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ALH Midterm

Inpatient and Ambulatory Care Sytems

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