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Flashcards in Health Care in the USA Deck (61):
1

Currently, what percentage of hospital beds are unoccupied?

1/3 (especially in city hospitals).

2

The average length of a hospital stay is ...?

4.8 days. --> Has been steadily DECREASING.

3

Types of hospitals in the USA (4):

1. Community hospitals.
2. Federal government hospitals.
3. Nonfederal psychiatric hospitals (often owned and operated by state governments).
4. Nonfederal long-term care hospitals.

4

Community hospitals - Subtypes:

1. Nongovernment not-for-profit.
2. Investor-owned (for profit).
3. State and local government.

5

Number of community hospitals:

5008.
Nongovernment not-for-profit = 2919.
Investor-owned (for-profit) = 998.
State and local government = 1092.

6

Number of federal government hospitals:

211.

7

Nonfederal psychiatric hospitals (often owned and operated by state governments):

444.

8

Nonfederal long-term hospitals - Number:

117.

9

Community hospitals - Category includes:

Nonfederal and short-term general and other special hospitals (eg obstetrics and gyn; rehabilitation, orthopedic), and academic medical centers or other teaching hospitals accessible to the general public.

10

Federal government hospitals - Category includes:

Veterans administration (VA) and military hospitals that are federally owned and reserved for individuals who have served (veterans) or are currently serving in the military.

11

Nonfederal psychiatric hospitals (often owned and operated by state governments) - Category includes:

Hospitals for chronically ill patients.

12

Nonfederal long-term care hospitals - Category includes:

Hospitals for chronically physically ill patients.

13

Nursing homes and other health care facilities - In 2011, there were about ...?

15.500 nursing homes with a capacity of 1.6million beds in the United States.
--> In the elderly, falls leading to broken bones commonly lead to the need for nursing home care.

14

Physicians - Currently, there are about ... accredited allopathic medical schools and ... accredited schools of osteopathic medicine in the United States.

130 and 26.

15

Both MDs and DOs (Doctor of osteopathy) are correctly called "physicians". There are currently about ...?

950.000 physicians in the USA.

16

Overall, physicians earn an AVERAGE income of ... annually.

200.000 USD.

17

The ratio of physicians to patients is higher where ?

In the NORTHEASTERN STATES + California than in the South and Mountain states.

18

People in the USA average fewer or more yearly visits to physicians than people in developed countries with systems of government-funded medical care.

FEWER YEARLY VISITS.

19

...% of people visit physicians in a given year.

75%.

20

In all age groups, the 2 MC medical conditions for which treatment is sought are:

1. Upper respiratory ailments.
2. Injuries.

21

Costs of health care - Health care expenditures in the USA make up more than ...?

14% of the total economy - More than ANY OTHER industrialized society.

22

Health care expenditures have increased because of the:

1. Increasing age of the population.
2. Advanced in med technology.
3. Availability of health care to the poor and elderly through Medicaid/Medicare, respectively.

23

Health care expenses and payment - Origin of Health Care Expenses (in Decreasing Order of Magnitude):

1. Hospitals.
2. Physicians' fees.
3. Nursing homes.
4. Medications and medical supplies.
5. Mental health services.
6. Dental and other care.

24

Health care expenses and payment - Sources of payment for Health Care Expenses (in Decreasing Order of Magnitude):

1. Private health insurance (36%).
2. Federal government (34%).
3. State and local government (11%).
4. Individuals (15%).

25

Payment for health care: Health insurance - Overview:

The USA is one of the FEW industrialized countries that do NOT have publicly mandated health care insurance coverage funded by the government for ALL citizens.
--> This is one reason that the USA has HIGHER INFANT MORTALITY rates and LOWER LIFE EXPECTANCIES than most other developed countries.

26

Most Americans must obtain HEALTH INSURANCE through ...?

Their employers OR on their own.
--> Typically, the employer and the employee share the cost of health insurance.

27

In 2007, health insurance costs averaged ...?

12,100 per year for a family of 4 and have been INCREASING.

28

About ...% of Americans have NO HEALTH INSURANCE.

15%.
--> Many others are "underinsured".

29

...% of bankruptcy fillings are related to the inability to pay medical expenses.

50%.

30

More than ... million Americans cannot afford adequate health care and go without prescription drugs, eyeglasses, or dental care.

40 million.

31

Certain citizens have government-funded health care insurance through ...?

Medicaid and Medicare.

32

No mattern what the insurance, the PRIVACY OF HEALTH INFORMATION (eg insurance claims, referral authorization requests) that is held or transmitted in any form (eg paper, electronic) is legally protected by the ...?

Health Insurance Portability and Accountability Act (HIPAA) implemented by The Standards for Privacy of Individually Identifiable Health Information (ie Privacy Rule).

33

Private health insurers - Blue Cross/Blue Shield (BC/BS):

A nonprofit private insurance carrier, is regulated by insurance agencies in each state.

34

BC/BS pays for ...?

Hospital costs (Blue Cross) and physician fees and diagnostic tests (Blue Shield) for UP TO HALF of the WORKING PEOPLE in the USA.

35

Individuals can also contract with one of at least 1000 other private insurance carriers, such as ...?

Aetna or Prudential.

36

Primary, Secondary, and Tertiary Prevention in Health Care:

1. Primary --> To reduce the incidence of a disorder by reducing its associated risk factors.
2. Secondary --> To reduce the prevalence of an existing disorder by decreasing its severity.
3. Tertiary --> To reduce the prevalence of problems cauused by an existing disorder.

37

2 examples of 1o prevention:

1. Immunization of infants to prevent infectious illnesses.
2. Improved obstetrical care to avoid premature birth and its associated problems.

38

2 examples of 2o prevention:

1. Early identification and management of otitis media in children to prevent hearing loss.
2. Mammography for the early identification and management of breast cancer.

39

2 examples of 3o prevention:

1. Physical therapy for stroke patients so that they can care for themselves.
2. Occupational training for mentally retarded persons so that they gain the skills needed to join the work force.

40

Medicare and Medicaid - Medicare - Source of funding:

The federal government (through the Social Security system).

41

Medicare - Eligibility:

1. People eligible for Social Security benefits (eg those older than 65yr of age regardless of income).
2. People of any age with chronic disabilities or debilitating illnesses.
3. Covers about 35 million people.

42

Medicare - Coverage - Part A:

1. Inpatient hospital care.
2. Home health care.
3. Medically necessary nursing home care (for up to 90 days after hospitalization).
4. Hospice care.

43

Medicare - Coverage - Part B:

1. Physician fees.
2. Dialysis.
3. Physical therapy.
4. Lab tests.
5. Ambulance service.
6. Medical equipment.
--> Part B is optional and has a 20% co-payment and a $100 deductible.

44

Medicare - Coverage - Part D:

Optional and covers a share of prescription drug costs.
--> Medicare does NOT cover long-term nursing home care.

45

Medicaid (MediCal in California) - Source of funding:

Both federal and state governments (the state contribution is determined by average per capita income of the state).

46

Medicaid - Eligibility:

1. Indigent (very low income) people.
2. 1/3 of all funds is allocated for nursing home care for indigent elderly people.
3. Covers about 25 million people.

47

Medicare - Coverage:

1. Inpatient and outpatient hospital care.
2. Physician services.
3. Home health care, eg hospice care, lab tests, dialysis, ambulance service, medical equipment.
4. Prescription drugs.
5. Long-term nursing home care.
6. Dental care, eyeglasses, hearing aids.
7. No co-payment or deductible.

48

EMTALA?

Hospitals are LEGALLY required to provide care to anyone needing EMERGENCY MANAGEMENT whether they have the means to pay or not via the Emergency Medical Treatment and Active Labor Act (EMTALA).

49

Gender and health - Women or men are more likely to seek health?

WOMEN.

50

Women are at higher risk than men for developing:

1. Autoimmune diseases.
2. MS.
3. Alcohol- and smoking-related illnesses.
4. AIDS (when they are already HIV(+) and have the same viral load as a man).
5. Cataracts.
6. Thyroid disease.

51

Age and health - The eldelry comprise ...% of the population.

12%.

52

The elderly incur over ...% of ALL HEALTH CARE COSTS.

30%.
--> Expected to rise to 50% by 2020.

53

Leading causes of death by age group (across sex and ethnic groups) - Infants (

1. Congenital anomalies.
2. Sudden infant death syndrome (SIDS).
3. Prematurity/Low birth weight.

54

Leading causes of death by age group (across sex and ethnic groups) - Children (1-4yr):

1. Accidents (in motor vehicles and in the home).
2. Congenital anomalies.
3. Cancer (Leukemia and CNS malignancies).

55

Leading causes of death by age group (across sex and ethnic groups) - Children (5-14yrs):

1. Accidents (most in motor vehicles).
2. Cancer (Primarily leukemias and CNS malignancies).
3. Homicide and legal intervention.

56

Leading causes of death by age group (across sex and ethnic groups) - Adolescents (15-24yrs):

1. Accidents (most in motor vehicles).
2. Homicide and legal intervention.
3. Suicide.

57

Leading causes of death by age group (across sex and ethnic groups) - Adults (25-44yrs):

1. Accidents (most in motor vehicles).
2. AIDS.
3. Cancer.

58

Leading causes of death by age group (across sex and ethnic groups) - Adults (45-64yrs):

1. Cancer.
2. Heart disease.
3. Stroke and other cerebrovascular diseases.

59

Leading causes of death by age group (across sex and ethnic groups) - Elderly (65yrs of age and over):

1. Heart disease.
2. Cancer.
3. Stroke and other cerebrovascular diseases.

60

Leading causes of death by age group (across sex and ethnic groups) - ALL AGES COMBINED:

1. Heart disease.
2. Cancer (lund, breast/prostate, and colorectal, in descending order).
3. Stroke and other cerebrovascular diseases.

61

Health care delivery systems - Hospitals - According to the American Hospital Association, the United States has close to ...?

6.000 hospitals with about 1.000.000 beds.