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77 Cards in this Set
- Front
- Back
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the jungle
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1906
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typhoid mary
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1907
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penicillin discovered
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1920's
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penicillin first used as antibiotic
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1940's
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was the first implant and where
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kidney, africa
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surgeon general warning
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1960's
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small pox irradicated,
healthcare starts to increase at alarming rate |
1970's
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what is a DRG?
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diagnostic related group- know how much they will get before surgery.
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when was social securiuty enacted?
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1935
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the hill burton act
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1946- increases number of hospitals to get 4.5 beds per 1000 people
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when we get medicare and medicaid?
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1965
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when did truman enact HMO's
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1973
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what is a gate keeper?
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a referring physician
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capitacion
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fixed amount per individual in accordance with the census (as opposed to a percentage of income).
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utilization review?
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Utilization review is a health insurance company's opportunity to review a request for medical treatment. The purpose of the review is to confirm that the plan provides coverage for your medical services
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what is managed care?
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-Managed care is a generic term for various health care payment systems that attempt to contain costs by controlling the type and level of services provided.
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what term is used synonomously with managed care?
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HMO's
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what are the different types of HMO's?
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-staff
-group -network |
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what are the trends when it comes to employee based health insurance?
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-trends are that the rate is decreasing except for those companies with at least 200 workers
--another trend is that it is cheaper for individuals. |
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moral hazard
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Moral hazard is the prospect that a party insulated from risk may behave differently from the way it would behave if it were fully exposed to the risk.
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adverse selection
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The tendency of those in dangerous jobs or high risk lifestyles to get life insurance.
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how many hospitals in US?
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4956
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how many hospitals in IL?
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211
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how much goes into diabetes treatment in IL alone
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- $269,454
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how much goes into diabetes treatment in IL
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20%
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what is LOS and what is it for bypass surgery?
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average length of stay, 8.5 days
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what was term used back in the 1800's where they provide food and shelter to the destitute?
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municipal aimhouses
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who was the victim of the economic restraints?
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rural hospitals
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used as a place for quarantine?
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penthouses
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cared for mostly the paying patients?
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voluntary hospitals
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who has the lowest hospitalization stats in US? why?
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western US, they are younger, and healthier
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who was run by a governing board and promoted by Ben Franklin?
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The Pennsylvania Hospital in Philadelphia
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what is highest level trauma center?
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level I
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Discoveries that transformed hospitals?
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antibiotics, anesthesia
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what are some Indicators used to measure hospital performance?
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Reports, surveys. Money, return patients
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what are some trends in hospitalization by users?
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age, ethnicity, gender, SES
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pay members on a PMPM scale
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capitation per member per month
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understanding what means success in healthcare?
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the iron triangle
cost quality access |
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what does 501 c 3 status work with/for
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United States and the tax system
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who visits the free clinics?
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uninsured blacks females mostly and underinsured
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What are barriers to care for users of free clinics?
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language, financial, economical
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what must be done before starting a free clinic? (?)
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1. needs assessment
2. community support 3. willing to serve uninsured 4. hospital support 5. diverse governing board (5) |
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what are good and bad incentives called?
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carrots and sticks
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The common thread binding free clinics together is?
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their dependence on
volunteers. |
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where does all the money in healthcare go?
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over half goes to hospitals and doctors
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what was the GDP in 2007?
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17% 2.4 trillion
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what are 3 major categories of health care expenditures? the largest?
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1) **people and their time
2) equipment 3) materials and supplies ** largest |
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what are the direct costs of healthcare?
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dr.'s, nurses, and equipment
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indirect costs to healthcare?
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hospitals, parking lots, hallways
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how many deaths occir annually because of medical errors
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98,000
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what is a prevetion cost?
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helps to prevent defective items from occuring
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what are appraisal costs?
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detecting problems before reaching client
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internal failure costs
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detecting a problem before getting to client
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external failure costs?
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detecting problem after reaching client, such as bad rxn to drugs
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top 1% consume how much of country's healthcare?
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30%
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how many uninsured?
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46 million
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what r the steps for opening a free clinic?
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1 assess 2 partnership 3 strategies 4 evaluate
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what is a key strategy in free clinics?
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fund raising
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ACTUAL 501 (c) 3 status?
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legal not for profit status
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what is ideal outcome of developmemt assisstance?
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to become more developed
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cant be ignored
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role of politics
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with the baby boom popiulation, they realized that what wouldnt work?
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indemnity care will not work
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Risk Sharing?
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everyone puts money into a huge pot and hoping that only a select few will use it
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not as much goes into the pot now because of?
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the uninsured
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many people ill because ?
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of poor life style choices
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idea behind managed care?
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balance care and delivery
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how do u balanmce care and financial aspect of healthcare?
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accessibility, cost & affordability, quality of care
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why do prices keep rising?
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to help the inured pay for the uninsured
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positives about managed care?
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-practices must be followed
-shown by research to have benefits such as health and wellness and education |
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what is consumerism?
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a number of strategies aimed at driving helth care costs
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what lifestyle choices are the hardest to modify?
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eating, smoking, consuming, excercising
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the best incentive programs will do what?
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provide many alternatrives to help in gaining lifestyle changes
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what are goals of employment based incentiive programs
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- improve hnealth
- decrease presenteeism and absenteeism |
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what are the steps to success om your career?
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- pay attention
- be passionate |
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the best wellness programs use what?
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simplest incentives that work
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current belief on incentives?
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positive rewards are more motivating
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tganglible incentives? intangible?
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cash-most motivating, merchandise, vacation days, reduving health insuranve premioum
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