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Flashcards in Review 1 Deck (73)
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1
Q

uniform anatomic gift act

A

people can have card to grant donation of their organs

-drivers license

2
Q

national organ transplant act

A

1984

  • united network for organ sharing (UNOS)
  • prohibited sale of organs
3
Q

UNOS

A

united network of organ sharing

nonprofit - operates system of distributing organs

4
Q

MELD

A

model for end stage liver disease

properly give out livers

5
Q

stages of moral reasoning for doc

A

pre-convential - black and white

convential - shades of gray

post-convential - no boundaries

6
Q

david hume

A

1947 transplant

attached kidney to arm so her kidneys could recover

7
Q

joe murray

A

transplant

transplanted kidney between twins

both survived

8
Q

christiaan barnard

A

first successful heart transplant

1967

9
Q

uniform determination of death act

A

1981

irreversible cessation of circulation or brain function law of land

10
Q

two focal points transplant ethics

A

donor and recipient

11
Q

issues with focal points transplant ethics

A

scarcity
disparitites
corruption
trafficking

12
Q

WHO guidelines transplantation

A

organs removed only with consent

donors and recipient - genetically, legally, emotionally related

organs allocated - clinical criteria

physician determine death should NOT remove organs

NEVER donate organs for money

13
Q

quality of life

A

level of satisfaction with life

social roles, physical health, intellectual function, emotional state, life satisfaction

14
Q

being well

A

integrity of body

15
Q

feeling well

A

quality of life

16
Q

dax cowart

A

guy got burned - and blind

keeping him alive, didn’t want it

perspective of patient best sets the standard of medical ethics

17
Q

conflict of interest

A

ones obligations vs ones self interest

18
Q

conflict of obligation

A

obligation to one group vs. obligation to another group

19
Q

fiduciary

A

one who is trusted

20
Q

rationing

A

limited care bc of limited resources

21
Q

economic activity

A

group possesses a skill or service that is provided to another for a price

22
Q

economic analysis

A

study of relationship between demand, supply, and price of economic activity

23
Q

market failure

A

failure of an economic system to effectively match supply and demand

often by third party derangement

24
Q

efficiency

A

relationship between cost of providing service and outcome it achieves

25
Q

QALY

A

quality adjusted years of life

unit of health benefit combining mortality with quality of life considerations

26
Q

cost-effective analysis

A

study of cost of treatment to produce desired effect

27
Q

cost-benefit analysis

A

study of relationship between cost of service and benefit it supplies

28
Q

risk benefit analysis

A

study of relationship between probability of harm in course of therapy and its likely benefits

29
Q

time trade-off analysis

A

written instrument used to assess the amount of diminution in quality of life that an individual patient will accept for a therapy likely to extend life by given amount

30
Q

1960

A

advent of insurance

31
Q

managed care

A

patient care subject to limitation or justification

providers - economic credentialing

32
Q

fee for service

A

arrangement where physician provides patient health care services and reimbursed by patient

most incentive for overuse**

33
Q

incentive to limit care given to each individual

A

health maintenance organization

34
Q

health maintenance organization

A

economic arrangement whereby insurance company pledges to care for all patients health care needs for one premium

PCP acts as gatekeeper to specialists

withhold provision - portion of reimbursement withheld at beginning of each year and only returned if HMO makes profit

35
Q

PPO

A

preffered provider organization

insurance company gives patient incentive to use group of providers

36
Q

capitation

A

one set fee per month for each patient, regardless of amount of service provided

37
Q

medicare

A

individuals over 65

hospitals - part A
physicians - part B
pharmacy - part D

38
Q

medicaid

A

low income residents of states

39
Q

EMTALA

A

emergency medical treatment and active labor act - 1986

patient anti-dumping act

ER must - conduct screening exam to determine if emergency exists AND stabilize patient before discharge

40
Q

concierge medicine

A

boutique medicine

physician paid to be available at any time

41
Q

unrestricted advocacy vs. restricted advocacy

A

balance patient preferences, safety, and benefit of treatment, cost effectiveness and cost to patient insurance company

42
Q

gunshot wounds

A

reporting is mandatory

societal need for safety supersedes privacy of patient

43
Q

gifts from industry

A

less than 100$ only if medical or educational in nature

cannot accept gift that are purely to enhance physician income or entertainment

44
Q

need to cause harm

A

to get sued

45
Q

total cost of healthcare in US

A

4.6 trillion

20% GDP

46
Q

bundled payment

A

care for single health care event is payed all at once

surgery, post op care, rehab all payed for together

47
Q

global payments

A

for patients with chronic conditions

encourages continuity of care and coordination among various providers

48
Q

quality incentives

A

pay for performance

49
Q

medical team caring for patient

A

should not ask for donation

50
Q

payment for organ donation

A

only renewable tissues

51
Q

organ donor card

A

family consent still necessary for donation

can overrule donor card

52
Q

average life expectancy

A

15 yrs shorter in low income countries

53
Q

greatest strides in average life expectancy at birth

A

low income countries

mainly due to decreased child mortality rates

54
Q

US rank world for men and women average life expectancy

A

not top 10

UK, spain, san marino, new zealand all higher

55
Q

lower infant mortality rate and under 5 mortality than US

A

UK
sweden
slovenia
singapore

56
Q

higher number of physicians per 10,000 population than US

A

uruguay
ukraine
switzerland
slovakia

57
Q

GDP spent on healthcare in US

A

17%

58
Q

US spends more than what countries (as percent of GDP)

A

canada
denmark
UK
france

59
Q

WHO method for analysis of health system performance ranks US

A

37th

60
Q

US healthcare

A

50% private insurance

50% state and federal

61
Q

uncompensated care

A

61 billion per year

62
Q

cost of medicare and medicaid

A

medicare 524 billion
medicaid 243 billion

total - 767 billion

63
Q

part C of medicare

A

medicare advantage

those who can afford to insure themselves can get insurance policy to cover deductible

64
Q

medicaid

A

poor >133% poverty line
pregnant women, children, moms
medically needy
nursing home care

65
Q

medicaid fiscal problems

A

access - due to low reimbursement

66
Q

ACA

A

affordable care act

require insurance by 2014

67
Q

ACA allow govt panel to make decisions about end of life care

A

no

68
Q

ACA expands medicaid to cover low income adults regardless of whether they have children

A

yes

69
Q

ACA prohibits insurance companies from denying coverage because of past medical history

A

yes

70
Q

business requirement for insurance

A

if >50 employees

71
Q

ACA offer new govt run insurance

A

no

72
Q

ACA has reduced number of uninsured

A

yes

73
Q

sunshine act

A

tell audience you are getting paid to give speech