final Flashcards
(90 cards)
What is Medicare
Individuals 65 and older; individuals under 65 who have qualifying disability (such as end stage renal failure or ALS) can also enroll
What is medicaid
Medicaid acts as a supplemental insurance for those enrolled in Medicare (younger, pregnant woman, people with disability)
What is Chip
Chip was created in 1997 to extend health coverage to uninsured children in families with moderate incomes. (Families with incomes too high for Medicaid but too low to afford private insurance premiums)
When was Medicaid and medicare created
1965
What is an HMO
Health Maintenance Organization- provides wide range of health services- pay a fixed monthly fee (includes copayments for visiting specialist and hospitals).
What is a PPO
Preferred Provider Organization- offers variety of healthcare providers, operates on fee for service basis, allowing patients to use any healthcare professional.
What is a DRG
Diagnosis related group- classification system for hospital reimbursement based on diagnoses, procedures, patient age, and expect length of stay (hospitals received a fixed fee for each drg)
Fee-for-service
Allows healthcare providers to bill for each individual service they perform, leading to more fragmented, often unnecessary care.
Capitation
A payment model providing healthcare providers with a fixed amount per patient, promoting preventive care and cost control, as it discourages unnecessary tests and services.
What happened in 1935
Social Security Act establishes the foundation for the modern safety net.
Health trend
The elderly population is increasing, leading to a rise in chronic diseases such as diabetes, heart disease, and cancer.
Demographic
Chronic conditions in older adults account for approximately two-thirds of total healthcare costs, highlighting the need for targeted health interventions and policy changes.
what led to decrease in mortality rates in 20th century
Significant improvements in hygiene practices
Public Health outcome (people and animals)
A rise in new infectious diseases such as Avian flu, Ebola, and MRSA pose major public health challenges with the potential for widespread impact.
WHO
Importance of Nutrition: The CDC emphasizes the critical role of proper nutrition in preventing chronic diseases and promoting overall health and well-being. (food)
Facility overview
The majority of hospitals in the United States are community hospitals, with approximately 5,000 total, of which around 3,000 operate as non-profit entities, serving diverse populations across the nation.
private facility
Typically funded by individuals or for-profit insurance models, focusing on providing lucrative care options.
Public facility
Funded by governmental agencies ensuring healthcare access to underserved populations.
Volunteer Facilities:
Funded through charitable donations and grants, designed to provide care at reduced costs to those without health insurance.
Health promotion
Programs aiming to reduce the risk of illness and promote healthy lifestyles through education and community initiatives.
Disease prevention
A service category offering various assistance and activities tailored to prevent illnesses in populations.
Diagnosis and Treatment:
The most utilized healthcare services are primarily offered in hospitals, encompassing a wide range of medical interventions.
Rehabilitation:
Services focusing on restoring optimal functionality after an illness, injury, or surgery, often involving therapy and support.
Chronic Care:
Deals with the ongoing management and monitoring of chronic conditions, ensuring patients receive timely interventions.
