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21 Cards in this Set

  • Front
  • Back
Fraud
The providing of unneccassary services or the billing of services not provided
Access
The ability to use affordable, convient, and effective health care services in a timely manner
TQM
synonymous with continuous quality improvement
Reliablilty
extent to which the same result is obtained during repeated trials
PRO
Statewide private organization that is paid by the federal government to review the care of Medicare recipient
APG
ambulatory patient group
Clinical practice guidelines
explicit descriptions of preferred clinical processes or treatment protocols
Administrative costs
The costs of financinbg, managing, delivering, and paying for health care
Validity
extent to which a scale actually measures what it purports to measure
Certificate of need
State legislation intended to control capital expedentures
Quality
degree to which the health services increase the desired outcome and follow established professionalknowledge and guidelines
Outcome
often viewed as bottom-line measure of effectiveness
Cost efficiency
the relationship between increasing medical expedentures and improvement of health levels
Critical pathway
time line with specific interventions and expected outcomes
Quality assurance
a step beyond quality assessment
quality assessment
measurement of quality against and established standard
defensive medicine
ordering tests solely to protect against malpractice
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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