The Healthcare Delivery System - Vocabulary Flashcards

Vocabulary flashcards covering key terms from the notes on the healthcare delivery system.

Wellness

Focus on maintaining or improving health and preventing disease; individuals assume more responsibility for their own health.

Client (vs. Patient)

Terminology shift in healthcare emphasizing partnership and active participation in care rather than a passive 'patient' role.

Health Maintenance Organization (HMO)

A managed care plan emphasizing disease prevention and health promotion, usually with prepaid services and in-network providers.

Managed care

A system that coordinates cost, utilization, and quality of care through contracts, networks, and standardized pathways.

Preventive services

Health services designed to prevent illness or detect disease early (e.g., immunizations, screenings, counseling).

Immunization programs

Public or organizational programs that provide vaccines to prevent infectious diseases.

Diabetic support groups

Patient groups offering education and peer support for diabetes management.

Cardiac rehabilitation

A program for people with heart disease focusing on exercise, education, and risk-factor modification.

Critical pathways / care maps / clinical pathways

Standardized, evidence-based plans of care used to guide treatment and coordinate care.

Unlicensed Assistive Personnel (UAPs)

Non-licensed staff who assist with basic caregiving tasks under supervision.

Licensed Vocational Nurse / Licensed Practical Nurse (LVN/LPN)

Licensed nursing personnel providing skilled nursing care under supervision.

Acuity

Level of care intensity and complexity required by a patient.

Affordable Care Act (ACA)

Major health care reform expanding insurance access and consumer protections; promotes preventive care.

Health Insurance Marketplace

Platform for comparing and purchasing health insurance under the ACA.

Patient’s Bill of Rights

Policies protecting patients’ rights and expectations in care and treatment.

Preexisting conditions

Health conditions that exist before enrollment; ACA prohibits denial of coverage for these conditions in many plans.

Medicare Part A

Hospital Insurance; covers inpatient hospital stays, some skilled nursing care, hospice.

Medicare Part B

Medical Insurance; covers outpatient services, doctor visits, preventive services.

Medicare Part D

Prescription drug coverage under Medicare.

Medicaid

Joint federal-state program providing health coverage to low-income individuals and families.

Diagnosis-Related Groups (DRGs)

Classification system used to determine hospital reimbursement based on diagnosis and procedures.

Prospective payment

A predetermined payment amount established before care is provided, tied to DRGs.

Acute Care Hospital

Facility providing short-term, high-intensity inpatient care; general hospitals.

Intensive Care Unit (ICU)

Specialized unit for critically ill patients with advanced monitoring and support.

Subacute care facility

Steep-down facility with intermediate acuity, often after ICU discharge.

Outpatient Care Center

Facility offering same-day procedures or services with patient discharge the same day.

Telehealth

Delivery of health services via telephone, video, or other remote communication technology to improve access.

Extended Care Facility (ECF)

Longer-term care facilities, including nursing homes and rehab centers; may be attached or standalone.

Skilled Nursing Facility (SNF)

ECF providing 24-hour nursing care under RN supervision.

Intermediate Care Facility (ICF)

ECF providing 24-hour services from nursing assistants under supervision.

Hospice

Care focusing on comfort for terminally ill patients; may be part of hospital or private agency.

Respite care

Part-time supervision or relief for the primary caregiver, often involving day-time care.

Home healthcare

Nursing and other services provided in the patient’s home to support recovery.