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Flashcards in exam II Deck (42):
1

U.S health care delivery

-more expensive
-does not correlate with a better outcome
-mixed system

2

medical education history

-1765: first med school
-1800's: internships under physicians
-1847: AMA standardization of medical education
-1928: Flexner report
-1940: third party insurance
-1950's: federal grants support medical schools
-2000's: subspecialty

3

Flexner report

-1928
-closing of substandard med schools
-MCAT is developed

4

hospital system history

-1820's: poorhouses
-1850's: first hospitals
-1890's: uniting of hospitals owed by physicians
-1920's: increased technology
-1940s: hospitals owed by churches
-1974: 1st patient bill of rights
-1980's: ambulatory and outpatient services become standard
-1997: Medicare begins reimbursement

5

public health history

-1700-1800s: epidemics
-1842: Edwin chadwick
-1854: snow linked cholera epidemic to water
-1920: public health defines (Charles winslow)
-1928: PCN discovered
-1946: national mental health act
-1950: cigarette smoke with lung cancer
-1952: polio vaccination
-1970: poison preventing act
-2002: prepared act

6

Edwin chadwick

-1842
-wrote "general report of the sanitary condition of the laboring population of Great Britain
-shed light on working conditions related to medical conditions

7

health insurance history

-1847: "sickness insurance"
-1929: hospital insurance for teachers, blue cross, Balor
-1935: Pres. Roosevelt signed social security act
-1965: Medicare and Medicaid
-1985: COBRA
-1993: FMLA
-1996: HIPPA
-2009: affordable care act

8

almshouses/ poorhouses

-1820's

9

john snow

-determined contaminated water was the cause of the cholera epidemic

10

first health insurance

-1847
-"sickness insurance"

11

Medicaid

-insurance offered to the indigent (poor)

12

Medicare

-insurance to those over 65, disabled, government employees

13

Medicare B:

outpatient services

14

Medicare D:

prescription coverage

15

Medicare A:

hospital or skilled nursing facilities

16

effective health care

-available (accessible to everyone)
-cost effective (affordable)
-high quality

17

managed care organization

-insurance through companies
-determines reimbursement
-control utilization of medical services
-covered services under the "health plan"

18

primary care

focuses on services provided for prevention and treatment of illness on an individual basis

19

secondary acute care

emergency or urgent care

20

tertiary care

-intensive care center
-trauma
-critical
-unstable patients

21

American public health association

“practice of preventing disease and promoting good health within groups of people, from small communities to entire countries. Health professionals work together with the common purpose of protecting the health of the population.”

22

risk

infer the risk of disease for individuals

23

risk factors

-exposures or causal agents that make one or more likely to suffer a disease or health problem

24

determining risk

-examining existing cases (prevalence)
-examining similarities between individuals
-determining risk factors: correlation or causation

25

incidence rate

-number of new cases of a disease during a specific time period

26

odds ratio

-how likely an individual to develop a disease given a certain risk factor

27

risk ratio

-risk in exposed
-risk of the unexposed
-how much more or less is an exposed individual at risk for developing the disease

28

primary prevention

-preventing the disease

29

secondary prevention

-disease has been discovered
-try to prevent long term effects

30

tertiary prevention

-disease and damage have occurred
-reduce worsening

31

health education

delivery of information

32

health promotion

-social supports
-laws
-policy change

33

national notifiable disease surveillance system (NNDSS)

-share notifiable disease related health information
-used to monitor and prevent disease occurrence and spread
-usually food borne illness

34

epidemic

-large number of cases that is out of proportion with what is expected

35

outbreak

-dramatic spike in the amount of cases of an endemic disease

36

morbidity

-number of people suffering with the disease

37

mortality

-number of people who have dies from the disease

38

role trust

-simply based on the role of the HCP in a position of superior knowledge

39

earned trust

-based on performance and behavior of the HCP and time

40

criteria for professional appropriate intimacy

patients whished and consent must be taken into consideration in every decision regarding the patients care

41

patients retain

~45-55% of the info you give to them

42

successful negotiation

-agree in what the clinical info is
-agree on the nature of the problem
-agree on the prognosis and treatment plan
-consent