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21 Cards in this Set
- Front
- Back
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Fraud
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The providing of unneccassary services or the billing of services not provided
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Access
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The ability to use affordable, convient, and effective health care services in a timely manner
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TQM
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synonymous with continuous quality improvement
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Reliablilty
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extent to which the same result is obtained during repeated trials
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PRO
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Statewide private organization that is paid by the federal government to review the care of Medicare recipient
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APG
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ambulatory patient group
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Clinical practice guidelines
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explicit descriptions of preferred clinical processes or treatment protocols
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Administrative costs
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The costs of financinbg, managing, delivering, and paying for health care
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Validity
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extent to which a scale actually measures what it purports to measure
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Certificate of need
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State legislation intended to control capital expedentures
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Quality
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degree to which the health services increase the desired outcome and follow established professionalknowledge and guidelines
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Outcome
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often viewed as bottom-line measure of effectiveness
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Cost efficiency
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the relationship between increasing medical expedentures and improvement of health levels
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Critical pathway
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time line with specific interventions and expected outcomes
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Quality assurance
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a step beyond quality assessment
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quality assessment
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measurement of quality against and established standard
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defensive medicine
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ordering tests solely to protect against malpractice
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What is meant by the term of "health care costs" Describe the three differentmeanings of the term costs.
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How do findings of the Rand Health Insurance Experiment reinforce the relationship between growth in third party reimbursement and increase in health care costs?Explain
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What are some of the reasons for increased health care costs that are attributed to the providers of medical care?
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Discuss the effectiveness of CON regulation in controlling health care expedentures.
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