Chapter 1.2 - Trends of Health Care Flashcards
What is the purpose of Cost Containment?
To control the rising cost of health care and achieve maximum benefit for every dollar spent.
What are four reasons why Cost Containment is used?
- Costs are increasing with technological advances
- Improved survival rates
- Aging population
- Health related lawsuits (malpractice insurance)
What are the 6 Cost Containment methods?
1) Diagnostic related groups (DRG’s)
2) Combination of services
3) Outpatient services
4) Mass or bulk purchasing
5) Early intervention and preventative services
6) Energy Conservation
What is Diagnostic related groups (DRG’s)?
- Created in order to control costs of Medicare/Medicaid.
- Patients with same diagnosis (same payment group)
- Maximum cost of care is set (facility must not spend more than maximum amount).
What is Combination of services?
- Avoids duplicating services.
- Multiple agencies share services.
- “All-in-one” facilities.
What is Outpatient services?
- Reduces need for hospital admissions.
- May include use of home care or skilled care facility.
What is Mass or bulk purchasing?
- Buying large quantities reduces price.
- May be done by a parent agency.
What is Early intervention and preventative services?
- Providing care before condition becomes more serious.
- May include education, immunizations, regular check ups, etc.
What is Energy Conservation?
- Monitoring use of energy, water, and gas.
- May include building energy-efficient facilities, renewable energy sources, maintenance, etc.
What are 5 things about Home Health Care?
- Industry grew rapidly when DRG’s initiated.
- Services provided in patient homes.
- Visits must be pre-authorized by insurance agency (unless private pay).
- Often necessary to teach family members to perform care since visits are limited.
- Emphasis on cost containment also applies to home health.
What are 3 things about Geriatric Care?
- Care for the elderly.
- Percent of elderly population growing rapidly due to improvements in health care.
- OBRA
What are 4 examples of Geriatric Care?
- Adult Day Care Centers
- Retirement Communities
- Assisted/Idependent Living Facilities
- Long Term Care Facilities
What does OBRA stand for?
Omnibus Budget Reconciliation Act
What are 4 things about OBRA?
- Federal law regarding long-term care and home health care.
- States must establish training and competency evaluation programs for nursing/geriatric assistants and maintain regristry of qualified individuals.
- Requires compliance with patients/residents rights.
- Ensure high standard of care.
What are 4 things about Telemedicine?
- Use of audio, video, and computers to provide health care from a distance.
- Field has exploded since Covid (Up 2000%)
- Increases accessibility to information.
- Decreases need for trip to medical centers & home health visits.
What are 4 things about Wellness?
- State of optimal health (balanced physical, mental, and social health).
- Increase awareness of maintaining health and preventative disease.
- Emphasis on preventative measures rather than waiting for need for curative intervention (improves quality of life and saves costs).
- Facilities include wellness centers, weight control facilities, health food stores, stress reduction counseling, etc.
What are the 5 types of Wellness?
- Physical
- Emotional
- Social
- Mental & Intellectual
- Spiritual
What is Physical Health?
Well balanced diet, exercise, routine exams and immunizations.
What is Emotional Health?
Understanding feelings and expressing them appropriately, coping with stress, etc.
What is Social Health?
Showing concern, fairness, affection, tolerance, and respect for others.
What is Mental & Intellectual Health?
Being creative, logical, curious, and open minded.
What is Spiritual Health?
Using values, ethics, and morals to find meaning and purpose to life.
What are 5 things about Holistic Health?
- Attends to all 5 types of wellness by treating the whole body, mind, and spirit.
- Recognizes that each person is unique with different needs (used many methods to diagnose and treat).
- Emphasis on protection and restoration.
- Based on the body’s natural health processes.
- Patient responsible for choosing care and worker must respect their choice.
What does CAM stand for?
Complementary and Alternative Methods (of Health Care).
What are 4 things about Complementary and Alternative Methods?
- Used to supplement (complementary) or replace (alternative) traditional medical treatment.
- Based on belief that the person has a life force or energy that can be used in the healing process.
- May vary by cultural values or beliefs.
- Integrative Health Care : uses both mainstream (“Western”) medicine and CAM therapies (belief that the mind can affect the healing process).
