U. S. Healthcare Review Questions Chapter 8

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ACADEMIC MEDICAL CENTER

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WHEN ONE OR MORE HOSPITALS WITH OR WITHOUT AFFLIATED OUTPATIENT CLINICS ARE ORGANIZED AROUND A MEDICAL SCHOOL

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ACCREDITATION (HOSPITALS)

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A PRIVATE MECHANISM DESIGNED TO ASSURE THAT ACCREDITED HEALTH CARE FACILITIES MEET CERTAIN BASIC STANDARDS, MANDATED FOR RECEPIENTS OF MEDICARE / MEDICAID FUNDING

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ADVANCE DIRECTIVES

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REFER TO THE PATIENT'S WISHES REGARDING CONTINUATION OR WITHDRAWL OF TREATMENT WHEN THE PATIENT LACKS DECISION MAKING CAPACITY

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VERAGE DAILY CENSUS

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THE AVERAGE NUMBER OF INPATIENTS RECEIVING CARE EACH DAY IN A HOSPITAL

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INPATIENT

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USED IN CONJUNCTION WITH AN OVERNIGHT STAY IN A HEALTHCARE FACILITY

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HOSPITAL

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AN INSTITUTION WITH AT LEAT SIX BEDS WHOSE PRIMARY FUNCTION IS TO DELIVER PATIENT SERVICES, DIAGNOSTIC AND THEREAPEUTIC, FOR PARTICULAR OR GENERAL MEDICAL CONDITIONS

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VOLUNTARY HOSPITALS

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NONPROFIT HOSPITALS FINANCED THROUGH LOCAL PHILANTHROPY AS OPPOSED TO TAXES

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BOARD OF TRUSTEES

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MEMBERS OF THE GOVERNING BOARD ELECTED FROM THE GROUP OF CONTRIBUTORS TO FUND THE HOSPITAL, RESPONSIBLE FOR MAKING THE LAWS AND REGULATIONS RELATING TO THE HOSPITAL'S OPERATION

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SWING BEDS

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ALLOWS SMALL RURAL HOSPITALS TO SWITCH THE USE OF HOSPITAL BEDS BETWEEN ACUTE CARE AND LONG TERM SKILLED NURSING FACILITY CARE AS NEEDED

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DISCHARGE

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REFERS TO THE TOTAL NUMBER OF PATIENTS DISCHARGED FROM A HOSPITAL'S ACUTE CARE BEDS IN A GIVEN PERIOD

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INPATIENT DAY

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(PATIENT / HOSPITAL DAY) A NIGHT SPENT IN THE HOSPITAL BY A PATIENT

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DAYS OF CARE

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THE CUMULATIVE NUMBER OF PATIENT DAYS OVER A CERTAIN PERIOD

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AVERAGE LENGTH OF STAY (ALOS)

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CALCULATED BY DIVIDING THE TOTAL DAYS OF CARE BY THE TOTAL NUMBER OF DISCHARGES
TOTAL DAYS OF CARE / TOTAL DISCHARGES

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AVERAGE DAILY CENSUS (DEFINITION)

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THE AVERAGE NUMBER OF INPATIENTS RECEIVING CARE EACH DAY IN A HOSPITAL; USED TO DEFINE OCCUPANCY OF INPATIENT BEDS

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OCCUPANCY RATE

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AVERAGE DAILY CENSUS FOR A PERIOD DIVIDED BY THE AVERAGE NUMBER OF BEDS (CAPACITY)

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AVERAGE DAILY CENSUS (FORMULA)

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TOTAL INPATIENT DAYS / NUMBER OF DAYS IN THE SPECIFIED PERIOD OF TIME

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PUBLIC HOSPITALS

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OWNED BY FEDERAL, STATE, OR LOCAL GOVTS

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PROPRIETARY HOSPITALS (INVESTOR OWNED)

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FOR PROFIT HOSPITAL OWNED BY INDIV, PARTNERS, CORPORATIONS

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COMMUNITY HOSPITAL

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A NONFEDERAL SHORT STAY HOSPITAL WHOSE SERVICES ARE AVAILABLE TO THE GENERAL PUBLIC

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MULTIHOSPITAL SYSTEM

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WHEN TWO OR MORE HOSPITALS ARE OWNED, LEASED, SPONSORED, OR CONTRACTUALLY MANAGED BY A CENTRAL ORGANIZATION

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GENERAL HOSPITAL

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PROVIDES GENERAL AND SPECIALIZED MEDICINE, GENERAL AND SPECIALIZED SURGERY, AND OBSTETRICS, TO MEET THE GENERAL MEDICAL NEEDS OF THE COMMUNITY IT SERVES

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SPECIALTY HOSPITAL

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ESTABLISHMENTS THAT PRIMARILY ENGAGE IN PROVIDING DIAGNOSTIC AND MEDICAL TREATMENT TO INPATIENTS WITH A SPECIFIC TYPE OF DISEASE OR MEDICAL CONDITION, EXCEPT SERVICES FOR PSYCHIATRIC CARE AND SUBSTANCE ABUSE

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REHABILITATION HOSPITALS

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SPECIALIZE IN THERAPEUTIC SERVICES TO RESTORE THE MAXIMUM LEVEL OF FUNCTIONING INPATIENTS WHO HAVE SUFFERED RECENT DISABILITY DUE TO AN EPISODE OF ILLNESS OR AN ACCIDENT

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SHORT STAY HOSPITAL

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ONE IN WHICH THE AVERAGE LENGTH OF STAY IS 25 DAYS OR LESS

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URBAN HOSPITAL

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LOCATED IN A COUNTY THAT IS PART OF A METROPOLITAN STATISTICAL AREA

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RURAL HOSPITALS

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ARE LOCATED IN A COUNTRY THAT IS NOT PART OF A METROPOLITAN STATISTICAL AREA

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CRITICAL ACCESS HOSPITALS

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CERTAIN RURAL HOSPITALS THAT HAVE NO MORE THAN 25 ACUTE CARE AND OR SWING BEDS, AND PROVIDE 24 HOUR EMERGENCY MEDICAL SERVICES

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TEACHING HOSPITAL

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HOSPITAL THAT HAS ONE OR MORE GRADUATE RESIDENCY PROGRAMS APPROVED BY THE AMA

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ACADEMIC MEDICAL CENTER

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WHEN ONE OR MORE HOSPITALS WITH OR WITHOUT AFFILIATED OUTPATIENT CLINICS, ARE ORGANIZED AROUND A MEDICAL SCHOOL

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BOARD OF TRUSTEES

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(GOVERNING BODY OR BOARD OF DIRECTORS), LEGALLY RESPONSIBLE FOR THE OPERATIONS OF THE HOSPITAL, AND FOR DEFINING THE HOSPITAL'S MISSION, LONG TERM DIRECTION, AND SETTING POLICY GUIDELINES

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EXECUTIVE COMMITTEE

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A COMMITTEE THAT HAS CONTINUING MONITORING, RESPONSIBILITY AND AUTHORITY OVER THE HOSPITAL, COLLECTS INFO FROM OTHER COMMITTEES, REPORTS TO BOARD OF TRUSTEES

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MEDICAL STAFF COMMITTEE

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COMMITTEE CHARGED WITH MEDICAL STAFF RELATIONS (PRIVILEGE AND PERFORMANCE)

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CHIEF OF STAFF

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MEDICAL DIRECTOR, HEADS THE MEDICAL STAFF

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CHIEF OF SERVICE

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CHIEF OF A MEDICAL SPECIALTY DEPT

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CREDENTIALS COMMITTEE

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GRANTS AND REVIEWS ADMITTING PRIVILEGES FOR THOSE ALREADY CREDENTIALED AND FOR NEW DOCTORS WHOSE SKILLS ARE YET UNTESTED

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MEDICAL RECORDS COMMITTEE

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ENSURES THAT ACCURATE DOCUMENTATION IS MAINTAINED ON THE ENTIRE REGIMEN OF CARE GIVEN TO EACH PATIENT, OVERSEES CONFIDENTIALITY ISSUED RELATED TO MED RECORDS

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UTILIZATION REVIEW COMMITTEE

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PERFORMS ROUTINE CHECKS TO ENSURE THAT INPATIENT PLACEMENTS AS WELL AS LENGTH OF STAY ARE CLINICALLY APPROPRIATE

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INFECTION CONTROL COMMITTEE

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RESPONSIBLE FOR REVIEWING POLICIES AND PROCEDURES FOR MINIMIZING INFECTIONS IN THE HOSPITAL

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QUALITY IMPROVEMENT COMMITTEE

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RESPONSIBLE FOR OVERSEEING THE PROGRAM FOR CONTINUAL QUALITY IMPROVEMENT

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LICENSURE

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OVERSEEN AND REGULATED BY THE STATE; REQUIREMENT OF ALL FACILITIES

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CERTIFICATION

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GIVES THE HOSPITAL AUTH TO PARTICIPATE IN MEDICARE/ MEDICAID

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CONDITIONS OF PARTICIPATION

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PROTECTS PATIENT HEALTH AND SAFETY AND HELP ASSURE THAT QUALITY CARE IS FURNISHED TO ALL HOSPITAL PATIENTS

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ACCREDITATION

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PRIVATE MECHANISM DESIGNED TO ASSURE THAT ACCREDITED HEALTH CARE FACILITIES MEET CERTAIN BASIC STANDARDS (VOLUNTARY)

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DEEMED STATUS

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HOSPITAL MEETS MEDICARE/ MEDICAID CERTIFICATION STANDARDS, VERIFIED BY JOINT COMMISSION

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MAGNET HOSPITAL

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A SPECIAL DESIGNATION BY THE AMERICAN NURSES CREDENTIALING CENTER TO RECOGNIZE QUALITY PATIENT CARE, NURSING EXCELLENCE, AND INNOVATIONS IN PROFESSIONAL NURSING PRACTICE IN HOSPITALS

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PATIENT'S BILL OF RIGHTS

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REFLECTS THE LAW CONCERNING ISSUES SUCH AS CONFIDENTIALITY AND CONSENT

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INFORMED CONSENT

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BASED ON THE PRINCIPLE OF AUTONOMY; FUNDAMENTAL PATIENT RIGHT; REFERS TO THE PATIENT'S RIGHT TO MAKE AN INFORMED CHOICE REGARDING MEDICAL TREATMENT

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PATIENT CENTERED CARE

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PRINCIPLES GOVERNING PATIENTS RIGHTS ARE BEING INCORPORATED INTO PROVIDER MINDSETS AND ORGANIZATION CULTURE; REVOLVES AROUND PATIENT INPUTS AND NEEDS

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ADVANCE DIRECTIVES

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REFERS TO THE PATIENT'S WISHES REGARDING CONTINUATION OR WITHDRAWAL OF TREATMENT WHEN THE PATIENT LACKS DECISION MAKING CAPACITY

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DO NOT RESUSCITATE ORDER

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DIRECTS MEDICAL CAREGIVERS NOT TO ADMINISTER ANY ARTIFICIAL MEANS TO RESUSCITATE THE PERSON WHEN HIS/HER HEART OR BREATHING STOPS

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LIVING WILL

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COMMUNICATES A PATIENTS WISHES REGARDING MEDICAL TREATMENT WHEN HE/ SHE IS UNABLE TO MAKE DECISIONS DUE TO TERMINAL ILLNESS

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DURABLE POWER OF ATTORNEY

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A WRITTEN LEGAL DOCUMENT IN WHICH THE PATIENT APPOINTS ANOTHER INDIVIDUAL TO ACT AS THE PATIENT'S AGENT FOR PURPOSES OF HEALTH CARE DECISION MAKING IN THE EVENT THAT PATIENT IS UNABLE OR UNWILLING TO MAKE SUCH DECISIONS

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ETHICS COMMITTEES

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DEVELOP GUIDELINES AND STANDARDS FOR ETHICAL DECISION MAKING IN THE DELIVERY OF HEALTH CARE

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MORAL AGENT

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THE MANAGER MORALLY AFFECTS AND IS MORALLY AFFECTED BY ACTIONS TAKEN

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WHAT IS THE DIFFERENCE BETWEEN INPATIENT AND OUTPATIENT SERVICES

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INPATIENT IS CHARACTERIZED BY AN OVERNIGHT STAY A HEALTHCARE FACILITY

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AS HOSPITALS EVOLVED FROM RUDIMENTARY CUSTODIAL AND QUARANTINE FACILITIES TO THEIR CURRENT STATE, HOW DID THEIR PURPOSE AND FUNCTION CHANGE?

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FUNCTION WENT FROM SUPPLYING FOOD, SHELTER, MEAGER MEDICAL CARE TO THE SICK, THOSE INFECTED WITH DISEASE, THE INSANE, AND THOSE REQUIRING EMERGENCY TREATMENT TO ORGANIZED INSTITUTIONS OF MEDICAL PRACTICE, TRAINING, AND RESEARCH

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WHAT WERE THE (6) MAIN FACTORS RESPONSIBLE FOR THE GROWTH OF HOSPITALS UNTIL THE LATTER PART OF THE 20TH CENTURY

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-ADVANCES IN MEDICAL SCIENCE
-DEVELOPMENT OF SPECIALIZED TECHNOLOGY
-ADVANCES IN MEDICAL EDUCATION
-DEVELOPMENT OF PROFESSIONAL NURSING
-GROWTH OF HEALTH INSURANCE
- ROLE OF GOVT

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NAME THE THREE FORCES THAT HAVE BEEN RESPONSIBLE FOR HOSPITAL DOWNSIZING. HOW HAVE EACH OF THESE FORCES BEEN RESPONSIBLE FOR THE DECLINE IN INPATIENT HOSPITAL UTILIZATION

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CHANGES IN HOSPITAL REIMBURSEMENT: PROSPECTIVE PAYMENT SYSTEM, HOPS ARE PAID A FIXED AMT PER ADMISSION BASED ON DIAGNOSIS, NOT ON AMT OF STAY

RURAL HOSPITAL CLOSURES: DUE TO ECONOMIC CONSTRAINTS

IMPACT OF MANAGED CARE:EMPHASIZED ALTERNATIVE DELIVERY SETTINGS (OUTPATIENT, HOME HEALTH CARE, ETC) TO DECREASE INPATIENT COSTS IN THE HOSPITALS

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WHAT IS A VOLUNTARY HOSPITAL? EXPLAIN. HOW DID VOLUNTARY HOSPITALS EVOLVE IN THE US

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NONPROFIT COMMUNITY HOSPITALS FINANCED THROUGH LOCAL PHILANTHROPY AS OPPOSED TO TAXES; POOR HOUSES AND ALMS HOUSES--> ALL CLASSES OF SOCIETY, SPECIFICALLY FOR THE SICK

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DISCUSS THE ROLE OF GOVERNMENT IN THE GROWTH , AS WELL AS THE DECLINE OF HOSPITALS IN THE US

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THE HILL BURTON ACT SET OUT TO PROVIDE FEDERAL GRANTS TO STATES FOR THE CONSTRUCTION OF NEW COMMUNITY HOSPITAL BEDS; CREATION OF MEDICARE AND MEDICAID PROGRAMS HELPED INCREASE HOSPITALS BASED ON MAKING HEALTH INSURANCE AVAILABLE TO MORE PEOPLE

TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1982, TRANSFORMED COST PLUS REIMBURSEMENT TO PROSPECTIVE PAYMENT SYSTEM RESULTING IN DIFFICULTIES FOR HOSPITALS TO GENERATE A PROFIT

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WHAT ARE INPATIENT DAYS? WHAT IS THE SIGNIFICANCE OF THIS MEASURE

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NIGHTS SPENT IN THE HOSPITAL BY A PATIENT;REFLECTS ACCESS TO INPATIENT SERVICES, AND THEIR UTILIZATION

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HOW DOES HOSPITAL UTILIZATION VARY ACCORDING TO A PERSON'S AGE, GENDER, AND RACE?

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UTILIZATION IS HIGHEST FOR PEOPLE OVER 75, CHILDREN UNDER 1; FEMALES USE HOSPITAL SERVICES MORE THAN MALES; AND HOSPITALIZATION IS HIGHER AMONG BLACKS THAN WHITES

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DISCUSS THE DIFFERENT TYPES OF PUBLIC HOSPITALS AND THE ROLES THEY PLAY INT THE DELIVERY OF HEALTH CARE SERVICES IN THE US

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THOSE OWNED BY THE GOVERNMENT: FEDERAL (MILITARY, VA, NATIVE AMERICANS); COUNTY / CITY RUN HOSPPITALS: (OPEN TO THE PUBLIC);(LARGE PUBLIC HOSPITALS AFFILIATED WITH MED SCHOOLS - PLAY A SIG ROLE IN TRAINING)

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WHAT ARE SOME OF THE DIFFERENCES BETWEEN PRIVATE AND NONPROFIT AND FOR PROFIT HOSPITALS

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PRIVATE NONPROFIT - OWNED AND OPEERATED BY COMMUNITY ASSOCIATIONS, OR OTHER NONGOV ORGANIZATIONS, MISSION IS TO BENEFIT COMMUNITY, EXPENSES ARE COVERED BY: PATIENT FEES, 3D PARTY REIMBURSEMENT, DONATIONS, AND ENDOWMENTS
FOR PROFIT HOSPITALS- INVESTOR OWNED, OPERATED FOR FINANCIAL BENEFIT OF STOCKHOLDERS