Dynamics of Healthcare Study Guide (Chapters 1-8)

Vocabulary flashcards covering core terms, concepts, programs, laws, and professional standards across Chapters 1-8 of the Honors Dynamics of Healthcare study guide.

Mortality

The state or condition of being subject to death, or the rate/number of deaths occurring in a specific population over a designated period.

Health Outcomes

Changes in health status resulting from healthcare measures or specific interventions, evaluated primarily in two parts: length of life (mortality) and quality of life (morbidity).

Health Equity

The condition in which everyone has a fair and just opportunity to attain their optimal health through the elimination of avoidable, unjust, and remediable differences.

Social Determinants of Health

Non-medical conditions and factors in the environments where people are born, live, learn, work, play, and age that influence health, functioning, and quality-of-life outcomes.

Affordable Care Act (ACA)

Also referred to as Obama Care, a major healthcare reform law enacted in 2010 designed to expand health insurance coverage, control rising healthcare costs, and improve system efficiency.

US Department of Health and Human Services (HHS)

The principal federal executive department responsible for protecting the health of all Americans and providing essential human services through 11 operating divisions.

Centers for Medicare & Medicaid Services (CMS)

A federal agency within the US Department of Health and Human Services that administers the nation's major healthcare programs, including Medicare, Medicaid, and CHIP.

Centers for Disease Control and Prevention (CDC)

A national public health agency under HHS dedicated to protecting health and safety by controlling and preventing disease, injury, and disability across the United States.

World Health Organization (WHO)

A specialized agency of the United Nations responsible for international public health, coordinating global disease response, and setting worldwide health standards.

Ambulatory Care

Medical services and outpatient care provided to patients who do not require an overnight stay or admission to a hospital or acute care facility.

Behavioral Health

A healthcare discipline focusing on the connection between behaviors and the health and well-being of the mind and body, encompassing mental health conditions and substance abuse disorders.

Patient Care Partnership

A hospital document replacing the Patient's Bill of Rights that outlines patient expectations regarding high-quality care, a clean environment, privacy, and informed consent.

Fee-for-Service (FFS)

A traditional healthcare payment mechanism where healthcare providers are reimbursed individually for each separate medical service, procedure, or test provided.

Capitation

A provider reimbursement arrangement in which a healthcare provider or physician group is paid a set, flat fee per enrolled patient for a specified period, regardless of the volume of care provided.

Managed Care Organization (MCO)

A healthcare delivery system (such as an HMO, PPO, or EPO) that manages costs, healthcare utilization, and quality of care through network contracts and coordinated services.

Activities of Daily Living (ADLs)

Fundamental self-care activities required for basic daily functioning, including bathing, dressing, eating, transferring, and toileting.

Instrumental Activities of Daily Living (IADLs)

Complex daily tasks necessary for independent community living, such as managing money, preparing meals, grocery shopping, housekeeping, and administering medications.

Dual Eligible

A term designating qualifying low-income elderly or disabled individuals who are enrolled simultaneously in both Medicare and Medicaid.

Health Literacy

The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

1973 Older Americans Act

Federal legislation that authorized the establishment of 622 Area Agencies on Aging to support community-based services and independent living for older adults.

Essential Health Benefits

A mandated set of 10 comprehensive categories of health services that insurance plans offering coverage under the Affordable Care Act must include.

Pre-Existing Condition

A health issue, illness, or medical condition that an individual had prior to applying for or enrolling in a health insurance policy.

Electronic Health Record (EHR)

An individual patient health record stored in a computer database for easy access by physicians and other healthcare workers regardless of the setting.

HITECH Act of 2009

Legislation providing incentive payments to hospitals and healthcare providers that demonstrated criteria-based adoption and 'Meaningful Use' of certified electronic health record systems.

Clinical Decision Support System (CDSS)

A health information technology tool providing clinicians, staff, or patients with knowledge and person-specific information, intelligently filtered or presented at appropriate times, to enhance health decisions.

Patient Portal

A secure online web application that allows patients to view, download, and transmit their personal health information, as well as communicate electronically with healthcare providers.

Health Insurance Portability and Accountability Act (HIPAA)

Federal legislation establishing nationwide standards to safeguard patient confidentiality, ensure data security, protect health information privacy, and impose fines for violations.

Health Resources and Services Administration (HRSA)

An agency of the US Department of Health and Human Services tasked with improving access to healthcare for medically vulnerable populations and strengthening the healthcare workforce.

Licensing

A mandatory legal credential granted by a governmental agency permitting an individual to practice an occupation within an established legal scope of practice.

Certification

A voluntary credential granted by a professional association or certifying board verifying that an individual has demonstrated predetermined knowledge, skills, and standards of competence.

Registration

The formal entry or listing of a qualified healthcare professional on an official administrative roster or registry maintained by a professional association or state board.

Accreditation

A formal evaluation process through which an external recognized body assesses and validates that an educational program or healthcare facility meets predetermined standards of excellence.

Negligence

The failure of a healthcare professional to exercise the level of care and skill that a reasonably prudent professional would exercise under similar circumstances, causing injury to a patient.

Malpractice

Professional misconduct or failure to perform legal and professional duties by a licensed provider, the most common form of which is negligence.

Four Elements of Negligence

The legal components necessary to establish a malpractice claim: duty of care, breach of duty, direct causation of injury, and quantifiable damages.

Continuing Education

Ongoing, post-credential instruction and learning required for healthcare professionals to maintain competence, refresh clinical skills, and renew professional licenses or certifications.