US Health Care CHPT. 4-6 (EXAM 2 Study)
What is the #1 ranking challenge according to CEOs in 2019? What was the #2 ranking challenge? What ranked #3?
#1 = Financial Challenges #2 = Personnel Shortages #3 = Behavioral health/addiction (Article: Top Issues Confronting Hospitals in 2019)
What were the top 3 specific financial challenges in 2019? (According to the survey)
#1 Increasing costs for staff, supplies, etc. #2 Medicaid reimbursement (including adequacy and timeliness of payment, etc.) #3 Bad debt (including uncollectable emergency department and other charges) (Article: Top Issues Confronting Hospitals in 2019)
What were the top 3 specific behavioral health/addiction issues in 2019? (According to the survey)
#1 Lack of appropriate facilities/programs in the community #2 Lack of funding for addressing behavioral health/addiction issues #3 Insufficient reimbursement specifically for behavioral health/addiction services (Article: Top Issues Confronting Hospitals in 2019)
What were the top 3 specific personnel shortage challenges in 2019? (According to the survey)
#1 Registered nurses #2 Primary care physicians #3 Technicians (e.g., medical technicians, lab technicians) (Article: Top Issues Confronting Hospitals in 2019)
What are Quality Improvement Organizations?
(QIOs) protect patient rights for appropriate discharge planning by providing a review process. If an appeal is upheld, Medicare may be required to cover the cost of additional hospital days. (Chapter 4 Overview)
How many hospitals were there in 1946? How many beds available for every 1000 people?
1. 6000 American Hospitals 2. 3.2 beds per 1000 people (Chapter 4 Overview)
IHI developed three objectives to "optimize" health care:
1. Improving the patient experience of care (including quality and satisfaction) 2. Improving the health of populations 3. Reducing the per capita cost of health care (Chapter 4 Overview)
MACRA includes two elements designed to improve quality and reduce costs of care:
1. Merit-Based Incentive Payment System (MIPS) 2. Alternative Payment Models (APMs) Physicians can choose which of these two payment systems to participate in (Chapter 4 Overview)
What were the first two hospitals established in the United States?
1. Pennsylvania Hospital in Philadelphia (1751) 2. New York Hospital (1773) (Chapter 4 Overview)
Modern hospitals organizational structure includes what 4 things?
1. committees 2. departments 3. personnel 4. services. (Chapter 4 Overview)
Two Midnight Rule
A CMS policy that defines hospital stays of less than two-midnights' duration as outpatient visits billable under Medicare Part B, rather than more highly reimbursed inpatient care under Medicare Part A. Exceptions to the rule may be granted only on a case-by-case basis per judgment of the attending physician and supporting documentation. The rule also moved hospital Medicare audits from Recovery Audit Contractors who were paid contingency fees, to independent not-for-profit Quality Improvement Organizations. (Book Chapter 4)
What is the AHA?
American Hospital Association. It is the national organization that represents and serves all types of hospitals and health care networks. (Chapter 4 Overview)
When was The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law
April 2015 (Chapter 4 Overview)
The Population Health Focus Readmissions Reduction Program is designed to do all the following except: A) save Medicare money by reducing the number of hospital readmissions within 60 days of discharge for the same condition. B) save Medicare money by reducing the number of hospital readmissions within 30 days of discharge for the same condition. C) it does not reimburse hospitals for patient stays that are deemed to be readmissions for the same condition within a specified period. D) it is only focused on a certain set of diagnoses that Medicare is targeting.
B) save Medicare money by reducing the number of hospital readmissions within 30 days of discharge for the same condition. (Ebook Question)
What was the first group responsible for kind and humane nursing?
Catholic religious orders (Book Chapter 4)
True or False? Healthcare professionals, such as dentists, podiatrists, social workers, psychologists, physical therapists, and optometrists, typically conduct practices in acute care settings
False (Ebook Question)
What was the purpose of the Hill-Burton Hospital Construction Act?
Fund hospital expansion. This resulted in an increase to 4.5 beds per 1000 people. The number of acute care hospitals also grew to reach a high of approximately 7200 facilities. (Chapter 4 Overview)
Who is ultimately responsible for the quality of care received within hospitals?
Governing boards (Chapter 4 Overview)
What is discharge planning?
Hospitals are responsible for discharge planning to help patients arrange for safe and appropriate care after a hospital stay. The process involves physicians, social workers, insurance companies, and nursing. The discharge planner must ensure that the patient who needs follow-up services obtains them. If a patient requires transfer to another level of institutionalized care, the planner must arrange that transfer before the patient can be discharged from the hospital. (Chapter 4 Overview)
What are acute care hospitals?
Hospitals that offer short-term care (less than 30 days) (Chapter 4 Overview)
Horizontal Integration
In horizontal integration, a group of hospitals merge or form alliances in order to purchase supplies and services at a volume discount. The group of hospitals may also market themselves together. However, horizontal integration by itself is not enough. (Chapter 4 Overview)
Who/What developed the Triple Aim Initiative?
Institute for Healthcare Improvement (IHI) (Chapter 4 Overview)
What is Hospital System of the Department of Veterans Affairs
It is the largest healthcare system in the U.S. with 150 hospitals and 819 community clinics. The annual budget proposed for 2017 was more than $180 billion. The VA hospitals are major teaching and research centers, as most are medical school affiliated. There are 12,000 salaried physicians serving 22 million veterans. This hospital system is insulated from other hospitals' financial pressures due to strong congressional and public support. The recent scandal over long registration periods and unauthorized waiting lists has changed the public's view of the system. (Chapter 4 Overview)
Merit-Based Incentive Payment System (MIPS) VS. Alternative Payment Models (APMs)
MIPS is based on a quality reporting program. The composite score will determine if providers will receive an upward, downward, or no payment adjustment. Those who choose APMs will not be subject to MIPs adjustments. Instead, those providers will receive an annual lump sum payment based on five percent of the previous year's estimated aggregate expenditures under the fee schedule. Qualifying for these payments will be based on providing value-based care instead of a high quantity of care. Participating in Accountable Care Organizations, Patient-Centered Medical Homes, and bundled payment models are examples of APMs. (Chapter 4 Overview)
Hospitals are likely the most appreciated, most maligned, and least understood.
N/A (Book Chapter 4)
People with mental illness, poor health, homeless, and the petty criminal joined the contagious ill that occupied pest houses aka isolation hospitals.
N/A (Book Chapter 4)
There is a new focus and reforms on outcomes rather than the numbers of patients served.
N/A (Book Chapter 4)
the AHA convinced Senators Lister Hill and Harold Burton to pass and move forward with the Hill-Burton Hospital Construction Act.
N/A (Book Chapter 4)
"Geographic variations" in the amounts and types of care provided to patients with the same diagnoses have been well documented. The amount of hospital treatment was found to be often more related to the physician specialties and individual preferences of the physicians than to patients' conditions.
N/A (Chapter 4 Overview)
An Institute of Medicine report in 1999 suggested that there are 44,000-98,000 annual deaths from errors during hospitalization. System deficiencies, not negligent providers, were primarily the cause. Failures were attributed to failures in diagnostic, treatment, preventive, and other procedures. Congressional and professional responses were rapid but short-lived. Improvement efforts continue with some successes, but there is no system-wide uniformity.
N/A (Chapter 4 Overview)
Before the ACA, 20% of all Medicare payments were for unplanned re-admissions
N/A (Chapter 4 Overview)
Congress has encouraged the adaptation of health information systems by providing various incentives.
N/A (Chapter 4 Overview)
During the late 19th and early 20th century, a shift toward scientific medicine occurred. Proper nursing training, effective anesthetic agents, modern methods of antisepsis and sterilization, and other medical advances had revolutionized hospital practices.
N/A (Chapter 4 Overview)
Hospitals are complex organizations with hundreds of inter-related services, functions and procedures. Most employ more than 1,000 employees and there were more than 5 million U.S. hospital employees in 2016. Hospitals can be a complicated tangle for patients and families to navigate. Patient advocates help navigate issues and concerns within a hospital, but patient records do not always transfer easily between different institutions.
N/A (Chapter 4 Overview)
Hospitals now routinely conduct patient-focused hospital satisfaction studies to obtain patients' views on the services they receive. A quality issue related to technology was that some patients received too many tests, procedures, and medications that were inappropriate, useless, or even harmful. Studies on test and procedure appropriateness found that on average, one third or more of all procedures are of questionable benefit
N/A (Chapter 4 Overview)
In England, between 1536 and 1539, the hospital system crumbled with the dissolution of the monasteries.
N/A (Chapter 4 Overview)
Many hospitals involved in mergers and other multi-hospital deals have not benefited that much from gained market share and economies of scale. Rather, economic problems, costly new technology, pharmaceuticals, and inflationary increases combined with declining occupancy, significantly reduced operating margins.
N/A (Chapter 4 Overview)
Prior to 1923, diabetes was treated as a hospital disease. After the discovery of insulin, that was no longer the case. The discovery of antibiotics aided in the treatment of infectious diseases and pneumonia, removing patients with these conditions from hospitals
N/A (Chapter 4 Overview)
Private health insurance, including Blue Cross and other plans, changed the charitable mission of hospitals to business motives.
N/A (Chapter 4 Overview)
Since the 1980s, hospital admissions have decreased as outpatient hospital visits have increased by 40 percent. Fewer admissions and shorter stays resulted in a significant reduction in the number of hospitals and hospital beds.
N/A (Chapter 4 Overview)
The 1950's saw chronic illness become more important as a hospital problem, and now that has shifted to long term care facilities.
N/A (Chapter 4 Overview)
The humanitarian spirit of the 18th and 19th centuries had its effect on facilities serving the sick. Hospitals became places dedicated to the relief and maintenance of curable poor people. Instead of focusing on the incurable, the emphasis was placed on treating the curable. Hospitals in early America provided shelter to the aged, dying, orphaned, and vagrants, and protected the inhabitants of a community from the contagiously sick and the insane.
N/A (Chapter 4 Overview)
The medical advances that transferred many procedures to ambulatory settings and cost containment strategies reduced hospital numbers to approximately 5,700 through mergers and closures. It is predicted that the number of hospitals will eventually be reduced to 4000 to 4500.
N/A (Chapter 4 Overview)
Declining occupancy due to major shifts of care to ambulatory settings has affected the financial condition of hospitals. There has been private insurer and Medicare pressures to cut utilization and costs, while at the same time as rising operational and capital costs for more advanced technology. Competition with physician-owned facilities for the most profitable diagnostic and treatment services has also had an impact.
N/A (Chapter 4 Overview)
Hospitals have developed into one of the most complex institutions of society with regards to its functions, professional organization, and labor forces. In addition to serving as a place for treatment, hospitals may serve as a research laboratory, an educational institution, and a major employer within the community. The history of their development extends back many years.
N/A (Chapter 4 Overview)
Hospitals may also be teaching or nonteaching hospitals. Teaching hospitals are affiliated with medical schools and provide education for medical students, and medical and dental residents. These hospitals and others also provide clinical education for nurses, allied health personnel, and a variety of technical specialist. About 7% of all hospitals are teaching facilities affiliated with one or more of the medical schools in the United States. Most are not for profit or government sponsored public facilities. Most VA Hospitals are medical school-affiliated. Teaching hospitals are in the forefront of clinical research on medical conditions and treatments due to the presence of faculty and the availability of medical residents to collect data. Non-teaching hospitals are not medical-school affiliated, but may provide educational experiences for health-related students.
N/A (Chapter 4 Overview)
Other concerns facing hospitals are complaints that the focus on the patient has been lost due to the emphasis on cost containment. Many hospitals are now attempting to refocus on the patient, and new patient-focused care programs are being developed.
N/A (Chapter 4 Overview)
The Medicare DRG system provides hospitals with financial incentives to discharge patients as soon as possible. However, Medicare also recognizes that patients should not be discharged before they are ready and planning is complete.
N/A (Chapter 4 Overview)
Today, more educated and assertive patients increasingly reject the passive role and demand active participation in their care. Patient involvement is a key to the quality of care.
N/A (Chapter 4 Overview)
Voluntary not-for-profit hospitals, sponsored by religious groups or other community-based organizations, make up about 51% of acute care hospitals. Most for-profit hospitals belong to one of the large hospital management companies. The number of for-profit hospitals grew after the 1965 Medicare and Medicaid legislation to about 18% of all current hospitals.
N/A (Chapter 4 Overview)
unnecessarily long hospitalizations resulted in patients being exposed to more infections and diseases than if they were sent home. Long hospitalizations also result in decreased functioning, especially related to daily activities
N/A (Chapter 4 Overview)
What brought appreciation to the work of women in nursing?
The Civil War in the 1860s (Book Chapter 4)
What is the leapfrog group? Who/What supported its establishment?
The Leapfrog Group fields the Hospital Quality and Safety Survey, a voluntary online survey that tracks hospitals' progress in implementing the 30 National Quality Forum safety practices. The results are available free online to anyone. Supported by Robert Wood Johnson Foundation (Chapter 4 Overview)
The AHA replaced the Patient's Bill of Rights with a brochure called?
The Patient Care Partnership (Book Chapter 4)
What is the main reason that led to mergers and consolidations?
The demand for lower hospital costs and improved quality (Chapter 4 Overview)
Choosing Wisely Campaign
The goal of advancing the national dialogue on avoiding wasteful or unnecessary medical tests, treatments, and procedures. (Chapter 4 Overview)
What are physician-owned hospitals? What is their focus?
These hospitals tend to be specialized in cardiology, orthopedics, and surgery, and exhibit high efficiency with many amenities. They focus on less complex, profitable cases. Physician-owned hospitals create concerns regarding financial incentives and competition with community hospitals. Supporters point out the owners' service to community hospitals and tax payments as for-profit entities. (Chapter 4 Overview)
What are Academic health centers (AHC)
They are composed of a degree-granting institution that consists of a medical school, one or more other professional schools or programs such dentistry, nursing, public health, pharmacy, and allied health sciences with an owned or affiliated relationship with one or more teaching hospitals, health system, or other organized care provider. AHCs are typically technologically advanced and sources of major clinical research. They provide training sites for all health professionals and serve medically needy populations, but at high costs. Scientific and technical advancements fuel specialization. Fragmented services result from multiple specialists treating the same patient, and communication challenges between multiple specialists and institutions exist. (Chapter 4 Overview)
Patients are urged to become savvy health consumers, and a plethora of rating systems for hospitals and physicians are available to help them. However, none of these systems are standardized, and, as it turns out, even the best known do not yield reproducible results. True or False?
True (Article: Rating Systems Seldom Agree on Hospital Quality)
In the 19th century, most hospitals were dirty, unventilated, and contaminated with infections. They were overcrowded and offered little medical care. Visitation was restricted, and the public knew little about the conditions. True or False
True (Chapter 4 Overview)
In the future, hospitals will no longer be the hub of the health care system. Instead they will be important components of community based integrated systems. True or False?
True (Chapter 4 Overview)
Leper colonies were considered to be the first 'hospitals'. True or False
True They were not established to serve or aid lepers, but rather to protect society by isolating the diseased individuals. (Chapter 4 Overview)
The quality of hospital-based care was historically based on the degree of conformance with pre-set standards. True or False?
True (Chapter 4 Overview)
Two decades ago, a patient stayed in the hospital until the physician decided the patient was well enough to be discharged. Physicians generally tried to balance the interests of the patient with those of the hospital. The length of stay varied from one region of the country to another, even for those with the same condition True or False
True (Chapter 4 Overview)
Vertical Integration
Vertical integration in health care includes several service components, with each addressing some dimension of the population's health care needs. For example, a complete vertically integrated system would include facilities, personnel, and technological resources to render the complete continuum of care. (Chapter 4 Overview)
Hospitals have one of three basic sponsorships. What are they?
Voluntary not-for-profit entities Owned and managed by profit-making corporations Public facilities, supported and managed by government jurisdictions (Chapter 4 Overview)
What are hospitalists?
a relatively new physician specialty and the ranks of hospitalists are rapidly growing. Hospitalists substitute for patients' primary physicians and coordinate all in-hospital care. Most are qualified in internal medicine. Many assessments are currently underway regarding quality and coordination of care. (Chapter 4 Overview)
The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) requires physicians to choose between two quality reporting systems: a. Alternative Payment Model (APM) or Merit-Based Incentive Payment System (MIPS). b. Population Health Focus Readmissions Reduction Program or the Alternative Payment Model (APM). c. Diagnosis-Related Group (DRG) Reimbursement or Merit-Based Incentive Payment System (MIPS). d. Value-Based Purchasing (VBP) or Diagnosis-Related Group (DRG) Reimbursement.
a. Alternative Payment Model (APM) or Merit-Based Incentive Payment System (MIPS). (Ebook Question)
The Patient-Centered Medical Home (PCMH) a. is responsible for providing all of the patients healthcare needs or appropriately arranging a patients care with other qualified professionals b. offers specific care from specialists and is not accountable for the patients general physical and behavioral health needs c. is a group of providers and suppliers involved in patient care that work together to coordinate care for the patients they serve under the traditional Medicare free-for-service program d. provides resources to support the development and testing of two service delivery and reimbursement models
a. is responsible for providing all of the patients' healthcare needs or appropriately arranging a patients care with other qualified professionals (Ebook Question)
A major trend in hospital corporate organization over the past few years as hospitals strategically prepared for system reforms has included: a. mergers and consolidations into larger systems of care. b. downsizing of nursing and related support personnel. c. closures of ambulatory clinics. d. publicly disclosing fees and charges to improve competitive market position.
a. mergers and consolidations into larger systems of care. (Ebook Question)
Federal support of hospital construction was critically important to the location of hospitals in underserved rural areas in the mid-twentieth century. a. true b. false
a. true (Quiz Question)
In health care, which of the following terms refers to a system that includes several service components with each addressing one or more dimensions of a population's healthcare needs? a. vertically integrated b. laterally integrated c. parallel integrated d. horizontally integrated
a. vertically integrated (Quiz Question)
What is informed consent?
an important patient right. Legally recognized since 1914, informed consent means that the patient understands the medical procedure to be performed, its necessity, and alternatives. Benefits and risks must be explained, along with the consequences and likelihood of each. Consent must be freely given by the patient. It is also appropriate for patients to as for Second opinions regarding the necessity and safety of various tests and procedures. Many insurers now require a second opinion before agreeing to pay for certain procedures. Second opinions can help guard against unnecessary, inappropriate, or non-beneficial procedures. (Chapter 4 Overview)
For many years, the standard for assessing hospital quality of care was peer review using physician audits of selected patient records to judge "the degree of conformity with preset standards." Which of the following was not a reason for the ineffectiveness of such audits? a. Reviewers used implicit standards to make qualitative judgments b. Hospital administrators influenced how reviewers were selected c. No rational basis existed for chart selection to permit extrapolation of sample findings to the larger patient population d. When deficiencies were identified, reviewers were reluctant to pass judgment on their colleagues
b. Hospital administrators influenced how reviewers were selected (Quiz Question)
Retail clinics are so-named because they: a. provide menus from which patients may select services b. are located in sites such as pharmacies, grocery and "big box" stores c. offer periodic discounts on certain preventive services d. accept credit cards for payment
b. are located in sites such as pharmacies, grocery and "big box" stores (Ebook Question)
Until the mid-1980s, hospitals were reimbursed for whatever they charged on a "retrospective" basis. Now they are paid a certain amount for each patient's care on a predetermined "prospective" basis. The amount they are paid is based on a. empirical data b. diagnosis related groups (DRGs) c. cost of resources used d. prospective patient categories (PPCs)
b. diagnosis related groups (DRGs) (Quiz Question)
The development that contributed most significantly to the decline of the social mission of voluntary hospitals was the a. specialization of clinical practice b. enactment of private and public insurance reimbursement for hospital care c. development of high technology hospital care d. passage of 1973 HMO legislation
b. enactment of private and public insurance reimbursement for hospital care (Quiz Question)
The Balanced Budget Act of 1997 increased payments for Medicare patients to cover the cost of treating them and stabilized the U.S. hospital system. a. true b. false
b. false (Quiz Question)
Hospitals in the future healthcare system will: a. expand as hubs of more technologically sophisticated healthcare systems. b. no longer be the axis of healthcare delivery, but will retain core roles as sites of sophisticated care, professional teaching, and clinical research. c. surrender their charitable missions to embrace profit-making principles. d. emphasize competition with community physicians.
b. no longer be the axis of healthcare delivery, but will retain core roles as sites of sophisticated care, professional teaching, and clinical research. (Ebook Question)
The Affordable Care Act (ACA) includes all the following provisions except: a. requiring all Americans to have a basic form of health insurance or pay a federal tax penalty. b. requiring all Americans to only be seen by physicians as assigned by the federal government. c. allowing young adults to continue coverage on their parent's health insurance up to the age of 26. d. ending pre-existing condition exclusions. (Insurance companies cannot refuse to insure an applicant due to an existing medical condition.)
b. requiring all Americans to only be seen by physicians as assigned by the federal government. (Ebook Question)
In colonial America, the primary functions of hospitals were to a. support scientific research b. shelter older adults, the dying, orphans, and vagrants and protect community residents from contiguously sick and mentally ill persons c. provide congregate sites for training nurses d. provide entrepreneurial enterprises for business-minded physicians
b. shelter older adults, the dying, orphans, and vagrants and protect community residents from contiguously sick and mentally ill persons (Quiz Question)
Hospitals must adjust by:
becoming part of an integrated system developing new management structures meeting population-based needs developing relationships with physicians developing and maintaining patient-focused clinical processes implementing total quality management emphasizing and measuring quality and outcomes (Chapter 4 Overview)
Through discharge planning, hospitals help assure that safe and appropriate post-hospital care is arranged for each patient. Medicare patients may appeal what they believe to be a premature or inappropriate discharge by petitioning which of the following organizations? a. hospital board of directors b. hospital medical staff c. Quality improvement organization (QIO) d. American Hospital Association
c. Quality improvement organization (QIO) (Quiz Question)
The ultimate responsibility for a hospital's quality of care, including the medical care provided, rests with a hospital's: a. medical staff organizations b. department of quality management c. board of directors d. chief executive officer
c. board of directors (Quiz Question)
A major obligation of physicians when obtaining informed consent for a medical procedure is to a. shield the patient from information about possible negative side effects b. ensure that family members agree with patient's decision c. ensure that the patient understands the risks, benefits, and alternatives of the procedure d. protect themselves from malpractice claims
c. ensure that the patient understands the risks, benefits, and alternatives of the procedure (Quiz Question)
The Triple Aim includes all of the following except: a. improving the patient experience of care (including quality and satisfaction). b. improving the health of populations. c. ensuring all healthcare professionals are properly credentialed. d. reducing the per capita cost of health care
c. ensuring all healthcare professionals are properly credentialed. (Ebook Question)
"Hospitals can no longer live in a four-walls, brick-and-mortar world." This statement refers to which encompassing principle of healthcare reform? a. primary doctors will be the system leaders, not specialists b. almost every American will have health insurance coverage c. focus on population health status with community-based delivered in multiple provider sites d. measures of hospital quality will become more transparent and available to the public
c. focus on population health status with community-based delivered in multiple provider sites (Quiz Question)
There are a number of major operating divisions within a hospital. Allied health professionals are the group whose staff members may be best described as: a. performing a wide array of imaging, including ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). b. providing numerous special diets ordered for patients as part of their overall care in the hospital. c. supporting, complementing, or supplementing the functions of physicians, nurses, and other professionals in delivering care to patients. d. providing specialized care to assist patients in achieving optimal physical, mental, and social functioning after resolution of an illness or injury
c. supporting, complementing, or supplementing the functions of physicians, nurses, and other professionals in delivering care to patients. (Ebook Question)
Hospital value-based purchasing now required by the ACA for over 3,500 Medicare-participating hospitals is a program that may be best described as using: a. Organizations composed of multiple providers which are paid incentives for enabling Medicare patients to avoid hospitalizatoins b. Hospital fines and penalties dor readmissions with the same diagnosis within 30 days of discharge c. Consolidated Medicare payments based on a complete "episode of care" rather than piecemeal payments for individual services d. Incentive payments for achievements and improvements in clinical care and patient satisfaction
d. Incentive payments for achievements and improvements in clinical care and patient satisfaction (Ebook Question)
Under the general business definition, horizontally integrated organizations: a. gain the advantage of an increased market share across a mixture of high-profit, loss-generating, and break-even revenue sources. b. operate a variety of business entities, each of which is related to the other. c. include all facilities, personnel, and technologic resources to render the complete continuum of care. d. are aggregations that produce the same goods or services.
d. are aggregations that produce the same goods or services. (Ebook Question)
In its landmark report on hospital errors, "To Err is Human," the Institute of Medicine emphasized that errors in care most typically originate from which one of the following sources? a. distracted, fatigued physicians b. inadequate nurse training c. medical equipment failures d. deficiencies in the systems of care
d. deficiencies in the systems of care (Quiz Question)
Which of the following maintains the largest ownership interest in ambulatory surgery centers? a. physician specialty societies b. shareholders of publicly-traded companies c. hospital corporations d. physicians
d. physicians (Ebook Question)
The following is true of teaching hospitals except: a. they provide clinical education for medical students and medical and dental residents. b. they comprise approximately 7% of all hospitals in the United States and provide 37% of hospital charity care. c. they are affiliated with one or more allopathic or osteopathic medical schools. d. they require patients to pay more for medical services because of the research that is performed at these institutions.
d. they require patients to pay more for medical services because of the research that is performed at these institutions. (Ebook Question)
What is the "Patient Care Partnership"?
explains patients' rights and responsibilities in six sections: 1. High-quality hospital care 2. A clean and safe environment 3. Involvement in your care 4. Protection of your privacy 5. Help when leaving the hospital 6. Help with your billing claims (Chapter 4 Overview)
What is sub-acute care?
is a level of care between hospitalization and nursing home care. It is a mix of convalescent and rehabilitative services, and can last from ten to one hundred days. This level of care is a financial opportunity for hospitals and nursing homes to capture the maximum Medicare reimbursement. Lower hospital costs are also attractive to managed care organizations. (Chapter 4 Overview)
Diagnosis-related groups (DRGs)
is designed to provide hospitals with an incentive to discharge patients as soon as possible. This system pays hospitals a set amount based on the patient's diagnosis, regardless of the length of stay. Shorter lengths of stay result in increased income for hospitals, while longer stays result in decreased earnings. This system changed hospital behavior and led to quicker discharges and fewer diagnostic tests that were of marginal value. It also led to an increased need for home health care services and long-term care facilities. (Chapter 4 Overview)
What were "pesthouse" used for?
isolate patients during epidemics. (Chapter 4 Overview)
The governance of the hospitals is generally divided among the _____, _____, and _____
medical staff, the administration, and the board of directors or trustees. (Chapter 4 Overview)
Avedis Donabedian introduced the concept of three basic components of medical care in the 1960s. What were the 3 components?
structure, process, and outcome. Previously, only structural components of hospitals were considered for evaluation (Chapter 4 Overview)
What are public hospitals?
those run by a city, county, the military, Department of Veterans Affairs, or the U.S. Public Health Service. These hospitals often have a high percentage of economically disadvantaged patients. They also usually provide high-cost, low-return services such as trauma centers that other hospitals are reluctant to provide. (Chapter 4 Overview)