question

Major Components

answer

Healthcare workforce, practice setting, Suppliers of therapeutics, orkforce training departments, research and system oversight

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Health

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A state of complete physical , mental and social well-being and not merely the absence of disease or infirmity

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Health 5 differ

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Health conditions social position , training of physician , organization of systems and expected outcomes

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Fundamental differences in beliefs based on cultural differences

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Yin and yang - Chinese medicine

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Yin

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Represent the cold or passive, principle

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Yang

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Represent hot, or active principle

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Set of beliefs about health and healthcare which is referred to as

answer

Western medicine originated over time in Western Europe . Also called allopathic medicine

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Allopathic

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Biologically based approach to healing, focus is on the specific ailment using pharmaceutical or surgery

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Osteopathic

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Licensed to practice full scope of medicine, focus on holistic, philosophy, and a system of hands-on diagnosis and treatment known osteopathic manipulative medicine " emphasis on health education and injury and disease prevention(DO)

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A lot of similarities among western medicine countries in how medicine is practiced

answer

Basic structure and organizations in how healthcare is delivered, similar economies and abilities to finance healthcare

question

Major differences between US and other countries

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Paying for healthcare, equity and efficiency of healthcare provided and population health outcomes

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Central focus of healthcare

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Is to restore health or prevent exacerbation of health problems

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Health is the product of multiple factors

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Genetic inheritance , physical environment , social environment and response to those factors

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Healthcare has an impact late in the game determinants of health have already made an impact for better or for worse need for healthcare

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Is seen as failure to prevent those determinants of health from adversely affecting the patient

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Healthcare is associated with

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Primary, secondary and tertiary prevention

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5 components of healthcare systems

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Facility where healthcare is provided,workforce that provides the healthcare, providers of healthcare therapeutic, education and research institutions and financing mechanism read page 11-16

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Organization of healthcare systems

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Government healthcare agencies( federal, state, local) private, non-profit healthcare sector( private medical, health profession and practices), and private , profit - making , or commercial sector.(proprietary) health services enterprises

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Healthcare system management

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Administration, planning, regulation, and evaluation

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Primary care

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The care most people need most of the time for most of their health and illness concern for patient who are not in institution bed include a range of person treatment and preventive measures

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Secondary care

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Service that are available in both community hospital and physicians offices. There are arranged through referral and consultantion after preliminary evaluation by primary care

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Tertiary care

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Consists of highly specialized diagnostic, therapeutic ,and rehabilitative services requiring staff and equipment

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Administration

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Is a complex matter, the subject of many lengthy books. Physician decision making has decrease as MCO expanded lead to cost containment used to delivering individual services

question

Planning

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Any deliberate action to determine unmet needs, goals and objectives, design a program to meet them and allocate resources. In US had been very weak legally enforcing planning has largely been confined to hospital contraction left to institution provider parties

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Government regulation

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More reactive after serious financial or quality issues arise modest level

question

Evaluation

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A good idea of academic program evaluation- very little on MCO

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US compared to other industrialized countries uniqueness

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No central trunk, no national ministry of health(decentralized) Care provided for and paid for- fee for service system since WW2 Physician income higher Since mid1980s has become a major venue for the generation of corporate profits from the direct provision of healthcare services

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Principle health agency

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Department of health and human services, runs federal social security, state run public assistance programs allocation of money to public & private entities throughout nation

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Non healthcare gover agencies

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Dept of labor, dept of agriculture and environmental protection agency

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Private non-profit sector

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Voluntary agencies non governmental agencies that play a role in the healthcare system AHA, red Cross

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Professional organization

answer

AMA,ANA, organization dues, journal subscription

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For profit sector

answer

For profit health services and suppliers Corporation that deliver health services to their employees as benefit of employment

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For profit proprietary

answer

Therapeutic production, commercial health insurance, nursing homes, for profit general hospital( managed care and independent) profit managed car sector, employee health services

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Care of special population and disease

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Special care programs for defined population group provided by gov military personnel and dependent, service vets and native Amricans

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Healthcare performance criteria

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Quality, equity , and efficiency

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1st public institutions established for care of sick" pest house"

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1794 on Manhattan island - bell vue , Ben Franklin established first hospital in Philadelphia in 1751

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AHA

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Primary agency that count and classifies hospitals in the US , guide classification of hospitals

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1850

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Acute, chronic & psychological hospital mold took shape

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Classification

answer

General, special, rehab, and chronic disease and psychiatric

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2 type of control ownership

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Private and public

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Private ownership

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Investor- owned , for profit( proprietary) or non for profit( voluntary )

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Public ownership

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Federal, state and local

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Beds

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Hospital classified by number of beds regularly maintained for inpatient

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LOS

answer

Long term and short term ( stays of 30 days or more) # of inpatient / # of admissions ( total facility LOS include nursing home admission and inpatient days from nursing home types

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Public hospital

answer

Short term , general and certain special hospital excluding federal provide care for those unable to be treated elsewhere , homeless, poor, and uninsured

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Census

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Average number of people served on an inpatient basis on a single day during the reporting period- # of impatient days/ # of days in the reporting period

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Hill- burton

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Hospital construction program post ww2 Rural hospital built where there were no healthcare outlet previously

question

Hospital structure admin

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Keeps instruction running in all areas other than in direct patient care : finance, personnel, maintain acne, housekeeping, public relations and development

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Hospital structure medical division

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Organized by medical specialties , additional med specialties & depts organized around organs& organ systems where physician use both surgical,and non surgical intervention ( ophthalmology, urology )

question

Medical staff committees

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Exec- overall coordination and set general policy, conference committee services as a liaison between medical staff and hospital governing board, credentials committee - review application and re- appointment , infections committee, pharmacy& therapeutic , tissue, medical records, and quality assurance

question

Other hospital division

answer

Nursing,diagnostic& therapeutic , lab

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Hospital governance in private sector

answer

Board of trustees for non for profit, leader of board or paid CEO, board of directors set policy and CEO carries it out, for profit similar structure board made up of owner.

question

Complimentary medicine

answer

Large amount of $ being spent on non allopathic medicine ( acupuncture , massage, pet therapy

question

Luxury medicine

answer

Patient that pay cash and go anywhere luxurious accommodation

question

Mission oriented hospital

answer

Mission defined by needs of community Rational planning process provides individuality and flexibility Health center rather than illness center

question

Long term care

answer

Range of supportive, rehab, nursing home and palliative care service ever provide to people fro young to old capacity to perform daily activities is restricted due to cgi if disease or disability

question

Nursing homes

answer

Decrease in numbers more than half funded by public medicaid

question

Solution

answer

Improve home health care services and health promotion

question

Ambulatory care

answer

Healthcare given to a person who is not a bed patient covers all health services other than communty health services and personalized health services for institution patient private physician fee for service Basis or working with managed care capitation, hospital based ambulatory services

question

Hospital outpatient Departement

answer

Emergency services, clinic services for outpatient

question

3 categories of clinics

answer

Teaching, medical surgical and other

question

5 functional categories of physician staff in teaching hospital

answer

Attending medical staff to draw clinic duty Medical school facility Assign inpatient physician( junior ) Residents, fellow and interns Hire outside physicians to exclusively work in them on session or part time

question

Ambulatory problems

answer

Fragmented care Specialty clinics higher compensation decrease future development of primary care Not in tune with community and health needs

question

Hospital emergency services

answer

Provide care to injury and critical I'll Secondary well equipped Source of patient admission to hospital Not critically ill but cannot reach private physician Geographic out of region Have no insurance nowhere to go

question

3 categories of patient in emergency

answer

Non urgent non acute minor in severity Urgent acute, but not severe Emergent

question

Hospital ambulatory outside of hospital

answer

Public hospital or through local health dept or other venues satellite Through advances in medicine can offer services

question

5 characteristics of community health

answer

Must be located in medically underserved area Provide comprehensive car services and supportive such as transportation or translation Must be available to all resident area with few adjusted upon patient ability to pay They must be governed by community board with health patient comprising majority Must meet other performance and accountability standard their admin, financial and clinic opration

question

Industrial health services

answer

Industrial hazards, in plant health unit, staffedwithtrained industrial in school clinics very little disease treatment such as vision, hearing , immunization

question

Primary care 2 main functions

answer

Provide most care gatekeeper Control use of hospital or specialist care

question

Hospitalist

answer

Physician who see patients slope on an inpatient basis

question

Medical specialization

answer

Narrow range of knowledge and skills Incentive based on knowledge technology explosion and financial incentives Advantages and disadvantages

question

Medical education

answer

136 fully accredited allopathic medical school 26 DO

question

ACGME

answer

Accreditation council for graduate medical education

question

IMG

answer

International medical graduate

question

Utilization of health services

answer

Is generally higher in those areas that have more physician

question

PSM

answer

Physician supply a model demographic utilization based computerized system to forecast the supply and specialization of area for 18 medical specialties required to meet a high quality of physician service

question

Supply of primary care physician

answer

Is growing slightly faster than demand could help with current under supply of primary caw physician

question

Nursing

answer

The protection promotion and option of health abilities prevention of illness injury , alleviation of suffering through the diagnosis and advocacy in the care of indivual , family, community and population

question

Reason of nursing shortage

answer

Low salaries Limited chances of increases Poor working conditions Poor professional image and greater working apportunity for woman Doctor relationship Healthcare sector growing in jobs despite job loses 2011 Nurse to patient ratio Long workin hours

question

Health,personnel

answer

Complex in Us Highly developed and many patient benefit from Gaps and overlaps Maldistribution by geographic area Differing level of patient access

question

COPC

answer

Community oriented primary are a defined population health problems are systematically identified and addressed

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