Ananya Balusu/PHS Chapter 2/Health Care Systems

What events have led to changes in healthcare?

wars, pandemics, new tech, changing demographics

What are some new health related changes?

new drugs, revised treatments, emerging diseases

Why must health care workers be aware of changes?

To be competent and provide safe, ethical care

What are some current trends in healthcare?

Cost containment, home health care, technology influence, societal shifts

What is cost containment?

controlling rising healthcare costs while achieving maximum benefits for every dollar spent

When was the Affordable Care Act passed?

2010

What are the 4 parts of the Affordable Care Act?

1. Everyone must be insured

2. Everyone has to play

3. The government will help pay

4. Fairer Rules

What is the goal of the Affordable Care Act?

To get more people covered by insurance and cut down the costs of medicine

What are four technological advances that add to the cost of healthcare?

• Organ transplants (heart, lung, liver, kidney)

• Artificial hearts

• Computers for examining internal body parts (CT scans, MRIs)

• Advanced technology prolongs life but increases need for lifelong care

How does an aging population increase healthcare costs?

Increased use of pharmaceuticals, more chronic diseases, greater demand for healthcare services

What are health related lawsuits?

Expensive malpractice and Defensive medicine

What is defensive medicine?

ordering unnecessary tests to avoid lawsuits

What are the consequences of high cost?

Limiting services to those who can pay and potentially reducing access for those unable to pay.

What is a Diagnostic Related Group (DRG)

A congressional attempt to control Medicare/Medicaid costs

What are Hospital-Acquired Conditions

Diseases/illnesses/conditions you get in the hospital

What is Medicare?

medical care for the elderly

What is Fee-for-service?

payment per service rendered, go to doctor multiple times, little incentive to limit cost

What is value-based care?

bundled payments for each diagnosis/ treatment type, go to doctor multiple times for one condition

What are HMOs and PPOs?

Share services and lower cost per patient

What is the combination of services?

Agencies combine services to avoid duplication

What are outpatient services?

Receiving care without hospital admission

What is mass/bulk purchasing?

Buying large quantities at reduced cost

What are early intervention/prevention services?

Education, immunization, physical exams, screening

What is energy conservation?

To monitor and reduce energy use

What is the Agency for Healthcare Research and Quality?

An agency with the purpose of improving quality, accessibility, and affordability to care

What is the Healthcare workers role?

maintain quality while minimizing waste

What is the Healthcare consumers role?

take responsibility, know options, prevent illness

What is home health care?

• Includes nursing care

• physical and occupational therapy

• respiratory therapy

• social services

• nutritional and food services

• homemaking services

What are the advantages of home health care?

• Lower cost than hospital stays

• Familiar environment for patient

• Promotes independence and recovery

What is the definition of geriatric care?

health care for old folks

What is the goal of geratric care?

Meet physical, social, and emotional needs of older adults

What two factors contribute to the growth of geratric care?

Longer life expectancy and the “baby boom” generation aging

What are four examples of geriatric care facilities or services?

Adult day care centers, retirement communities, assisted living facilities, long-term care facilities

What is telemedicine?

It’s the use of video, audio, and computer systems to provide medical services

What are the two methods of telemedicine?

Interactive video conferencing for consultations and exams and Transmission of medical images and data to specialists

What are the benefits of telemedicine?

1. Increased access to care for rural or underserved areas

2. Decreased need for patient travel

3. Quicker specialist consultations

What are three applications of telemedicine?

1. Remote monitoring of chronic conditions

2. Follow-up appointments

3. Emergency services support

Define Wellness

State of optimum health with a balanced relationship between physical, mental, and social well-being

What are five different types of wellness?

1. Physical wellness

2. Emotional wellness

3. Social wellness

4. Mental/intellectual wellness

5. Spiritual wellness

What is the definition of Complementary and Alternative methods of healthcare?

Healthcare outside of regular medicine

What are six examples of CAM therapies?

1. acupuncture

2. tai chi

3. herbal remedies

4. hypnosis

5. acupressure

6. diluted natural substances

What is Pandemic preparedness?

Being prepared for a pandemic

What are two historical examples of pandemics?

1918 influenza and COVID-19 pandemic

What is biotechnology?

The use of genetic and biochemical processes to develop products and technologies in healthcare

What are the potential benefits of biotechnology?

• More effective treatments

• Personalized medicine tailored to genetic profile

What are the four different types of hospitals?

1. General

2. Specialized

3. Government funded

4. University hospitals

What are long term care facilities?

Facilities that serve elderly individuals and people with chronic illnesses or disabilities

What are the different types of long term care facilities?

• Nursing homes

• Assisted living centers

• Independent living communities

What services are provided at long term care facilities?

• Personal care

• Meals

• Basic medical care

• Social support

What are medical offices?

Where you go for checkups or smaller treatments but not emergencies; general or specialized care

What is concierge medicine?

It’s like having a doctor on a “subscription service”; personalized care for a monthly/yearly fee

What are dental offices

Provide care to teeth, gums, and oral health

What are clinics?

Mini hospitals scattered around town for quick access

What do clinics include?

• Surgical clinics

• Urgent care centers

• Rehab clinics

• Specialty centers

What are optical centers?

They provide eye exams, prescriptions and screening for eye diseases

What are emergency care services?

Offer immediate care for accidents or sudden illness

What do emergency care services include?

• Ambulance services

• ER departments

• Helicopter transport

• Urgent care clinics

What are laboratories?

• Medical labs that perform diagnostic tests

• Dental labs create dentures crowns and orthodontic services

What is a hospice?

Provides care for patients with life expectancy under six months

It isn’t about curing but making their last stretch of life peaceful and comfortable

What are mental health facilities?

Provide care for mental illness, emotional disorders and substance abuse

What are genetic counseling centers?

• “DNA Advisors”

• Help patients recover and regain independence after illness or injury

• Provide screening testing and prenatal advice

What are rehabilitation centers?

Help patients recover and regain independence after illness or injury

What do rehabilitation centers include?

• Physical therapy

• Occupational therapy

• Speech therapy

• Recreational therapy

What do HMOs emphasize?

Emphasize preventive care including exams treatment and hospital services

What are industrial health centers?

Located in large workplaces or industries

What do industrial health centers provide?

• Basic medical care

• Health screenings

• Emergency care

• Safety education

What are school health services?

“school nurse” ; found in schools and colleges

Provide:

• Emergency care

• Health screenings

• Immunizations

• Health education

What is the World Health Organization? (WHO)

International disease monitoring and global health info

What is the US Department of Health and Human Services? (USDHHS)

Oversees national health programs

What is the NIH? (National Institutes of Health)

Supports medical research

What is the CDC? (Centers for Disease Control and Prevention)

Prevents and controls disease outbreaks

What is the FDA? (Food and Drug Administration)

Regulates food, drugs, and medicals services

What is the AHRQ? (Agency for Healthcare Research and Quality)

Improves healthcare quality and efficiency

What is OSHA? (Occupational Safety and Health Administration)

Enforces workplace safety standards

What is the ONC? (Office of the National Coordinator for Health Information Technology)

Promotes secure electronic health records

What are state and local health departments?

Provide immunizations inspections and education

What is a voluntary and non profit agency?

Funded through donations, fundraisers and grants.

They offer public education, support services, and research funding.

What are three things associated with the cost of health care?

1. Major concern for everyone who needs health services

2. Health care costs are over 17% of the gross national product

3. Costs increasing faster than other living costs

What is health insurance?

A provider that helps pay for your healthcare

What is a premium?

A free paid to insurance company

What is a coverage?

Company pays for covered medical services

What is a deductible

The amount paid by the patient before insurance pays

What is coinsurance?

Specific percentages shared by the individual and insurance companies. Like an 80/20 split or 50/50 split.

What is a co-payment?

Flat fee per service negotiated by insurance with doctors

What are different sources of insurance?

1. Employer based plans

2. Private policies

What are the advantages of a HMO?

• Early detection

• Better health maintenance

What are the disadvantages of a HMO?

• Limited to affiliated providers