Healthcare Management Exam 1 – Flashcards
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Leading cause of death in teens now
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1. Car accidents 2.Homicide 3. Suicide
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Leading cause of death in the US
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1. Health Disease 2. Trauma Related Disease 3. Cancer
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Leading cause of death in the 1900
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pneumonia, influenza, tuberculosis, diarrhea (enteritis), strokes MEDICINE HAS CHANGED OVERTIME
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How many people were uninsured prior to the affordable care act
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50 Million
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Primary Care
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Prevention, screening (Ambulatory Care, outpatient care,xrays, lab testing)
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Secondary Care
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General acute care hospital (Watauga community hospital- inpatient care for simple or limited health conditions)
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Tertiary Care
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Special and teaching hospitals (Duke, UNC- inpatient care for complex/multiple health problems)
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Morbidity
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Disease or Disability (AIDS, Ebola, etc)
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Co-Morbidity
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Having more than one disease
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Longevity
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life expectancy
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Life Expectancy
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a prediction of how long a person will live
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Life expectancy at birth
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how long a newborn can expect to live
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Life expectancy at age 65
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expected remaining years of life for a 65 year old
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Mortality
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Death Rates **Women Live Longer**
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Crude Death Rate
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total deaths/ total populations
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Age Specific
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# of deaths with certain age group/ total # of people in age group
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Cause Specific
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# of deaths form specific disease/ total population
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Infant Mortality
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# of deaths from birth-one year of age/ # of live births that year
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Natality
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birth rate measured by: crude brith rate- # of live births/ total population
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Fertility
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capacity of population to reproduce measured by: fertility rate- # of live births/# of females aged 15-44
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Migration- geographic movement of populations between countries
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Immigration- in migration Emigration- out migration
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Sources of health status data
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Vital statics, public opinion and attitudes, actual utilization of formal health services
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Vital Statistics
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birth, death, marriage certificates Demographic data- measurable Subjective Data- cause of death is an opinion
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Public Opinion and Attitudes
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nation surveys
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Formal Health Services
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data reported by providers and insurance companies
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Will we have jobs?
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We will have jobs due to aging of population; US population is growing, so is population over 75 Birth rates are declining
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Cultural Competency
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know the diversity of the world, get outside your norm
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Life Expectancy...
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is increasing, there is a disparity between whites and african americans WE HAVE A LOW LIFE EXPECTANCY RATE COMPARED TO OTHER COUNTRIES
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Females live longer due to
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estrogen protection, women have safer jobs, men don't go to doctor as often as women
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We rank poorly for...
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infant mortality rate
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Hispanic is not a race, it is...
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An ethnicity
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Obesity is a problem in the...
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Southeast
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What type of justice is the US?
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Market Justice HISTORICALLY DRIVEN BY PHYSICIANS
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Market Justice "The Economic Good"
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The economic good; if you have the money,you can do it. Those not able to pay have barriers to health care
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Social Justice "The Good Society"
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A social good; healthcare should be equal based on need rather than cost
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Early History (Galen 200 AD)
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4 humors -blood -phlegm -yellow bile -black bile
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Pre Industrial (Vesalius 16th century) Anatomy and physiology, surgery
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(17th to 18th century) -blood letting -purging -pesthouses -almshouses -dispensary med practice was a trade, not profession, primitive med procedures, missing institutional core:social welfare, Unstable Demand- health care optional, no medical university
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Almshouse
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nuns, health houses
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Dispensory
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Dispense stuff in dispensary, drug store... pharmacist
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Pest House
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pests carry disease
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Post-Industrial: Lister, Pasteur Ehrlich
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19th- 20th century -germ theory -antisepsis, anesthesia -science, technology, facilities, education reform, ANTIBIOTICS Transformation of medical practices due
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Why was there a transformation of medical practices?
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urbanization, science and technology, hospitals, patient dependency, American Medical Association, Licensing, Education reform
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Cultural Authority
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relying on physician, no other source of info
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Groundbreaking medical discoveries
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1846- Anesthesia (people don't go into shock Aseptic technique- wash hands, sterilize X-Ray Antibiotics
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Flexner Report
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wrote report on all med schools, set standard on all med schools, requires if you're educated
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Corporate Features
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Corporatization - big money, HUGE Information Revolution Globalization
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Corporatization
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integrated health care, hospitals expand
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Info Revolution
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improves access in rural areas E-Health - find info over internet
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Globalization
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Zeca, AIDS, Ebola, health care abroad, migration of nurses from other countries
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Obama Plan
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Universal health care: through some mechanisms everyone can get health care
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Corporate (mid 20th-21st century - large corporations
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-insurance information -information technology (E-health, telemedicine) -genome, high tech -globalization (migration of health professionals, cross-border activities) -big money, less invasive
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Specialization
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Britain: Patient to General Practitioner to Specialist US: Patient to any person they want, General Practitioner or Specialist
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Discretionary Spending
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programs created by Congress on an annual basis or need basis (Highway Construction, Defense and Homeland Security)
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Non-Discretionary Spending
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programs that are required by federal law, MANDATORY (social security, medicare and medicaid)
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Instrumental Activities of Daily Living (IADL)
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activities necessary for independent living... using phone, taking meds, preparing meals, handling money/bills, shopping, walking up and down stairs, light housework
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Activities of Daily Living (ADL)
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functions that measure disability, evaluates 7 activities of self care... feeding, bathing, dressing, using toilet, transferring, mobility, grooming, able to walk distance of 8 feet
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Incidence
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# of new cases of disease occurring/population at risk
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Prevalence
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TOTAL # of cases of disease at a specific point in time/ specific population
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Epidemic
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Large # of people who acquire disease from common source
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Pandemic
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when disease crosses continents (Africa to USA)
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Holistic Health (all aspects that make a person whole and complete)
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Physical (climate, food, housing), Social(education, occupation, income), Spiritual, and Mental
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Individual Traits
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Age, sex, genetics, immunity, ethnicity
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Behavioral Model of health Risk factors
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smoking, alcohol use, drug use, malnutrition, lack of physical activity, unsafe activity like texting and driving
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What is the Behavioral Model of Health Service use?
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Predisposing (family characteristics, social structure beliefs), Enabling(Family resources, community resources), Need, Use
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What is health?
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The absence of illness and disease
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Illness
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Persons PERCEPTION of how they feel (stress)
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Disease
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Professional Evaluation
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Risk Factors of health
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Lifestyle-eating, sleeping, exercise (50%), Access-binge drinking in college (10%), Environment (20%), Heredity(20%)
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Classifications of Disease
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Acute, Subacute, Chronic
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Acute
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relatively severe, short duration, often treatable (viruses)
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Subacute
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some acute features, post acute treatment after discharge
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Chronic
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less severe, long and continuous (diabetes, asthma)
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Wellness Model of health
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efforts and programs that PREVENT disease and optimize well-being
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Therapeutic Preventions
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Primary, Secondary, Tertiary
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3 factors of wellness model
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1. Understand risk factors- health risk appraisal 2. Intervention- behavior modifications, therapeutic interventions 3. Adequate public health and social services
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Primary Prevention
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activities to decrease or restrain the problem that a disease will occur- smoking cessation to prevent lung disease, hand washing to decrease spread of infection
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Secondary Prevention
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early detection and treatment of disease- pap smears, mammograms, prostate exam
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Tertiary Prevention
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rehab and monitoring to prevent further injury or complication- turning bed-bound patients
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EPA
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Environmental Protection Agency
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OSHA
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Occupational Safety and Health Administration
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Bioterrorism, Homeland Security Act 2002
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use of chemical, nuclear agents to harm populations - training, civil defense, countermeasures between interagency groups (anthrax, smallpox)
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Medical Model vs Public Health
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Medical Model- Focuses on individual patient, biological causes of disease with treatment, treat disease and recover health; physicians, nurses, dentists, therapists, social workers Public Health- Focuses on populations; prevent disease, promote health, and provide education; sanitarians, hygienists, economists, food/drug inspectors, and same as medical model
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Managerial Epidemiology
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Manage; 1. Plan 2. Organize 3. Staff (hire people) 4. Direct (supervise) 5. Control (micromanaging)
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Epidemiology
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Agent: Pathogen/Automobile Host: Human Body/ Passengers Environment: Physical, cultural, social
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Epidemiology Tools
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1. Measure burden of disease in specific populations 2. Determine differences in burden of disease between populations 3. Explore origins or causes for differences in disease burdens 4. Determine effect of treatments and interventions on reducing burden of disease
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National Health insurance
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Roosevelt died, Truman didn't get national health insurance passed, Affordable care act passed in 2011 (Obama)
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Hillary Care
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national health care proposal defeated and almost cost Clinton next election
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New Deal
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Pres Roosevelt, WWII got us out of great depression
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Why don't we have National health insurance?
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1. Political Inexpediency (war between Germany WWI) 2. Institutional Dissimilarities (labor unions, pharma, insurance companies, American Medical Association 3. Ideological Differences (individualism, distrust government) 4. Tax Aversion (overtaxing)
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Medicare
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Elderly people
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Medicaid
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Poor people based on income
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Why we received health insurance
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WWII wage freezes and health care getting expensive results in insurance in workplace
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Workers Comp
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get hurt on the job, you get workers comp
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Healthcare System Models
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Beveridge model, Bismarck model, National health insurance
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Beveridge Model
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Hospitals are all government... doctors work for government (England, Cuba, and Britain)
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Bismarck Model
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Social Insurance, employed persons (Germany, France, Japan
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National Health Insurance
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single payer system, health insurance provided by government providers are private (Taiwan, Canada)
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Baylor Plan
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University in Texas... started Blue Cross Blue Shield
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Single Specialties
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Having one specialty in your group/business; all cardio or all ENT
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Multispecialties
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Having multiple specialists in one office/ business; cardio, ENT, and oncology
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Why is population inclining but death rate is inclining
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Migration
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Types of specialized advanced practice nurse
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Nurse Anesthesist (CRNA), Nurse Practitioner, Certified Nurse Mid Wives, Clinical Nurse Specialist
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Technology
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Advanced treatments available, but expensive... we all pay insurance so one person that needs it uses all of our money
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What are the two types of physicians?
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Allopathic Physicians (M.D.) and Osteopathic Physicians (D.O.)
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Homeopathy
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bacteria- antibiotic homeopathic- like treats like (vaccines)
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Doctor but not physician
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Doctors, optometrists (eye), podiatrists (foot), chiropractors, psychologists PHYSICIANS CAN PRESCRIBE MEDS
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Primary Care Practitioners
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Family practitioner/ general Internal medicine Pediatrics OB/GYN (malpractice is very high)
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Medical Specialists
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Cardiology (heart) Oncology (cancer) Hematology (blood) Pulmonary Neurology (nerves) Gastroenterology (digestive)
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Surgical Specialists
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General surgery/plastic surgery Orthopedic Neurosurgery Urologic Ophthalmology Otolaryngology (ENT)
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Hospital-based physicians
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Radiology Pathology (biopsies and samples) EMT Anesthesiology Hospitalists are PCPS (internal meds) Intensivists
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To become a physician
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Undergrad - 4 years Med school - 4 years, clinical Residency - 3-7 years Fellowship - 1-3 years
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Nursing
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RN: hospital based diploma, associate degree (comm college), bachelors degree Licensed Practical Nurse (LPN): 1 year comm college Nurse Adies: comm college 1 semester
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Advanced practice RNS
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Nurse practitioners, clinical nurse specialists, CRNAs (anesthetists), certified nurse midwives
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Solo Practice
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one or two physicians
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Group Practice
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3 or more physicians, positive if you share being on call, more free time, reduce costs, allow physicians to focus on medical care
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Ownership models
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Owned by physicians (MDs) managed by an office manager hired by MDs, contract managed by corporate entity or Owned and managed by a corporate entity: hospital or health system, for-profit corporate structure
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Kidney Doctor
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Nephrologist
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Bladder Doctor
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Urologist
