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Policy Week 4
Terms in this set (37)
Chronic conditions are how common in US? How often do they lead to death?
Leading cause of death in the world
#1 cause of mortality/morbidity in USA
Why have chronic conditions become a bigger problem that acute conditions in the US (5)
Increased knowledge of genetics
ACA supports initiatives for improved -- of care and reimbursement for :
Improved quality of care
Reimbursement for "quality not quantity"
US -- more diseases but is not a healthier nation:
**Increased cost does not equal increased healthcare quality
Chronic disease costs more than --% of the nation's healthcare budget
We are paying --- but:
We are paying more for treatment of chronic disease but we are not a healthier nation
Philosophy of primary care includes what characteristics? (6)
Focused on safety and quality
What are the dimensions of patient centered care? (8)
Respect for patients' values, preferences, and expressed needs
Information and education
Access to care
Emotional support to relieve fear and anxiety
Involvement of family and friends
continuity and secure transition between healthcare settings
Coordination of care
Primary care is built on the Chronic Care Model..what does this mean?
Approach that requires a whole-person orientation and relationship between patient and provider which is regular, accessible, and mutual
Longterm care and relationship between a provider and a patient
Includes the 8 dimensions of patient centered care
Patient care is led by
What is the Patient-Centered Medical Home (PCMH)?
-Started in 1967 as:
-Turned into a model or philosophy of primary care that is (6)
-Includes reimbursement for:
-At the core of PCMH:
-It is an initiative that:
Started in 1967 as a place where all medical information about a patient would be located
Turned into a model or philosophy of primary care that is patient-centered, comprehensive, team-based, coordinated, accessible, and focused on quality and safety
The Patient-Centered Medical Home (PCMH) is a care delivery model whereby patient treatment is coordinated through their primary care physician to ensure they receive the necessary care when and where they need it, in a manner they can understand.
Includes reimbursement for system based care rather than quantity
At the core of a PCMH, there must be a physician-patient relationship and the PCMH must occur within a physician led practice setting
An initiative that blends comprehensive care with quality and reimbursement
How did the American College of Physicians (ACP) expand PCMH?
Expanded it to include reimbursement incentives for the management and coordination of care
Reimbursement in this model would support system-based vs. volume based care, that is, payment based on a process of care delivery that assures positive outcomes rather than the volume of patients seen by a given provider
Core values in a medical home that are fundamental nursing skills (4)
Patient centered care
Orientation of the Whole person
Consideration of the patient's emotional, social and educational needs
Coordinate care across multiple communities and health care agencies
What is a medical home?
A model of philosophy of primary care that is patient-centered, comprehensive, team based coordinated, accessible and focused on quality and safety
Lobbied for name change from Medical home to Health home - not successful
The term Medical home refers to:
The term Health home refers to:
Medical home = medicare
Health home = medicaid
-Physical and mental health?
-Who is often the caregiver?
-Gender of caregivers?
Negative effects on physical and mental health
Burnout - they often work other full time or part time jobs
Depletion of financial resources - lost wages, pensions, retirement funds, benefits
Can create secondary stress
Most family caregivers - not prepared for caregiving
Typically females are the ones providing cares -- society classifies women as nurturing caregivers
What can the government do to help prepare caregivers for caregiving? (4)
Assess caregiver, educate and provide support
Need to provide resources (money and nursing)
We must update our Medicare and Medicaid programs to support these families (should provide for assessment of caregiver needs and include in care plan)
Assess emotional and mental stability of caregivers
Look at patient and caregiver as:
People do better when they are cared for in what environment?
At home - in their own environment
Family caregivers save money, but may need to:
Pay something up front in order for them to learn the necessary skills
What is the fastest growing segment of medicare?
What are the 5 segments of home care?
Home medical equipment (HME)
Home infusion pharmacy (HIP)
Hospice can be located in what 2 environments?
At home or in skilled facilities
Issues with long term services r/t policy and politics (LTSS)
-Weak enforcement of:
-Financial classification of nursing home?
-Inadequate assistance with:
-Inadequate monitoring and treatment of:
Poor quality of care
Weak enforcement of of federal quality regulations for care
Inadequate staffing levels (single most important contributing factor to poor quality of nursing home care)
For profit nursing homes (tend to operate with lower costs and lower staffing)
Financial accountability of government for long term care (nothing stops LTSS from cutting staff or quality and keeping the money they earn from medicare/medicaid for profit)
Inadequate assistance with ADLs
Inadequate monitoring and treatment of acute and chronic conditions
Who sets the standard of care for LTSS?
If long term facilities show compliance with LTSS, they receive:
Increased funding for nursing homes
**23% cited for actually causing harm or immediate endangering patients
Many LTSS facilities FAILED to meet standards of care in what areas of service? (4)
Many LTSS facilities received deficiencies in what areas? (3)
-Adequate infection control
-Failure to meet professional standards
-Failure to provide comprehensive care plans
-Giving unnecessary drugs
LTSS inadequate staffing levels
-Major factor that:
-Increased RN staffing has been shown to: (4)
-States with higher minimum staffing standards have
Major factor to poor quality of care in nursing home
Studies have shown that more RN staffing creates:
-Improved mortality rates
-Better Physical functioning
-Less infection rates
-Less Pressure ulcers
States with higher minimum staffing standards have:
-Lower deficiency citations
-higher nursing staffing levels
-Improved quality outcomes
LTSS for profit and non-profit
-Operate on a lower budget & lower level staffing (like more LPNs than RNs)
-Billions of dollars in revenue
-Higher level staffing
-Higher quality of care
-More trustworthy governance
Was marijuana legal or illegal until 1936?
Marihuana Tax act of 1937
-What is it?
Stopped the use of MJ for medical use (which had previously been completely legal for doctors to use) - stopped when people started dangerously using it for recreation
Alliance for Cannabis Therapeutics (ACT)
-What is it?
-Who formed it?
A nonprofit organization to let others know about the therapeutic benefits of cannabis and how patients could get a legal, federally approved supply of it
Formed by a man who used marijuana to treat glaucoma (Robert Randall)
The investigational new drug program for access to marijuana shut down in 1992 because:
Because of the increasing demand/requests
Medical MJ is different from recreational because:
they use the oil that is not addictive and does not have the same effects as THC
Barriers to legalization of medical marijuana:
--- presented as ---
-Laws and regulations that:
-Federal promotion of an image based on:
Misinformation presented as facts
Censorship of information
Laws and regulations that prevent research
Federal promotion of an image based on racism and ideology rather than science and reality
Pharmaceutical industry pressure to prevent potential competition
Strategies for furthering legalization of medical marijuana?
Building a coalition
Starting non-profit organizations
Educate public through media
U.S Department of Veterans Affairs issued a new directive called --- which:
Medical Marijuana Directive in which to provide guidance on access to and the use of cannabis by veterans
Sets found in the same folder
Escape Fire questions
Policy Week 1
Policy Week 2
Policy Week 3
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US Healthcare - Final
Track 3 - Patient Centered Medical Care
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