Chapter 1.2 - Trends of Health Care

Question 1

What is the purpose of Cost Containment?

Answer 1

To control the rising cost of health care and achieve maximum benefit for every dollar spent.

Question 2

What are four reasons why Cost Containment is used?

Answer 2

• Costs are increasing with technological advances
• Improved survival rates
• Aging population
• Health related lawsuits (malpractice insurance)

Question 3

What are the 6 Cost Containment methods?

Answer 3

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

Question 4

What is Diagnostic related groups (DRG’s)?

Answer 4

• 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).

Question 5

What is Combination of services?

Answer 5

• Avoids duplicating services.
• Multiple agencies share services.
• “All-in-one” facilities.

Question 6

What is Outpatient services?

Answer 6

• Reduces need for hospital admissions.
• May include use of home care or skilled care facility.

Question 7

What is Mass or bulk purchasing?

Answer 7

• Buying large quantities reduces price.
• May be done by a parent agency.

Question 8

What is Early intervention and preventative services?

Answer 8

• Providing care before condition becomes more serious.
• May include education, immunizations, regular check ups, etc.

Question 9

What is Energy Conservation?

Answer 9

• Monitoring use of energy, water, and gas.
• May include building energy-efficient facilities, renewable energy sources, maintenance, etc.

Question 10

What are 5 things about Home Health Care?

Answer 10

• 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.

Question 11

What are 3 things about Geriatric Care?

Answer 11

• Care for the elderly.
• Percent of elderly population growing rapidly due to improvements in health care.
• OBRA

Question 12

What are 4 examples of Geriatric Care?

Answer 12

• Adult Day Care Centers
• Retirement Communities
• Assisted/Idependent Living Facilities
• Long Term Care Facilities

Question 13

What does OBRA stand for?

Answer 13

Omnibus Budget Reconciliation Act

Question 14

What are 4 things about OBRA?

Answer 14

• 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.

Question 15

What are 4 things about Telemedicine?

Answer 15

• 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.

Question 16

What are 4 things about Wellness?

Answer 16

• 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.

Question 17

What are the 5 types of Wellness?

Answer 17

• Physical
• Emotional
• Social
• Mental & Intellectual
• Spiritual

Question 18

What is Physical Health?

Answer 18

Well balanced diet, exercise, routine exams and immunizations.

Question 19

What is Emotional Health?

Answer 19

Understanding feelings and expressing them appropriately, coping with stress, etc.

Question 20

What is Social Health?

Answer 20

Showing concern, fairness, affection, tolerance, and respect for others.

Question 21

What is Mental & Intellectual Health?

Answer 21

Being creative, logical, curious, and open minded.

Question 22

What is Spiritual Health?

Answer 22

Using values, ethics, and morals to find meaning and purpose to life.

Question 23

What are 5 things about Holistic Health?

Answer 23

• 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.

Question 24

What does CAM stand for?

Answer 24

Complementary and Alternative Methods (of Health Care).

Question 25

What are 4 things about Complementary and Alternative Methods?

Answer 25

• 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).