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Part 1 Chapter 2; Health Care Systems

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Hospitals
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One of the major types of health care facilities.
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General Hospitals
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Treat a wide range of conditions and age groups.
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Specialty Hospitals
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Provide care for special conditions or age groups.
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Government Hospitals
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Operated by federal, state, and local government agencies.
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University or College Medical Centers
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Provide hospital services along with research and education.
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Long Term Care Facilities (LTCs or LTCFs)
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Mainly provide assistance and care for elderly patients, usually called residents.
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Residential Care Facilities
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Nursing homes or geriatric homes designed to provide basic physical and emotional care to individuals who can no longer care for themselves.
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Extended Care Facilities or Skilled Care Facilities
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Designed to provide skilled nursing care and rehabilitative care to prepare patients or residents for return to home environments or other long-term care facilities.
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Independent Living and Assisted Living Facilities
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Allow individuals who can care for themselves to rent or purchase an apartment in the facility.
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Medical Offices
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Vary from offices that are privately owned by one physician to large complexes that operate as corporations and employ many physicians and other health care professionals.
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Dental Offices
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Vary in size from offices that are privately owned by one or more dentists to dental clinics that employ a group of dentists.
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Clinics, Satellite Clinics, or Satellite Centers
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Are health care facilities found in many types of health care.
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Surgical Clinics or Surgicenters
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Perform minor surgical procedures.
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Urgent, Walk-in, or Emergency Care Clinics
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Provide first aid or emergency care to ill or injured patients.
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Rehabilitation Clinics
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Offer physical, occupational, speech, and other similar therapies.
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Substance Abuse Clinics
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Provide rehabilitation for drug and alcohol abuse.
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Specialty Clinics
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Provide care for specific diseases.
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Outpatient Clinics
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Usually operated by hospitals or large medical groups to provide care for patients not admitted to the hospital.
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Health Department Clinics
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May offer clinics for pediatric health care, treatment of sexually transmitted diseases and respiratory disease, immunizations, and other special services.
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Medical Center Clinics
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Usually located in colleges or universities and offer clinics for various health conditions while providing learning experiences for medical students.
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Optical Centers
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Can be individually owned by an ophthalmologist or optometrist or they can be part of a large chain of stores to provide vision examinations, prescribe eyeglasses or contact lenses, and check for the presence of eye diseases.
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Emergency Care Services
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Provide special care for victims of accidents or sudden illness.
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Laboratories
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Are often a part of other facilities but can operate as separate health care services to perform special diagnostic tests such as blood or urine tests.
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Home Health Care
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Are agencies designed to provide care in a patient’s home.
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Hospice
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Provide care for terminally ill persons who usually have life expectancies of 6 months or less.
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Mental Health Facilities
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Treat patients with mental disorders and diseases.
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Genetic Counseling Centers
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Work with couples or individuals who are pregnant or considering a pregnancy to determine existing or chance of genetic disorders.
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Rehabilitation Facilities
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Provide care to help patients with physical or mental disabilities obtain maximum self-care and function.
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Health Maintenance Organizations (HMOs)
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Are both health care delivery systems and types of health insurance that provide total health care services that are primarily directed toward preventive health care for a fee that is usually fixed and prepaid.
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Industrials Health Care Centers or Occupational Health Clinics
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Provide health care for employees of the industry or business by performing basic examinations, teaching accident prevention and safety, and providing emergency care.
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School Health Services
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Provide emergency care for victims of accidents and sudden illness while also performing tests for speech, vision, and hearing.
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World Health Organization (WHO)
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An international agency sponsored by the United Nations to compile statistics and information on disease, publish health information, and investigate and address serious health problems throughout the world.
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U.S. Department of Health and Human Services (USDHHS)
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A national agency that deals with the health problems in the United States.
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National Institutes of Health (NIH)
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A division of the USDHHS involved with research on disease.
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Centers for Disease Control and Prevention (CDC)
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Another division of the USDHHS concerned with the causes, spread and control of diseases in the population.
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Food and Drug Administration (FDA)
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A federal agency responsible for regulating food and drug products sold to the public.
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Agency for Healthcare Research and Quality (AHRQ)
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A federal agency established to improve the quality, safety, efficiency, and effectiveness of health care for Americans.
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Occupational Safety and Health Administration (OSHA)
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Establishes and enforces standards that protect workers from job-related injuries and illnesses.
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Health Departments
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Provide health services as directed by the U.S. Department of Health and Human Services (USDHHS), state, and local community.
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Voluntary or Nonprofit Agencies
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Are supported by donations, membership fees, fund-raisers, and federal or state grants at national, state, and local levels.
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Health Insurance Plans
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Offered by several thousand insurance agencies.
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Deductibles
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Amounts that must be paid by the patient for medical services before the policy begins to pay.
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Co-insurance
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Requires that specific percentages of expenses are shared by the patient and insurance company.
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Co-payment
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A specific amount of money a patient pays for a particular service, for example, $10 for each physician visit regardless of the total cost of the visit.
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Preferred Provider Organization (PPO)
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Another type of managed care health insurance plan usually provided by large industries or companies to their employees.
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Medicare
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A federal government program that provides health care for almost all individuals over the age of 65, for any person with a disability who has received Social Security benefits for at least 2 years, and for any person with end-stage renal (kidney) disease.
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Medigap
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Policies that are health insurance plans offered by private companies that help pay expenses not covered by Medicare.
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Medicaid
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A medical assistance program that is jointly funded by the federal government and state governments but operated by individual states.
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Workers’ Compensation
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A health insurance plan providing treatment for workers injured on the job.
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TRICARE
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A U.S. government health insurance plan for all military personnel.
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Managed Care
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An approach that has developed in response to rising health care costs that requires all care to have a purpose.
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Health Insurance Portability and Accountability Act (HIPAA)
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An act passed in 1996 for various reasons such as health care access, portability, renewability, preventing health care fraud and abuse, administrative simplification, medical liability reform, tax-related health provisions, application and enforcement of group health plan requirements, and revenue offsets.
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Patient Protection and Affordable Care Act
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Signed into law in March of 2010, and by 2014 most of the provisions of the act were in place.
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Organizational Structure
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A system that health care facilities use that encompass a line of authority or chain of command.