ph162 quiz2

allopathic medicine

practiced by MDs, views medical treatment as an active intervention to counteract and neutralize the effects of disease

osteopathic medicine

praticed by DOs, emphasizes musculoskeletal system of the body like correction of joints or tissues

generalists

most DOs, PCPs

specialists

must seek certification in an area of medical specialization; requires years of advanced residency training and practice

primary care

first-contact care, the entry point to the health system. longitudinal because it includes initial diagnosis, treatment, referral, consultation, monitoring and follow-up. Focuses on the person as a whole

specialty care

centers on particular diseases or organ systems of the body, generally follows primary care and requires referral from PCPs

maldistribution in the supply of medical professionals and its implications

refers to a surplus or a shortage of the type of physicians needed to maintain the health status of a given population at an optimal level. Both shortages and surpluses result in increased health care expenditures without yielding a positive return in health outcomes. The US faces this in terms of both geography and specialty

“Allied Health” professionals

someone who has received a ceritificate, associates, bachelors, or masters degree; doctoral-level preparation; or post-baccalaureate training in a science related to health care and has responsibility for the delivery of health or related services. 2 broad categories: technicians/assistants & therapists/technologists.

medical technology

the practical application of the scientific body of knowledge for the purpose of improving health and creating efficiencies in the delivery of health care

nanomedicine

seeks to manipulate materials on the atomic and molecular level

precision/personalized medicine

the customization of disease treatment based on genetic, environmental, and lifestyle factors of individual patients

health information technology (IT)

deals with the transformation of data into useful information. includes medical records

clinical information systems

support patient care delivery. e.g. electronic medical records

administrative information systems

assist health care staff in carrying out financial and administrative support activities. e.g. payroll, patient accounting, billing, materials management, budgeting and cost control, office automation

electronic health records (EHRs)

IT applications that enable the processing of any electronically stored information pertaining to individual patients for the purpose of delivering health care services

HIPAA Act

makes it illegal to gain access to patient’s personal health information (PHI) for reasons other than health care delivery, operations, and reimbursement

HITECH Act

provided financial incentives for hospitals and physician offices/clinics to adopt EHRs

E-health

all forms of electronic health care delivered over the internet

M-health

the use of wireless communica ion devices to support public health and clinical practice; mobile health

telemedicine

distance medicine; employs telecommunications technology for medical diagnosis and patient care. eliminates need for face-face contact between clinician and patient

telehealth

encompasses telemedicine, educational, research, administrative uses; clinical applications that involve a variety of professionals like physicians, nurses, psychologists, pharmacists

synchronous technology

allows telecommunication to occur in real time

asynchronous technology

employs store-and-forward technology that allows users to review the information later

self-referral

physicians sending patients to facilities in which the referring physician or a family member has an ownership interest or some kind of compensation arrangement

how does the system address self-referral

congress passed legislation curtailing the practice, based on the theory of provider-induced demand which could create overutilization and result in increased health care costs

role of FDA in regulating drugs, devices, biologics

responsible for ensuring that drugs and medical devices are safe and effective for their intended use. also controls access to drugs by deciding whether a certain drug will b available by prescription or OTC

outpatient/ambulatory care

constitutes diagnostic and therapeutic services and treatments provided to the “walking” patient

secondary care

short term, involving sporadic consultation from a specialist to provide expert opinion and surgical or other advanced interventions that PCPs are not equipped to perform. e.g., hospitalization, routine surgery, specialty consultation, and rehabilitation

tertiary care

provided for relatively uncommon conditions. rendered in large teaching hospitals like university hospitals. e.g., trauma care, burn treatment, neo natal intensive care, tissue transplants, open heart surgery

gatekeeping

patients do not visit specialists and are not admitted to a hospital without first being referred by their PCPs

growth in outpatient services compared to inpatient services

in the US, outpatient surgeries increased from 16.3% in 1980 to 66.3% in 2015. this decline in inpatient procedures has been outpaced by the growth of outpatient/ambulatory procedures

emergent conditions

critical and require immediate medical attention, time delay is harmful to the patient, acute disorder and potentially threatening to life or function

urgent conditions

require medical attention within a few hours, a longer delay presents possible danger to patient, acute disorder but not severe enough to be life threatening

nonurgent conditions

do not require the resources of an emergency service, nonacute disorder / not severe

inpatient care

overnight stay in a health care facility

historical development and transformation of hospitals

1840-1900: from merely supplying food, shelter and insufficient care to the poor, sick, insane, armies, persons infected with contagious diseases or requiring emergency treatment - they began to provide skilled medical and surgical attention and nursing care to all classes of people. hospitals became centers of medical training and research. most recent transformations have been organizational in nature as hospitals have consolidated into medical systems

discharge data

indicates the total number of patients discharged from the hospital’s acute care beds during a given period (including deaths)

inpatient days/patient days

a night spent in the hospital by a patient

average length of stay (ALOS)

= (total days of care)/(total # of discharges). measured the number of days that a patient spends in the hospital on average

average daily census

average number of inpatients receiving care each day in a hospital

occupancy rate

= (average daily census)/(average # of beds)

public hospitals

owned by agencies of federal, state, or local governments

private nonprofit hospitals

owned and operated by community associations or other nongovernment organizations, primary mission to benefit the community in which they are located. patient fees, third-party reimbursement, donations, and endowments cover their operating expenses

private for-profit hospitals

owned by individuals, partnerships, or corporations. they are accountable to their stockholders. aka investor-owned hospitals

general hospitals

provides variety of services, including general and specialized medicine, general and specialized surgery, obstetrics, to meet almost all medical needs of its community. provides diagnostic, treatment, and surgical services for patients. most US hospitals are this

specialty hospitals

establishments that primarily engage in providing diagnostic and medical treatment to inpatients with a specific type of disease or medical condition. e.g., rehabilitation hospitals and childrens hospitals

managed care

an organized approach to delivering a comprehensive array of health care services to a group of enrolled members through efficient management of services needed by the members and negotiation of prices or payment arrangements with providers

historical growth of managed care

rapid cost escalations in the 70s and 80s under the fee-for-service system. employers, who mostly paid the entire cost of health insurance premiums for employees, began switching to managed care after they experienced escalations in premium costs. HMO Act of 1973 provided some federal support for creation of HMOs and made this alternative to fee-for-service medicine more well-known

case management

advanced level of care coordination that uses a client centered approach for evaluating and coordinating care, particularly for patients who have complex, potentially costly problems. e.g. AIDS, spinal cord injury, bone marrow transplant, lupus, cystic fibrosis

disease management

population-oriented strategy for people with chronic conditions (asthma, diabetes, depression, coronary artery disease). focuses on patient education, training in self-management, ongoing monitoring of the disease process, and follow-ups

preferred provider organization (PPO)

establishes contracts w a select group of physicians and hospitals, the enrollee can use out of network providers but at a higher cost sharing

health maintenance organization (HMO)

provides medical care during illness AND offers variety of services to help people maintain their health

MCO influence on cost, quality, and access

managed care provides cost savings and better value for money than traditional reimbursement insurance