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34 Cards in this Set
- Front
- Back
Managed Care
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Managed Care is a mechanism of providing health care services in which a single organization takes on the management of financing, insurance, delivery, and payment.
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HMO
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Health Maintenance Organization
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PPO
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Preferred Provider Organization
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Enrollee
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(Member) Refers to the individual covered under the plan
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TRICARE
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Military health plan that offers 3 options: TRICARE Prime, Extra, and Standard
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Quasi-market
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?
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Item-based pricing
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?
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market justice
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The principle of market justice places the responsibility for the fair distribution of health care on the market forces in a free economy.
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social justice
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Social justice emphasizes the well-being of the community over that of the individual; thus the inability to obtain medical services because of a lack of financial resources would be considered unjust.
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system
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Consists of a set of interrelated and interdependent components designed to achieve some common goals.
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system structure
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Helps one understand that the structure of health care services in the US is based on foundations, provide logical arrangement, and demonstrate a progression from inputs to outputs.
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system processes
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Hospitals, clinics, and nursing homes associated with distinct health conditions.
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system outcomes
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Refer to the critical issues and concerns surrounding what the health services system has been able to accomplish, or not accomplish, in relation to its primary objective.
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system outlooks
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Projections in the future of accomplishment of desired system outcomes
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medical model
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The medical model presupposes the existence of illness or disease. It therefore emphasizes clinical diagnosis and medical intervention in the treatment of disease or its symptoms.
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health care delivery
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The delivery of medical care or illness care
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WHO
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World Health Organization
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health
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The optimum capacity of an individual to perform his or her expected social roles and tasks, such as work, school, and doing household chores.
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holistic medicine
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Seeks to treat the individual as a whole person
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holistic health
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Incorporates the spiritual dimension as a fourth element in addition to the physical, mental, and social aspects necessary for optimal health.
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acute conditions
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Relatively severe, episodic (of short duration), and often treatable. ex: heart attack
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subacute conditions
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postacute, requiring further treatment after a brief stay in the hospital. ex: head trauma care
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chronic conditions
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Less severe but of long and continuous duration. ex: asthma, diabetes, and hypertension
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quality of life
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the overall satisfaction with life during and following a person's encounter with the health care delivery system.
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planned rationing
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?
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almshouse
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Existed in almost all cities of moderate size and run by the local government. It was a place where the destitute and disruptive elements of society were confined.
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John Hopkins
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University that took the lead in further reforming medical education when it opened its school.
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Flexner Report
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Based on an inspection of medical schools.
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AMA
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American Medical Association
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Blue Cross plans
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A hospital insurance plan designed for teachers at Baylor Univ.
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Medicare Part A
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Designed to use Social Security funds to finance hospital insurance and short-term nursing home coverage after discharge from a hospital
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Medicare Part B
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Designed to cover physicians' bills through government-subsidized insurance in which the elderly would pay part of the premiums
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Medicaid
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Intended to cover the eligible poor, would be financed through federal matching funds to the states based on financial needs determined by each state's per capita income.
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Blue Shield plans
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Plan designed to pay physician fees.
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