

1. Cost, quality and access
-technology overuse
-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

61

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.

62

Are hospitalists certified? What did they specialize in?

-yes
-family medicine
-Improve coordination because they know the hospital system

63

What is capitation?

Physicians get paid for the health of their patients, not by how many times they come into the office.

64

Where is Idaho places for family medicine?

At the bottom.

65

Why do hospitals buy private practices?

So they can market share.

66

What is evidence-based clinical practice?

Rules by literature on how to treat patients.

67

What area of health care has the largest malpractice?

OB/GYN

68

What are ethical issues in healthcare?

Technology keeps patients alive much longer.

69

What physician training do physicians need?

1. Undergraduate degree (4yrs)
2. Medical school (4yrs)
3. Residency (3-7yrs)
4. Pass board exam

70

Why do physicians specialize?

-money

71

What is the highest level of education most NPs and PAs have?

Masters degree.

72

What is podiatrist medicine?

Consult, foot doctor.

73

What jobs are under allied health personnel?

-Technologist
-Radiologist
-Nuclear medicine

74

What jobs are under Therapeutic Science Practitioners?

-PTs
-OTs
-speech language pathologist

75

What jobs are under Behavioral Scientist?

-social work
-Rehabilitation counselors-mental health

76

What jobs are under Support services?

-Alternative therapists
-Integrative medicine
-Medical Assistant

77

What privileges does a PA have under an MD?

-diagnose
-prescribe
-counsel
-refer to specialists

78

When can dentists work?

Right out of dentistry school.

79

What is complementary medicine?

Used together with traditional medicine.
-acupuncture

80

What is alternative medicine?

Used in place of real medicine
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