The US Health System

Question 1

International Classification of Diseases (ICD)

Answer 1

now in its tenth version,
from the World Health Organization, provides a standard
coding system

Question 2

Current Procedural Terminology
(CPT) codes

Answer 2

from the American Medical Association. Both
coding systems

Question 3

Diagnosis Related Groupings
(DRGs)

Answer 3

from the Centers for Medicare and Medicaid

Question 4

British physician John Snow

Answer 4

first documented recording of population health data to monitor trends in health and disease to determine the source of causation.
Snow, a nineteenth-century anesthesiologist from London,
England, is credited with systematically studying a cholera
epidemic in his community and identifying polluted drinking
water as the source.

Question 5

Florence Nightingale, a nurse in the British military in the
1860s serving in the Crimean War

Answer 5

horrible sanitary
conditions and linked that to the unnecessary death of many
British soldiers, also decades before the discovery of the
germ theory of disease. She used detailed accounts and statistics in a presentation to the Royal Commission on the
Health of the Army. Instead of using tables for her data,
which was the standard method, she used data visualization
in the form of a ‘rose diagram’ (Fig. 4.2) or modifed pie
chart to show the staggering differences that sanitation made
in the mortality of the injured troops in the hospital at Scutari.

Question 6

Health Information Exchange (HIE) networks

Answer 6

e individual patient
health information is now aggregated within large health
care organizations/systems for clinical decision support

Question 7

Health System

Answer 7

sum of organizations, institutions, and resources focused on health at a
high level

Question 8

Health care delivery

Answer 8

the resources and
processes which enable people to receive health care services

Question 9

Providers

Answer 9

all organizations, services, and resources
(including the workforce) that directly deliver or facilitate
healthcare services to patientsAcute care hospitals, primary care physician offces, dental
offces, rehabilitation facilities, home health services, telemedicine, and numerous other organizations and services are
considered providers within the health care delivery system.

Question 10

Health Care Delivery: Payers

Answer 10

Organizations (public and private) that fnance health care
services, such as government-sponsored health insurance
programs (Medicaid and Medicare), as well as commercial
insurance carriers, managed care organizations, and selfinsured employers, are commonly referred to as payers.
Although healthcare payers are typically larger organizations or entities, individuals directly paying for their services
are also considered a payer within the health care delivery
system.