Health Care Systems (Unit 2)

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Hospitals fall under different income classifications. What are they?
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Private or Propriety (for profit) Religious (funds by religious affiliation) Nonprofit (funds used for institution only) Government (funded by government)
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General Hospitals
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Treat all age groups and conditions; provides diagnostic, medical, surgical, and emergency care services; usually private
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Specialty Hospitals
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Provide care for special conditions or age groups; private; donations. Ex: MD Anderson Cancer Centers
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Government Hospitals
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Operated/funded by federal, state and local governments. Ex: Veterans Administration (VA) Hospital
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University/College Medical Centers
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Provide hospital services; research & education facility as well; can be funded privately, donations, or government sources
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Long-Term Care
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Provide assistance/care for elderly patients called “residents”. They can also provide care for persons with disabilities and/or chronic long-term illness
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Nursing/Geriatric Homes
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Provide basic care for those who can no longer care for themselves; assist with ADL’s; provide safe/secure environment; social interaction
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ADL
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Activities of Daily Living
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Extended/skilled care
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Provide skilled nursing care and rehabilitative services to prepare residents to return home or to another LTC facility
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Subacute Units
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Provide services to residents who need rehabilitation to recover from majors illness (surgery, cancer, dialysis, heart disease, stroke)
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Independent/Assisted Living
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Individuals who can care for themselves (ADL’s) can rent or purchase apartment in facility (meals, housekeeping, laundry, transportation, social events, basic medical care are provided) Most are associated with nursing homes; this allows residents to move from one facility to another as conditions warrant
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AHCA
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Agency for Health Care Administration
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OBRA
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Omnibus Reconciliation Act of 1987
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Medical Offices
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Can vary to only a single doctor or a group of doctors; can be a general practice or specialty practice; offer several different opportunities for employment. Administration, nursing, bookkeeping, billing, medical coding. Offices can be found in different locations to include; office buildings, stand-alone offices and even malls
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Specialty Practices
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Pediatrics, Cardiology, Obstetrics, Orthopedics etc.
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Dental Offices
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Can vary in size; one dentist, group of dentist. Can be found in many different places to include professional office buildings, stand-alone offices and even malls
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DDM
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Doctor of Dental Medicine
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DDS
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Doctor of Dental Services
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Clinics
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Health care facilities which can provide different type of care. Can be dental or medical or vetinary
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Surgical
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Perform minor surgeries, also called outpatient or “one-day” clinics; patient is sent home same day after surgery
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Urgent Care
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Provide first aid or emergency care to ill or injured patients; not equipped to treat critically ill patients
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Rehabilitation
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Offer physical occupational, speech therapies for patients after injury or illness
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Specialty
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Offer care for patients with specific diseases (diabetes, cancer), disorders (stroke), or injuries (head injury).
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Outpatients
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Offer procedures to patients who are then not admitted to the hospital- go home. Different than surgical clinics in that procedures are not only surgeries (endoscopy, colonoscopy)
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Health Department
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May offer treatment for pediatric patients; sexually transmitted diseases; respiratory diseases; immunizations and other services (pharmacy)
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Medical Centers
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Usually located in colleges and universities; often offer FREE medical care and treatment to provide learning experiences for medical students
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Optical Centers
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Can be individually owned by ophthalmologist (M.D. or D.O.) or optometrist (O.D.); or part of a large chain of stores (Lens Crafters, Pearle Vision, etc.)
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Emergency Care Services
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Provide care for victims of accidents or sudden illness by highly trained medical professionals; Private ambulance services, rescue squads (Fire Dept.), Emergency/Urgent Care Clinics, Emergency rooms, aircraft (helicopters/airplanes)
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Laboratories
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Can be part of a larger facility, such as hospital, clinic, or college/university, or can be stand-alone. Pathologist, Laboratory Technicians, Phlebotomist
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Home Health Care
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Nursing care, personal care, therapy, homemaking.
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Hospice
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Care for patients who have less than 6 months to love as a result of a medical condition. Can occur in the patients home or in hospice care centers. The family of the patient is ALSO cared for.
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Mental Health Types
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Counseling centers, psychiatric clinics, chemical abuse, physical abuse
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Genetic counseling
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Prenatal (before birth) tests, checking for abnormalities & birth defects, identify all medical options, assist parents on coping with genetic disorders of child
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Rehabilitation
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Can be located in hospitals, clinics or be stand-alone entity; the goal of rehabilitation is to has the patient reach their maximum potential, given their specific medical condition
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Health Maintenance Organizations (HMO’s)
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Provide total health care directed toward preventative health care; some HMO’s are run by large corporations with many employees (lowers cost)
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Industrial Health Care Centers
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Found in large companies; provide healthcare for employees of the company; focus on accident prevention and safety
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School Health Services
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Found in many school and colleges; many different levels of services provided
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Government Agencies
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Are financially supported by taxes. National and international organizations exist around the world which monitor health and health care-related issues
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World Health Organization (WHO)
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International agency sponsored by the United Nations. Statistics & info about diseases; publishes health info; investigates/addresses serious health threats around the world
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U.S. Dept. Of Health and Human Services (USDHHS)
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Deals with health problems within the United States
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National Institutes of Health (NIH)
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National agency. Division of USDHHS involved in research of diseases
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Centers for Disease Control and Prevention (CDC)
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National agency. Division of USDHHS concerned with causes, spread, and control of diseases in populations
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Food and Drug Administration (FDA)
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National agency. Responsible for regulating food and drug products sold to the public
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Agency for Health Care Policy and Research (AHCPR)
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National agency established in 1990. Responsible for researching the quality of health care delivered and identify standards of treatment for health care facilities
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Occupational Safety and Health Administration (OSHA)
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National agency. Establishes & enforced standards that protect worker from job related injury and illness
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Health Departments
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National agency; falls under USDHHS. Community based, gather statistics, trends, prevention education, immunizations
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Health Insurance plans
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In order to pay for costs associated with health care most people rely on this. There are THOUSANDS of them, but most work under same basic idea: You pay premium to insurance company and insurance covers costs.
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Detuctible
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Amount paid by patient for medical services before policy begins to pay. Ex: $500 out-of-pocket before insurance pays anything.
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Co-insurance
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Expenses for medical care are showed between the patient and the insurance company. Ex: 80/20 plan: insurance pays 80%, you pay remaining 20%.
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Co-payment
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Also known as “co-pay”, this is the amount of money you pay for a particular service regardless of total cost of service. Ex: $25 per visit; whether for a physical or more serious illness.
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Medicare
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Government programs that provides health care for individuals over the age of 65 and for any person who has been disabled for at lease 2 years.
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Part A
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covers hospital services and care provided by an extended facility, or home health care agency after hospitalization.
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Part B
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Covers doctor’s visit, outpatient treatments, therapy and other health care. A deductible is paid for Medicare. Only pays 80%
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Medicaid
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Medical assistance program operated by individual states. Persons covered by this program vary from state to state. Low income, children who qualify, physically disabled or blind. Provides inpatient and outpatient hospital services, physician’s medical and surgical care, lab, x-Ray, well-baby and well-child care, including immunizations.
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Workers Compensation
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Provides treatment for workers injured on the job. Funded by employers and each individual state.
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TRICARE
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U.S. Government health insurance program. Provides care for all active duty personnel and their families, survivors of military personnel, and retired members of the military.

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