U. S. Healthcare Review Questions Chapter 7

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ACCOUNTABILITY

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A RESPONSIBILITY. CLINICAL SYSTEM IS ACCOUNTABLE FOR PROVIDING QUALITY CARE, PRODUCING PATIENT SATISFACTION, USING RESOURCES EFFICIENTLY, AND BEHAVING IN AN ETHICAL MANNER; PATIENTS ARE RESPONSIBLE THEIR OWN HEALTH TO THE EXTENT OF WHAT THEY CAN INFLUENCE p254

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ADULT DAY CARE

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COMPLEMENTS INFORMMAL CARE PROVIDED AT HOME BY FAMILY MEMBERS WITH PROFESSIONAL SERVICES AVAILABLE IN ADULT DAY CARE CENTERS DURING THE NORMAL WORK DAY p274

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ALTERNATIVE MEDICINE

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(COMPLEMENTARY AND ALTERNATIVE MEDICINE) REFERS TO THE BROAD DOMAIN OF ALL HEALTH CARE RESOURCES OTHER THAN THOSE INTRINSIC TO BIOMEDICINE AND COVERS A HETEROGENEOUTS SPECTRUM OF ANCIENT TO NEW APPROACHES THAT PURPORT TO PREVENT OR TREAT DISEASE p277

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AMBULATORY CARE

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OUTPATIENT SERVICES, DIAGNOSTIC AND THERAPUTIC SERVICES AND TREATMENTS PROVIDED TO THE WALKING PATIENT p249

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CASE MANAGEMENT

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PROVIDES COORDINATION AND REFERRAL AMONG A VARIETY OF HEALTH CARE SERVICES, INTENT IS TO FIND THE MOST APPROPRIATE SETTING TO MEET A PATIENT'S HEALTH CARE NEEDS p274

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CATEGORICAL PROGRAMS

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PROGRAMS SPECIFICALLY DESIGNED TO ADDRESS CERTAIN CATEGORIES OF DISEASE OR TO SERVE SPECIFIC CATEGORIES OF PERSONS p274

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COMMUNITY ORIENTED PRIMARY CARE

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BASED ON THE CONCEPT OF 'ECOLOGY OF CARE', EMPHASIZES THE RELATIONS BETWEEN THE POPULATION & COMMUNITY, AND PERSONAL HEALTH CARE p256

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DURABLE MEDICAL EQUIPMENT

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SUPPLIES AND EQUIPMENT NOT IMMEDIATELY CONSUMED, SUCH AS OSTOMY SUPPLIES, WHEELCHAIRS, AND OXYGEN TANKS p577

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EMERGENT CONDITION

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CRITICAL CONDITIONS THAT REQUIRE IMMEDIATE MEDICAL ATTENTION, TIME DELAY IS HARMFUL TO THE PATIENT, AND THE DISORDER IS ACUTE AND POTENTIALLY THREATENING TO LIFE OR FUNCTION p264

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FREE CLINIC

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A GENERAL AMBULATORY CARE CENTER, SERVING PRIMARILY THE POOR, THE HOMELESS, AND THE UNINSURED p276

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GATEKEEPING

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PATIENTS DO NOT VISIT SPECIALISTS AND ARE NOT ADMITTED TO A HOSPITAL WITHOUT BEING REFERRED BY THER PCPs p252

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HOME HEALTH CARE

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PATIENT SERVICES ARE BROUGHT INTO THE PATIENT'S HOMES p267

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HOSPICE

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A CLUSTER OF COMPREHENSIVE SERVICES FOR THE TERMINALLY ILL WITH A LIFE EXPECTANCY OF 6 MOS OR LESS p272

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IA TROGENIC

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COMPLICATIONS CAUSED BY THE PROCESS OF HEALTHCARE p252

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MEDICAL HOME

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CONSISTS OF AN INTERDISCIPLINARY TEAM OF PHYSICIANS AND ALLIED HEALTH PROFESSIONALS WHO PARTNER WITH PATIENTS AND THEIR FAMILIE, TAKING RESPONSIBILITY FOR ONGOING PATIENT CARE USING A TEAM APPROACH, TECHNOLOGY, AND EVIDENCE BASED PROTOCOLS TO COORDINATE AND PROVIDE CARE p255

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MEDICALLY UNDERSERVED

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INDICATES A DEARTH OF PRIMARY CARE PROVIDERS AND DELIVERY SETTINGS AS WELL AS POOR HEALTH INDICATORS FOR THE POPULACE p275

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NON-URGENT CONDITIONS

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DO NOT REQUIRE THE RESOURCES OF AN EMERGENCY SERVICE, AND THE DISORDER IS NONACUTE OR MINOR IN SEVERITY p264

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OUTPATIENT SERVICES

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ANY HEALTH CARE SERVICES THAT ARE NOT PROVIDED ON THE BASIS OF AN OVERNIGHT STAY IN WHICH ROOM AND BOARD COSTS ARE INCURRED p249

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PALLIATION

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1 OF 2 PRIMARY AREAS OF EMPHASIS IN HOSPICE CARE THAT DEALS WITH PAIN AND SYMPTOM MANAGEMENT p272

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PRIMARY HEALTH CARE

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BASIC AND ROUTINE HEALTH CARE PROVIDED IN AN OFFICE OR CLINIC BY A PROVIDER WHO TAKES RESPONSIBILITY FOR COORDINATING ALL ASPECTS OF A PATIENT'S HEALTH CARE NEEDS p588

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SECONDARY TERM

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SHORT TERM, INVOLVING SPORADIC CONSULTATION FROM A SPECIALIST TO PROVIDE EXPERT OPINION AND / OR SURGICAL OR OTHER ADVANCED INTERVENTIONS THAT PRIMARY CARE PHYSICIANS ARE NOT EQUIPPED TO PERFORM (HOSPITALIZATION, ROUTINE SURGERY, REHAB) p251

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SURGICENTER

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FREE STANDING AMBULATORY SURGERY CENTERS INDEPENDENT OF HOSPITALS, PROVIDING A FULL RANGE OF SERVICES FOR THE TYPES OF SURGERY THAT CAN BE PERFORMED ON AN OUTPATIENT BASIS AND DO NOT REQUIRE OVERNIGHT HOSPITALIZATION p266

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TELEPHONE TRIAGE

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A TYPE OF ACCESS THAT BRINGS EXPERT OPINION AND ADVICE TO THE PATIENT, ESPECIALLY DURING THE HOURS WHEN PHYSICIANS' OFFICES ARE CLOSED (TELEPHONICALLY) p276

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TERTIARY CARE

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MOST COMPLEX LEVEL OF CARE; NEEDED FOR CONDITIONS THAT ARE RELATIVELY UNCOMMON. INSTITUTION BASED, HIGHLY SPECIALIZED AND TECHNOLOGY DRIVEN p251

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URGENT CARE CENTERS

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CENTERS THAT OFFER A WIDE RANGE OF ROUTINE SERVICES FOR BASIC AND ACUTE CONDITIONS ON A FIRST COME FIRST SERVED BASESIS, NOT COMPARABLE TO HOSPITAL EMERGENCY DEPARTMENTS; OFFER EXTENDED HOURS p266

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URGENT CONDITIONS

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REQUIRE MEDICAL ATTENTION WITHIN A FEW HOURS, A LONGER DELAY PRESENTS POSSIBLE DANGER TO THE PATIENT AND THE DISORDER IS ACUTE BUT NOT SEVERE ENOUGH TO BE LIFE THREATENING p264

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WALK IN CLINIC

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PROVIDE AMBULATORY SERVICES, FROM BASIC PRIMARY CARE TO URGENT CARE, BUT THEY ARE USED FON A NONROUTINE, EPISODIC BASIS p266

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WHAT IMPLICATIONS HAS THE DECLINE IN HOSPITAL OCCUPANCY RATES HAD FOR HOSPITAL MANAGEMENT? p283

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EXECUTIVES MUST NOW VIEW AMBULATORY CARE / OUTPATIENT CARE AS AN ESSENTIAL PART OF THEIR OVERALL BUSINESS, AS OPPOSED TO A SUPPLEMENTAL PRODUCT LINE IN ORDER TO REMAIN COMPETITIVE WITH NONHOSPITAL BASED OUTPATIENT CARE CENTERS p249

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DESCRIBE HOW SOME OF THE CHANGES IN THE HEALTH SERVICES DELIVERY SYSTEM HAVE LED TO A DECLINE IN HOSPITAL INPATIENT DAYS AND A GROWTH IN AMBULATORY SERVICES p283

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HOSPITALS ARE MORE EXPENSIVE; RANGE OF SERVICES AVAILABLE FOR OUTPATIENT CARE INCREASED p248

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ALL PRIMARY CARE IS AMBULATORY BUT NOT ALL AMBULATORY SERVICES REPRESENT PRIMARY CARE. DISCUSS

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PRIMARY CARE IS THE FOUNDATION FOR AMBULATORY HEALTH SERVICES. BOTH INCLUDE DIAGNOTIC AND THERAPEUTIC SERVICES AND TREATMENT FOR THOSE 'WALKING PATIENTS.' HOWEVER, AMBULATORY CARE IS SUBDIVIDED INTO A VARIETY OF CATEGORIES: ER, DIALYSIS, IMAGING CENTERS, WELLNESS CENTERS, ETC WHICH FOCUS ON SPECIFIC AILMENTS OR COMPONENTS OF THSOE AILMENTS, WITH LITTLE REGARD FOR THE PATIENT AS A WHOLE (PRIMARY CARE)

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WHAT ARE THE MAIN CHARACTERISTICS OF PRIMARY CARE (3)? p283

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POINT OF ENTRY- IT IS THE FIRST CONTACT A PERSON MAKES WITH THE HEALTH CARE DELIVERY SYSTEM

COORDINATION OF CARE - COORDINATES THE DELIVERY OF HEALTH SERVICES BETWEEN THE PATIENT AND OTHER COMPONENTS OF THE SYSTEM

ESSENTIAL CARE - OPTIMIZE POPULATION HEALTH (ACCESSIBLITY) p252-254

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DISCUSS THE GATEKEEPING ROLE OF PRIMARY CARE p283

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PCPs MANAGE AND REFER PATIENTS TO SPECIALTY CARE, PROTECTS PATIENTS FROM UNNECESSARY PROCEDURES, OVERTREATMENT, RISK FOR COMPICATIONS

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WHAT IS COMMUNITY ORIENTED PRIMARY CARE? p283

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BASED ON THE CONCEPT OF ECOLOGY OF MEDICAL CARE, WHICH EMPHASIZES THE RELATIONS BETWEEN THE POPULATION AND COMMUNITY, AND PERSONAL HEALTH CARE. ADDS A POPULATION BASED APPROACH TO IDENTIFYING AND ADDRESSING COMMUNITY HEALTH PROBLEMS p256

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DISCUSS THE TWO MAIN FACTORS THAT DETERMINE WHAT SHOULD BE AN ADEQUATE MIX BETWEEN GENERALISTS AND SPECIALISTS p283

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DEPENDENT ON HOW RIGIDLY THE HEALTH CARE DELIVERY SYSTEM EMPLOYS THE CONCEPT OF GATE KEEPING; PROPENSITY OF PEOPLE IN A GIVEN POPULATION TO USE PRIMARY CARE SERVICES p257

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WHAT ARE SOME OF THE REASONS SOLO PRACTITIONERS ARE JOINING GROUP PRACTICES p283

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UNCERTAINTIES CREATED BY RAPID CHANGES IN THE HEALTH CARE DELIVERY SYSTEM, CONTRACTING BY MCOS WITH CONSOLIDATED RATHER THAN SOLO ENTITIES, COMPETITION FROM LARGE HEALTH CARE DELIVERY ORGANIZATIONS, HIGH COST OF OPERATING A SOLO PRACTICE, COMPLEXITY OF BILLINGS AND COLLECTIONS IN A MULTIPLE PAYER SYSTEM, AND INCREASED EXTERNAL CONTROL OVER THE PRIVATE PRACTICE OF MEDICINE p260

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WHY IS IT IMPORTANT FOR HOSPITAL ADMINISTRATORS TO REGARD OUTPATIENT CARE AS A KEY COMPONENT OF THEIR OVERALL BUSINESS STRATEGY? p283

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OUTPATIENT CLINICS ARE A KEY SOURCE OF PROFIT

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DISCUSS THE (5)MAIN HOSPITAL BASED OUTPATIENT SERVICES p283

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1- CLINICAL: REFERRALS FOR INPATIENT, SURGICAL, SPECIALIZED SERVICES

2- SURGICAL SERVICES : SAME DAY SURGICAL CARE

3- EMERGENCY SERVICES: SERVICES AROUND THE CLOCK FOR PATIENTS WITH SERIOUS OR LIFE THREATENING CONDITIONS THAT REQUIRE IMMEDIATE ATTENTION

4- HOME HEALTH: POST ACUTE CARE AND REHABILITATION THERAPIES

5- WOMEN'S HEALTH CENTERS: SCREENING INFORMATION, MENTAL HEALTH, PRIMARY CARE FOR WOMEN

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WHAT ARE SOME OF THE SOCIAL CHANGES THAT LED TO THE CREATION OF SPECIALIZED HEALTH CENTERS FOR WOMEN? p283

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- WOMEN ARE MAJOR USERS OF HEALTH CARE
- MORBIDITY IS GREATER AMONG MEN
- CHANGE IN AMERICAN CULTURE - GENDER EQUITY
- FEMALE MAJORITY OF POP IN THE US
- AGING POPULATION ALSO INCLUDES MORE WOMEN

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WHY IS THE HOSPITAL EMERGENCY DEPARTMENT SOMETIMES USED FOR NONURGENT CONDITIONS? WHAT ARE THE CONSEQUENCES? p283

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ACCESS TO CARE AT NIGHT AND ON THE WEEKENDS; UNAVAILABILITY OF PRIMARY CARE; ERRONEOUS SELF ASSESSMENT OF SEVERITY OF INJURY; CONVENIENCE; SOCIOECONOMIC STRESS; LACK OF SOCIAL SUPPORT

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WHAT ARE MOBILE HEALTH CARE SERVICES? DISCUSS THE VARIOUS TYPES p283

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HEALTH CARE SERVICES THAT ARE TRANSPORTED TO PATIENTS; PREHOSPITAL MEDICINE AMBULANCES, MAMOGRAMS, ROUTINE HEALTH SERVICES: EYE CARE, PODIATRY, DENTAL UNITS p267

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WHAT IS THE BASIC PHILOSOPHY OF HOME HEALTH CARE/ DESCRIBE THE SERVICES IT PROVIDES

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AMBULATORY CARE IS DELIVERED TO PATIENTS IN THEIR HOMES; CONSISTENT WITH THE PHILOSOPHY OF MAINTAINING PEOPLE IN THE LEAST RESTRICTIVE ENVIRONMENT POSSIBLE

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WHAT ARE THE CONDITIONS OF ELIGIBILITY FOR RECEIVING HOME HEALTH CARE UNDER MEDICARE

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IF THE PATIENT IS HOMEBOUND, HAS A PLAN OF TREATMENT AND A PERIODIC REVIEW BY A PHYSICIAN, AND REQUIRES INTERMITTENT / PARTIME SKILLED NURSING/ REHAB THERAPIES

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EXPLAIN THE CONCEPT OF HOSPICE CARE AND THE TYPES OF SERVICES A HOSPICE PROVIDES

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A CLUSTER OF COMPREHENSIVE SERVICES FOR THER TERMINALLY ILL WITH A LIFE EXPECTANCY OF 6 MOS OR LESS: MEETING THE PATIENT'S NEEDS WITH AN EMPHASIS ON PAIN MGMT, MEETING THE PATIENT'S AND FAMILY'S EMOTIONAL AND SPIRITUAL NEEDS, SUPPORT FOR THE FAMILY MEMBERS BEFORE AND AFTER THE PATIENT'S DEATH, AND FOCUSING ON MAINTAINING THE QUALITY OF LIFE RATHER THAN PROLONGING LIFE

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WHAT ARE SOME OF THE MAIN REQUIREMENTS FOR MEDICARE CERTIFICATION OF A HOSPICE PROGRAM (9)

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-PHYSICIAN CERT THAT THE PATIENT'S PROGNOSIS IS LIFE EXPECTANCY OF 6 MOS OR LESS

-NURSING, PHYSICIAN, DRUGS, AND BIOLOGICS AVAILABLE 24/7

- MAKE ARRANGEMENTS FOR INPATIENT CARE WHEN NECESSARY

- PROVIDE SOCIAL WORKER UNDER THE DIRECTION OF A PHYSICIAN

- MAKE COUNSELING SERVICES AVAILABLE TO BOTH THE PATIENT AND THE FAMILY

-PROVIDE NEEDED MEDS AND SUPPLIES AND EQUIPMENT FOR PAIN MGMT

- PROVIDE PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY SERVICES AS NEEDED

- PROVIDE HOME HEALTH AIDE AND HOME MAKER SERVICES

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DESCRIBE THE SCOPE OF PUBLIC HEALTH AMBULATORY SERVICES IN THE US

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WELL BABY, VENEREAL DISEASE CLINICS, FAMILY PLANNING SERVICES, SCREENING AND TREATMENT FOR TUBERCULOSIS, AND AMBULATORY MENTAL HEALTH

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DESCRIBE THE MAIN PUBLIC AND VOLUNTARY OUTPATIENT CLINICS AND THE MAIN PROBLEMS THEY FACE

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(PROBLEM: ALL HAVE SHORTAGE OF PCPs)
-COMMUNITY HEALTH CENTERS: FAMILY ORIENTED PRIMARY AND PREVENTIVE HEALTH CARE AND DENTAL SERVICESFOR MEDICALLY UNDERSERVED(POOR AND UNINSURED) AREAS

-FREE CLINICS: GENERAL AMBULATORY CARE CENTER SERVING THE POOR, HOMELESS AND UNINSURED, NO CHARGE; SERVICES ARE DELIVERED BY VOLUNTEERS

- OTHER CLINICS: MIGRANT HEALTH CENTERS SERVING TRANSIENT FARMWORKERS IN AG COMMUNITIES

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WHY DO BOTH REPUBLICAN AND DEMOCRAT PRESIDENTS SUPPORT THE COMMUNITY HEALTH CENTER PROGRAM

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IN AN ATTEMPT TO PROVIDE AN ACCESS TO CARE ENTITIY FOR THOSE THAT WOULD OTHERWISE NOT BE ABLE TO AFFORD IT

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WHAT IS ALTERNATIVE MEDICINE

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WHAT ROLE DOES IT PLAY IN THE DELIVERY OF HEALTH CARE, REFERS TO THE BROAD DOMAIN OF ALL HEALTH CARE RESOURCES OTHER THAN THOSE INTRINSIC TO BIOMEDICINE AND COVERS A HETEROGENEOUS SPECTRUM OF ANCIENT TO NEW APPROACHES THAT PURPORT TO PREVENT OR TREAT DISEASE; DEMAND IS INCREASING DUE TO FEAR OF HARMS CAUSED BY WESTERN MEDICINE, ACCESSIBILITY, PATIENTS FEEL EMPOWERED BY AN ABILITY TO TAKE CONTROL OF THEIR OWN HEALTH

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BRIEFLY EXPLAIN HOW A TELEPHONE TRIAGE SYSTEM WORKS

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TELEPHONIC SYSTEM IS MANNED 24/ 7 BY SPECIALLY TRAINED NURSES WHO RECEIVE PATIENTS CALLS, THE NURSES DEAL WITH THE PATIENT'S PROBLEM EITHER THROUGH RECOMMENDATION FOR CARE, OR DIRECTING THE PATIENT TO APPROPRIATE MEDICAL SERVICES