Term
| What makes the US healthcare system unique: |
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Definition
-No automatic coverage
-A true "system" does not exist
-The existing "system" is fragmented
-Continuously changes |
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Term
| How many people does the US health system employ? |
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Definition
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Term
| Name the "Functions" of the "Quad Function Model": |
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Definition
Financing
Insurance
Payment
Delivery |
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Term
| Name the 7 Major Elements that Affect he US Health Care System: |
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Definition
Political Climate
Economic Development
Technological Progress
Social and Cultural Values
Physical Environment
Population characteristics
Global Influences |
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Term
| Name the 3 categories of medical care services: |
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Definition
Curative
Restorative
Preventative |
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Term
| 10 Basic Characteristics that Differentiate the US Health Care Delivery System: |
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Definition
1. No Central Agency
2. Partial Access
3. Imperfect Market
4. Third-Party Insurers and Payers
5. Multiple Payers
6. Power Balancing
7. Litigation Risks
8. High Technology
9. Continuum of Services (care is segmented by specialties)
10. Quest for Quality |
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Term
| Name the three basic models of healthcare found in other Countries: |
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Definition
1. National health insurance
2. National Health system
3. Socialized Health Insurance |
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Term
| List the four dimensions of Holistic Health: |
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Definition
1. Physical
2. Social
3. mental
4. Spiritual |
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Term
| Three types of conditions in relation to type of care required: |
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Definition
1. Acute
2. Sub-acute
3. Chronic |
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Term
| LIst three contributions to the RISE in Chronic Conditions: |
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Definition
1. New technology
2. Screening and diagnosis
3. Lifestyle Choices |
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Term
| List three types of Prevention: |
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Definition
1. Primary: prevent illness all together
2. Secondary: early detection and intervention
3. Tertiary: manage chronic illness to avoid additional complications |
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Term
| What is "Public Healths" focus? |
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Definition
| on things that THREATEN public health |
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Term
| List Blum's Determinants of Health: |
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Definition
1. Environment
2. Lifestyle
3. Heredity
4. Medical Care |
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Term
| Name the two statistical measures used to assess a population's physical health: |
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Definition
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Term
| Name the four different categories of "health" |
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Definition
1. Physical
2. Mental
3. Spiritual
4. Social |
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Term
| 5 factors negatively affecting Preindustrial Medicine: |
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Definition
1. Medical Practice was in disarray
2. Procedures were primitive
3. Institutional Core was missing
4. Medical education was substandard
5. Demand was unstable (free-market) |
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Term
| Name the seven factors the lead to the growth of professional sovereignty in Postindustrial Medicine: |
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Definition
1. Urbanization
2. Science and Technology
3. Institutionalization
4. Dependency
5. Autonomy and organization
6. Licensing
7. Educational Reform |
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Term
| Name three aspects of the Globalization of Healthcare: |
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Definition
1. U.S. corporations expanded overseas
2. Medical care by U.S. providers in demand overseas
3. Global health discipline |
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Term
| When was the need for health insurance recognized? |
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Definition
| during the Great Depression |
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Term
| In what sector did U.S. insurance begin? |
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Definition
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Term
| What makes the ACA so controversial? |
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Definition
| passed without consensus among Americans |
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Term
| What were the two over-arching effects of the ACA? |
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Definition
-provisions helped low-income Americans obtain insurance
-Placed a greater financial burden on the middle class |
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Term
| Name the two types of Physicians: |
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Definition
DO- Practice Osteopathic Medicine
MD- Practice Allopathic medicine |
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Term
| Name the two subtypes of Maldistribution of Physicians: |
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Definition
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Term
| International Medical Graduates make up approximately what percentage of professionally active U.S. physicians? |
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Definition
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Term
| What is the fundamental difference between a Dental Hygienist and a Dental Assistant? |
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Definition
| A Dental Hygienist must be licensed while an assistant does not. |
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Term
| LIst the four areas of Nurse specialization: |
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Definition
1. Clinical Nurse Specialists (CNS)
2. Certified registered nurse anesthetists (CRNA)
3. Nurse Practitioners (NP)
4. Certified nurse-midwives (CNM) |
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Term
| Three types of Midlevel Providers that can substitute for a physician in certain cases: |
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Definition
-Nurse Practitioner
-Physician Assistant
-Certified Nurse-midwives |
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Term
| Name three types of medical IT systems: |
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Definition
1. Clinical information systems
2. Administrative information systems
3. Decision Support systems |
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Term
| Name the two primary ways technology has been a blessing to the healthcare industry: |
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Definition
-Reduced complications and disability
-Increased longevity |
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Term
| What is the fundamental burden imposed by health IT? |
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Definition
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Term
| What is the Medical Technology? |
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Definition
-The application of scientific knowledge to improve health and efficiencies.
- The transformation of data into useful information |
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Term
| What is Health Informatics? |
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Definition
| The application of information science. |
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Term
| Name the four components of an EHR system: |
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Definition
1. Collection and storage of EHI over time
2. Provides immediate access to the record for providers and patients alike
3. Provides access to knowledge and decision support
4. Supports efficient health care delivery processes |
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Term
| Difference between Telemedicine and Telehealth? |
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Definition
| Telemedicine is the use of technology to provide remote patient care, while Telehealth is a comprehensive term, often involving multiple "telemedicine" encounters accross multiple disciplines. |
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Term
| Two different types, or characteristics of telemedicine: |
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Definition
| synchronous and asynchronous |
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Term
| Name 4 areas in which the Government place a role in Technology Diffusion: |
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Definition
1. Regulation of drugs, devices, and biologics
2. Certificates of Need
3. Research on Technology
4. Funding for research |
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Term
| 4 assessments of Medical Technology: |
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Definition
1. Efficacy
2. Safety
3. Cost-effectiveness
4. Cost-benefit |
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Term
| What is Private Health Insurance also known as? |
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Definition
| "Voluntary Health Insurance" |
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Term
| List three types of cost-sharing: |
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Definition
Deductible
Copayment
Coinsurance |
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Term
| How does insurance affect the demand for healthcare? |
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Definition
|
|
Term
| E (healthcare expenditures) = |
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Definition
| P(price) X Q (quantity of services consumed) |
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Term
| Name the four fundamental principles of Insurance: |
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Definition
1. Risk is unpredictable for the insured
2. Risk can be predicted with a reasonable accuracy
3. Transfers risk from the individual to the group
4. Members of the insured group share losses |
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Term
| What type of private insurance funding makes up the highest percentage in the US? |
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Definition
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Term
| Name the six main ACA provisions as it pertains to insurance: |
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Definition
1. Extends a child's dependency to age 26.
2. Illegal to discriminate against pre-existing conditions
3. All plans must cover certain "essential benefits"
4. Fee on insurers for selling plans through the exchanges
5. Medical loss ratio
6. Requires U.S. residents to have health insurance at risk of heavy tax penalty. |
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Term
| Three main types of Public Health Insurance available in the US: |
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Definition
1. MEDICARE: elderly and disabled
2. MEDICAID: for the indigent (income-based)
3. DoD Programs (TRICARE)
4. VA
5. CHIP - for children
6. Indian Health Service |
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Term
| Name the two facets of the Payment function: |
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Definition
1. Pre-determine amounts and method of delivery
2. Actual payment after services are rendered |
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Term
| Name 8 types of payment structures: |
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Definition
1. Fee for service
2. Bundled payments
3. Resource-based relative value scale
4. value-based reimbursement
5. Managed care approaches (capitation)
6. Cost-plus reimbursement
7. Prospective reimbursement
8. Disbursement of Funds |
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Term
| Name three fact about the National Health care Expenditure: |
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Definition
-$3.2 Trillion
-$9,990 per-capita
-Represents 17.8% of US GDP |
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Term
| What does health care financing determine? |
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Definition
-Who pays for health care services and for whom
-Who produces which types of health care servcies |
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Term
| Three types of private health insurance: |
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Definition
1. Group Insurance
2. Individual
3. Self-insurance (investment vehicle) |
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Term
| Three types of private health insurance: |
|
Definition
1. Group Insurance
2. Individual
3. Self-insurance (investment vehicle) |
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