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Study sets matching "health care delivery systems"

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Study sets matching "health care delivery systems"

Health Care Delivery System
prospective payment system PPS
diagnosis-related groups DRGs
capitation
managed care
payment mechanism for reimbursing hospitals for inpatient hea…
groups of inpatient services with fixed reimbursement amounts…
payment mechanism in which a provider i e health care network…
decribes health care systems in which there is administrative…
prospective payment system PPS
payment mechanism for reimbursing hospitals for inpatient hea…
diagnosis-related groups DRGs
groups of inpatient services with fixed reimbursement amounts…
129 terms
Health Care Delivery System
Who is the biggest consumer of healthc…
Federal governmentpays for联邦政府
Professional Standards Review Organiza…
PSROs
The federal government
Medicare... Medicaid医疗补助计划
A program created by the federal government联邦政府 to review the…
Professional Standards Review Organizations
Who is the biggest consumer of healthc…
The federal government
Federal governmentpays for联邦政府
Medicare... Medicaid医疗补助计划
Health Care Systems and Delivery
Inpatient Setting
Outpatient Setting
Observation Status
2 kinds of Public Ownership include
Admitted to the hospital and stays at least 24 hours
Only receives treatment for a few hours, and does not stay ov…
not admitted to the hospital, although they stay overnight,th…
federal, state/local
Inpatient Setting
Admitted to the hospital and stays at least 24 hours
Outpatient Setting
Only receives treatment for a few hours, and does not stay ov…
13 terms
Health Care Delivery Systems
Delivery Systems
AIDS
Communicable Disease
Documentation
is a facility or organization that provides health care servi…
is a disease that suppresses the immune system so that it is…
is a type of infectious disease that is caused by microorgani…
is written communication that contains very specific and impo…
Delivery Systems
is a facility or organization that provides health care servi…
AIDS
is a disease that suppresses the immune system so that it is…
40 terms
Health care & delivery systems
Healthcare
Example of delivery systems
Services
Consumes
Facility or organization that provides health care services
Hospitals,medical offices, etc.
Card provided by the health care
The person who receives the services
Healthcare
Facility or organization that provides health care services
Example of delivery systems
Hospitals,medical offices, etc.
9 terms
Health care delivery systems
Services
Consumers
Health care personnel
Payment for services
The care provided by the health care facilitly
The person who recieves the services
The person who distributes the services
Paying for the care you recieve
Services
The care provided by the health care facilitly
Consumers
The person who recieves the services
35 terms
Health Care Delivery Systems
2 categories of health care systems.
Acute Medical Care systems
Primary care
2˚ care
Acute Medical Care System.... Post-acute care system
1˚... 2˚... 3˚... quatemary care
common, nonchronic, episodic disorders. provides cre in conte…
treat common, chronic-type disorders. long-term care required…
2 categories of health care systems.
Acute Medical Care System.... Post-acute care system
Acute Medical Care systems
1˚... 2˚... 3˚... quatemary care
12 terms
Health Care Delivery Systems
Components of Health Care Systems
Components: Participants
Components: Settings
Components: Regulatory Agencies
Participants... Settings... Regulatory Agencies... Health care financi…
Consumers... Licensed Providers... Unlicensed Providers
Hospitals... Homes... Skilled-nursing, assisted-living, and extende…
U.S. Department of Health and Human Services... U.S. Food and Dr…
Components of Health Care Systems
Participants... Settings... Regulatory Agencies... Health care financi…
Components: Participants
Consumers... Licensed Providers... Unlicensed Providers
22 terms
Health Care Delivery Systems
National Priorities:
According to Institute of medicine, nu…
PRSO's
PPS
Patient and family engagement... Population health... Safety/elimin…
Practicing to the full extent of their education and training…
Professional standards review organizations (used for medicar…
Prospective payment system
National Priorities:
Patient and family engagement... Population health... Safety/elimin…
According to Institute of medicine, nu…
Practicing to the full extent of their education and training…
129 terms
Health Care Delivery System
Who is the biggest consumer of healthc…
Federal government pays for
Professional Standards Review Organiza…
PSROs
The federal government
Medicare... Medicaid
A program created by the federal government to review the qua…
Professional Standards Review Organizations
Who is the biggest consumer of healthc…
The federal government
Federal government pays for
Medicare... Medicaid
Health Care Delivery Systems
organizational structure
informational, support, diagnostic, an…
determines a workers position in a fac…
All members of the health care staff a…
what helps a facility run smoothly by outlining the responsib…
what are the four divisions within a health care facility?
What does a line of authority do?
What is interdependence?
organizational structure
what helps a facility run smoothly by outlining the responsib…
informational, support, diagnostic, an…
what are the four divisions within a health care facility?
20 terms
Health Care Delivery Systems
Case management
Case method
Client-focused care
Clinical pathway
Range of models for integrating health care services for indi…
System in which one nurse is responsible for the comprehensiv…
Delivery model that brings all services and care providers to…
Method for tracking the client's progress, planning care, and…
Case management
Range of models for integrating health care services for indi…
Case method
System in which one nurse is responsible for the comprehensiv…
19 terms
Health Care Delivery Systems
Hospitals
Long-term Care Facilities
Medical Offices
Dental offices
Institution that provides medical or surgical care and treatm…
Mostly for elderly, disabled, or handicaps
Any type of doctors office including family practice, dental,…
An office that works inside the mouth
Hospitals
Institution that provides medical or surgical care and treatm…
Long-term Care Facilities
Mostly for elderly, disabled, or handicaps
Health care Delivery Systems
Hospice
optometrist
co-payment
emergency care
provides palliative or supportive care for terminally ill pat…
a person who practices optometry.
The amount a person pays each month for their health care ins…
An emergency service is any health care service provided to e…
Hospice
provides palliative or supportive care for terminally ill pat…
optometrist
a person who practices optometry.
18 terms
health care delivery systems
case management
coinsurance
critical pathways
diagnosis-related groups (DRGs)
describes a range of models for integrating health care servi…
is the percentage share (usually 20%) of a government-approve…
A critical pathway is an interdisciplinary plan or tool that…
This legislation limits the amount paid to hos- pitals that a…
case management
describes a range of models for integrating health care servi…
coinsurance
is the percentage share (usually 20%) of a government-approve…
20 terms
health care delivery systems
Levels of health care
Qsen
Preventive care
Preventive care ex
Preventive, primary, secondary, tertiary, restorative, contin…
Quality and safety education for nurses
Focuses on educating and equipping clients to reduce and cont…
Immunization, stress mngt, seat belt use
Levels of health care
Preventive, primary, secondary, tertiary, restorative, contin…
Qsen
Quality and safety education for nurses
25 terms
Health Care Delivery Systems
dentist
physician
optometrist
ophthalmologist
specializes in diagnosing and treating diseases and disorders…
a medical doctor
a person skilled in testing for defects of vision in order to…
physician who studies and treats diseases of the eye
dentist
specializes in diagnosing and treating diseases and disorders…
physician
a medical doctor
25 terms
Health care delivery systems
dentist
physician
optometrist
ophthalmologist
specializes in diagnosing and treating diseases and disorders…
a medical doctor
a person skilled in testing for defects of vision in order to…
physician who studies and treats diseases of the eye
dentist
specializes in diagnosing and treating diseases and disorders…
physician
a medical doctor
11 terms
Health care delivery systems
Managed care
Case management
Inclusion of case management
Case manager
Used to describe strategies in the healthcare delivery system…
Healthcare delivery strategy that supports managed-care using…
Assessment, development of a plan of care, coordination of al…
A professional nurse who assumes responsibility for coordinat…
Managed care
Used to describe strategies in the healthcare delivery system…
Case management
Healthcare delivery strategy that supports managed-care using…
29 terms
Health Care Delivery Systems
In which healthcare delivery framework…
Health care settings include..
An urgent care center is a type of amb…
Primary care centers employ more nurse…
Managed care
Hospitals... Primary care centers... Ambulatory care centers and cl…
Answer: A. True... An urgent care center is a type of ambulator…
Answer: B. False... Hospitals employ more nurses than any other…
In which healthcare delivery framework…
Managed care
Health care settings include..
Hospitals... Primary care centers... Ambulatory care centers and cl…
13 terms
HealthCare Delivery Systems
Health maintenance Organizations
Levels of Healthcare Services
Managed Care
Case Management
- provide health care directed toward preventative care... - ser…
Primary: health edu and disease prevention... Secondary: most ho…
quality healthcare delivered in cost effective way with prude…
a process for planning, coordinating and monitoring pt care a…
Health maintenance Organizations
- provide health care directed toward preventative care... - ser…
Levels of Healthcare Services
Primary: health edu and disease prevention... Secondary: most ho…
32 terms
Health Care Delivery Systems
Health care system
primary prevention
secondary prevention
tertiary prevention
the totality of services offered by all health disciplines
consists of health promotion and illness prevention
consists of diagnosis and treatment
consists of rehabilitation, health restoration, and palliativ…
Health care system
the totality of services offered by all health disciplines
primary prevention
consists of health promotion and illness prevention
35 terms
Health Care Delivery Systems
Health Care Delivery Systems
public hospital types
Private hospital types
outpatient health delivery types
-inpatient... -outpatient
-federal (VA)... -state... -prison
-not for profit... -for profit... (both are a tax distinction)
- ambulatory healthcare... - can be: private practice, comunity…
Health Care Delivery Systems
-inpatient... -outpatient
public hospital types
-federal (VA)... -state... -prison
11 terms
Health Care Delivery Systems
Acquired Immune Deficiency Syndrome (A…
Communicable
Delivery Systems
Documentation
AIDS, or acquired immune deficiency syndrome, is a disease th…
A communicable disease is a type of infectious disease that i…
Facility or Organization that provides health care services
Medical documentation is written communication that contains…
Acquired Immune Deficiency Syndrome (A…
AIDS, or acquired immune deficiency syndrome, is a disease th…
Communicable
A communicable disease is a type of infectious disease that i…
9 terms
Health care delivery systems
Medicare
Medicaid
Patient Protection and Affordable Care…
Primary Prevention -
Age : 65 years old or older / 장애잇는 65세 이하.... 이 두개만 메디케어에 들어감... b…
United States Government and individual State Government... eli…
millions of Americans- many of whom had been uninsured- have…
incorporates health promotion and illness prevention... Goal is…
Medicare
Age : 65 years old or older / 장애잇는 65세 이하.... 이 두개만 메디케어에 들어감... b…
Medicaid
United States Government and individual State Government... eli…
Health Care Delivery Systems
health care big issues
Patient protection and affordable care…
Nurses' role in health care reform
Primary Prevention
access to health care... quality and safety... affordability
expand coverage, control health care costs, and improve the h…
the focus of nursing care provided by all nurses is holistic…
an intervention implemented before there is evidence of a dis…
health care big issues
access to health care... quality and safety... affordability
Patient protection and affordable care…
expand coverage, control health care costs, and improve the h…
25 terms
Health Care Delivery Systems
hospice
co-payment
premium (health)
deductible
provides palliative or supportive care for terminally ill pat…
the portion of a service fee that a patient must pay
the amount a person pays each month for their health care ins…
specified amount of money that the insured must pay for cover…
hospice
provides palliative or supportive care for terminally ill pat…
co-payment
the portion of a service fee that a patient must pay
38 terms
Health Care Delivery Systems
Related concepts
Patient/Client
Environment
Health
patient, environment, health, nursing, health care delivery s…
"...include individuals, families, groups, communities, and p…
"...is the aggregate of all objects, conditions, forces, and…
"...a dynamic process between the patient and environment. Op…
Related concepts
patient, environment, health, nursing, health care delivery s…
Patient/Client
"...include individuals, families, groups, communities, and p…
15 terms
Health Care Delivery Systems
Primary Care (Health Promotion)
Preventative Care
Secondary Acute Care
Tertiary Care
(acute) focuses on improved health outcomes for an entire pop…
examples: blood pressure and cancer screening, immunizations,…
Emergency care, acute medical-surgical care, radiological pro…
intensive care, subacute care
Primary Care (Health Promotion)
(acute) focuses on improved health outcomes for an entire pop…
Preventative Care
examples: blood pressure and cancer screening, immunizations,…
15 terms
Health Care Delivery Systems
Services
Consumers
Health care personnel
Payment for services
The care provided by the healthcare facility
The patients, the people who receive the service
The person who distributes the services, each person provides…
Paying for the care that you get, insurance determines how mu…
Services
The care provided by the healthcare facility
Consumers
The patients, the people who receive the service
19 terms
Health Care Delivery Systems
Quality Improvement
Utilization Management
Third Party Reimbursement Methods
Capitation
a facility must maintain a Quality Improvement committee whic…
fuction of ensuring that resources are being effectively and…
schemes today greatly adds to the complexity of the practices…
healthcare provider is paid a fixed amount on a per patient b…
Quality Improvement
a facility must maintain a Quality Improvement committee whic…
Utilization Management
fuction of ensuring that resources are being effectively and…
10 terms
Health Care Delivery Systems
Health Care System
Medicare
Medicaid
Primary Care
Comprised of various healthcare settings & services, policies…
- For pts. 65+ or with a permanent disability... - Created in 19…
- Government assisted program for impoverished people... - Combi…
- Incorporates health promotion & illness prevention... - Addres…
Health Care System
Comprised of various healthcare settings & services, policies…
Medicare
- For pts. 65+ or with a permanent disability... - Created in 19…
Health Care Delivery Systems
Hospital
Clinic
Rehabilitation Center
Long term care
Religion based, corporate owned, education based
Multiple medical specialties in one facility
Therapy received to restore function
Formerly called nursing homes
Hospital
Religion based, corporate owned, education based
Clinic
Multiple medical specialties in one facility
22 terms
health care delivery systems
U.S. healthcare in the 20th century
Healthcare and Care Coordination in th…
care coordination
Healthcare Around the world: Compariso…
Increased specialization and use of technology led to signifi…
Private and public services... Systems:... Providers (i. e., physic…
Responsibility of all healthcare clinicians, especially nurse…
Single Payer... Tax $ fund health insurance provided to all resi…
U.S. healthcare in the 20th century
Increased specialization and use of technology led to signifi…
Healthcare and Care Coordination in th…
Private and public services... Systems:... Providers (i. e., physic…
43 terms
health care delivery systems
access to health care
primary prevention
secondary prevention
tertiary
decreasing the number of uninsured; 2010... patient protection…
health promotion and illness prevention
diagnosis and treatment; prevention of complications
rehabilitation and health restoration
access to health care
decreasing the number of uninsured; 2010... patient protection…
primary prevention
health promotion and illness prevention
20 terms
Health Care Delivery Systems
Describe the functions and purposes of…
Government Agencies
Physicians' Offices
Ambulatory Care Centers
Government Agencies.... Physicians' Offices.... Ambulatory Care Cen…
Public health services.... Local health departments programs to…
Primary care setting.... Routine health screening or Diagnosis a…
Diagnostic treatment facilities.... Minor surgery.... May or may no…
Describe the functions and purposes of…
Government Agencies.... Physicians' Offices.... Ambulatory Care Cen…
Government Agencies
Public health services.... Local health departments programs to…
14 terms
Health Care Delivery Systems
Health Maintenance Organization
Long Term Care Facilities
Medical Offices
Mental Health
Basic medical services, health, education, examinations. Type…
Extended, Skilled nursing. Independent living and assisted li…
Private offices, large complexes that employ many doctors.
A persons condition with regard to their psychological and em…
Health Maintenance Organization
Basic medical services, health, education, examinations. Type…
Long Term Care Facilities
Extended, Skilled nursing. Independent living and assisted li…
Health Care Delivery Systems
Forms Of Dental Care Delivery: *Local…
Forms Of Dental Care Delivery: *State…
Forms Of Dental Care Delivery: *Federa…
Forms Of Dental Care Delivery: *Privat…
-School based dental programs... -Oral rinse programs... -Sealants…
-School based health centers... -State prison system... -State hosp…
-Community health centers: FQHC (federally qualified health…
-Many community health centers... -Colleges/Universities... -Hospit…
Forms Of Dental Care Delivery: *Local…
-School based dental programs... -Oral rinse programs... -Sealants…
Forms Of Dental Care Delivery: *State…
-School based health centers... -State prison system... -State hosp…
16 terms
Health Care Delivery Systems
health care big issues
Patient protection and affordable care…
Nurses' role in health care reform
Primary Prevention
access to health care... quality and safety... affordability
expand coverage, control health care costs, and improve the h…
the focus of nursing care provided by all nurses is holistic…
an intervention implemented before there is evidence of a dis…
health care big issues
access to health care... quality and safety... affordability
Patient protection and affordable care…
expand coverage, control health care costs, and improve the h…
20 terms
Health Care Delivery Systems
Medicare Part A
Medicare Part B
Medicare Part C
Medicare Part D
Free part that is financed by payroll taxes and pertains to h…
Extra premium that can be purchased monthly voluntarily and c…
Advantage plan that person can choose to purchase
Voluntary monthly premiums for medications
Medicare Part A
Free part that is financed by payroll taxes and pertains to h…
Medicare Part B
Extra premium that can be purchased monthly voluntarily and c…
38 terms
Health Care Delivery Systems
Delivery system
Examples of delivery systems
Services
Consumers
Is a facilty of organization that provides healthcare services
Hospitals, long term care facilities, medical offices, labora…
Anything the health care industry does for you
The person that recives the services
Delivery system
Is a facilty of organization that provides healthcare services
Examples of delivery systems
Hospitals, long term care facilities, medical offices, labora…
29 terms
health care delivery systems
state health organization
local health department
federal government
In order to comply with the U.S. Depar…
responsible for assisting the local health departments
has the responsibility for:... -developing programs to meet the…
functions include:... -conducting research and providing trainin…
-Organize a park​ "cleanup day" to assure that the​ community…
state health organization
responsible for assisting the local health departments
local health department
has the responsibility for:... -developing programs to meet the…
35 terms
Health Care Delivery Systems
Gerald is having surgery done on his k…
___ plans connect you with a primary c…
Medicaid is a medical assistance progr…
___ provides people at the age of 65 a…
C
B
not d/B
B
Gerald is having surgery done on his k…
C
___ plans connect you with a primary c…
B
28 terms
Health Care Delivery Systems
Supplemental Security Income (SSI)
Children's Health Insurance Program (C…
Special Supplemental Nutrition Program…
Diagnosis-Related Groups (DRGs)
benefits for individuals with disabilities/are blind who are…
program established in 1997 to provide insurance coverage for…
program that provides nutritious foods, healthy eating info,…
system of classifying any inpatient stay into groups to deter…
Supplemental Security Income (SSI)
benefits for individuals with disabilities/are blind who are…
Children's Health Insurance Program (C…
program established in 1997 to provide insurance coverage for…
8 terms
Health Care Systems and Delivery
Inpatient Settings
Outpatient Settings
Observation Status
Ownership Public
Admitted to the hospital... Stay at least 24 hours
Only receives treatment for a few hours... Does not stay overnight
Not admitted to the hospital, although is staying overnight... M…
Federal ... State/ Local... Prison
Inpatient Settings
Admitted to the hospital... Stay at least 24 hours
Outpatient Settings
Only receives treatment for a few hours... Does not stay overnight
12 terms
Health Care Delivery Systems
SSI (supplemental security income)
CHIP (Children's Health insurance Prog…
WIC (women, infants, & Children) Program
Medicare created when and by whom?
for individuals with disabilities or may be blind and may not…
est. 1997 to provide insurance coverage for poor or working c…
special supplemental nutrition program
Lyndon Johnson in 1965... Title 18
SSI (supplemental security income)
for individuals with disabilities or may be blind and may not…
CHIP (Children's Health insurance Prog…
est. 1997 to provide insurance coverage for poor or working c…
28 terms
Health Care Delivery Systems
What ares some challenges to health ca…
what are some national priorities?
what is the IOM
what is/are the PSROS
reducing healthcare costs while maintaining high-quality care…
patient and family engagement... population health... safety/elimin…
institue of medicine... practice education and training... achieve…
professional standards review organizations; created to revie…
What ares some challenges to health ca…
reducing healthcare costs while maintaining high-quality care…
what are some national priorities?
patient and family engagement... population health... safety/elimin…
55 terms
Health Care Delivery Systems
What are the ultimate goals of managed…
What are two types of managed care?
How do HMOs function?
How do HMOs function for the members?
costs are reduced, effectiveness of care is improved so less…
Health Maintenance Organizations (HMO) and Preferred Provider…
annual payment made on behalf of members to a group of provid…
they have a limited choice of providers and a referral is nee…
What are the ultimate goals of managed…
costs are reduced, effectiveness of care is improved so less…
What are two types of managed care?
Health Maintenance Organizations (HMO) and Preferred Provider…
49 terms
Health Care Systems and Delivery
Inpatient settings
outpatient settings
observation status
public ownership
admitted to the hospital, stays at least 24 hours
only receives treatment for a few hours, does not stay overni…
not admitted to the hospital, although is staying overnight.…
federal, state/local, prison
Inpatient settings
admitted to the hospital, stays at least 24 hours
outpatient settings
only receives treatment for a few hours, does not stay overni…
12 terms
Health Care Delivery System
Compare and contrast primary, secondar…
Discuss the services provided for clie…
Discuss the collaborative roles of var…
Explore factors affecting healthcare d…
...
...
...
...
Compare and contrast primary, secondar…
...
Discuss the services provided for clie…
...
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