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ALH Midterm
Inpatient and Ambulatory Care Sytems
| Question | Answer |
|---|---|
| Delivery systems of the US health system | insurance companies, government agencies, teaching hospitals, private clinician groups, and private + public health care networks |
| Problem with US health system | minimal or no coordination of care |
| Flaws of the US health system | higher medical costs, delay services/results, duplication of services, unnecessary testing |
| Socialized health care system (other countries) | all individuals have assigned health care at no cost to the individual. Paid for by taxes. Health care will be available without risk to family income. |
| Problem with socialized health care system | availability of services may be delayed. Priority based in condition. |
| Present day health care system is complex because | billing process may be different for various networks within single system evaluation multi-faceted: clinician report card, institutional quality assurance (JCAHO) |
| electronic medical-record keeping is | required. May be costly and time-consuming to train personnel |
| PAs are required to be knowledgeable about individual | state laws and practices |
| Individual State Professional Associations | In NY: NYSSPA |
| _____ ______ used to design health care systems in the US | government policy |
| Diagnostic Related Groups (DRGs) | created to decrease hospital costs by relating certain medical conditions with "length of hospital stay." Discharge patient as soon as medically safe |
| Health care system becoming more expensive because | life-expectancy increased, survivable conditions have increase, viability of pre-term birth increase and cost of equipment and supplies have increased. |
| Small hospitals have merged into | larger networks |
| Large health care organizations offer cost-effective centralized services for | billing, purchasing, marketing, compliance services, and access to specialty care + referrals for specialized care. MORE RESOURCES |
| Community hospitals are federally funded because they provide service to | uninsured patients, patients with limited geographic access, community outreach (health fairs/screenings), etc. |
| Community hospitals= parallel health systems. Offer: | health promotion and disease prevention, oral health and community outreach. |
| Closed-system | maintains both clinics and hospitals. No referrals outside of network. Keeps patients within its system. |
| Mixed-model | purchase services from external hospitals and specialty groups and contract from outside of network structure to provide care in smaller communities. |
| Closed systems are for | veterans, military personnel, incarcerated individuals in federal prisons. Have structured processes and guidelines for practice |
| Integrated System goal: | improve patient care. Provide services to a defined population. |
| Facets of integrated system | high-quality, low cost, eliminate duplication of services, ensure follow-ups, continuity of care. |
| Horizontally Integrated Systems | network across a single specialty. Easiest system to set up. Building block of vertically and virtually integrated system. |
| Independent Practice Associations | Horizontally Integrated System led by MDs. |
| Vertically Integrated Systems | All levels of care consolidated under one organizational roof- MULTIPLE Specialties. Shared ownership. Open system |
| Advantages to Vertically Integrated System | smooth transition from hospital to outpatient decreases duplication of services promotes cooperation between health care providers |
| Virtually vs Vertically Integrated System | difference related to organizational structure |
| Virtually Integrated System | system relationships based on contractual agreements shared electronic health record |
| Advantages to Virtually Integrated System | more opportunities to adapt treatment guidelines and protocols to region-specific needs based on patient population. |
| Patient-Centered Medical Home, place for medical care that is | accessible, continuous, comprehensive, family-centered, coordinated, compassionate and culturally effective |
| Issues with Medical Homes | no reimbursement of PAs |
| Accountable Care Organizations | create structures with a hospital as the foundation. Provision of high-quality health care for any serious illness. Direct patient access to physician affiliated with hospital network. Almost entirely based on outpatient care |
| In a hospital network an MD may supervise up to __ PAs | 6 |
| In an outpatient setting an MD may supervise up to __ PAs | 4 |
| Issue with PA recruitment | interaction with supervising MD is established after hire. May be disadvantage bc collaboration between MD and PA is essential |
| Some institutions place PAs under ______ staff | nursing |
| True or False. In all states, PAs can order any medication | False. In some states PAs are not allowed to order certain medications or respiratory treatments |
| True or False: In NY, PAs are allowed to pronounce death | True |
| A nurse (can/can not) be legally assigned as a supervising MD | Can NOT |
Created by:
Gianna B
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