Chapter 4: Ethics & Research Terms Flashcards
Program evaluation- QI
Quality improvement: system oriented approach that views limitations & problems proactively as opportunities to increase quality.
Prevention emphasized, and no blaming
Program evaluation- TQM
Total Quality Management: creating of organizational culture that enables employees to contribute to environ. of cont. improvement
Program evaluation- PAI
Performance assessment & improvement (PAI): systematic method to evaluate appropriateness and quality of services
Program evaluation- Utilization review
plan to review the use of resources w/in a facility. determine med neccissary and cost effective? often component of QI or PAI
Program evaluation- Statistical utilization review
reimbursement claims data are analyzed to determine most efficient and cost-effective care.
Program evaluation- Peer review
system in which the quality of work of a group of health professionals is reviewed by their peers.
Program evaluation- Professional review organization (PRO)
groups of peers who evaluate appropriateness of services and quality of care under reimbursement/state licensure requirements
5 P’s of marketing
1- Product 2- Price 3- Place 4- Promotion 5- Position (place the product holds in relation to similar products or services in the market)
Quantitative methodology/design: True-experimental
classic 2 group design includes random selection and experimental (receives tx) and control group (no tx). Often difficult to use this design with human subjects.
Quantitative methodology/design: Quasi-experimental
Ind variable is manipulated to determine effect on dependent variable but theres lesser degree of researcher control and/or no randomization
Quantitative methodology/design: Non-experimental/correlational
No manipulation of Ind variable; no randomization or researcher control. Used to study relationships btwn two or more variables.
expressed as correlational coeffecient from -1.00 to +1.00.
Ex’s) 1-retrospective (data collected in past)
2- prospective (present data)
3- descriptive (inv of several variables at once to determine existing relationships
4- predictive (used to develop predictive models)
Qualitative methodology/design types: Phenomenological
Study of 1 or more ppl and how they make sense of their experience. Minimal interpretation by investigator. Meanings can only be ascribed by participants
Qualitative methodology/design types: Ethnographic
Patterns & characteristics of cultural group, including values, roles, beliefs, and normative practices
- done thru observations, interviews, examination of literature, & cultural immersion
- used to understand insiders perspective in order to develop meaningful services
Qualitative methodology/design types: Heuristic
complete involvement of researcher in the experience of the subject to understand and interpret a phenomenon. Meanings can only be understood if personally experienced.
Qualitative methodology/design types: Case Study
Single subject or group of subjects is investigated in an in-depth manner.
- purpose can be description, interpretation, or evaluation
- easy to use in most settings
Intradisciplinary Team
Members of ONE discipline evaluate, plan, and implement treatment. Too narrow, other disciplines not involved.
Multidisciplinary Team
Multiple disciplines assess and treat independent from one another. Limited communication, competition may develop.
Interdisciplinary Team
Individual assessments and intervention but all disciplines collaborate.
Transdisciplinary Team
Characteristics of interdisciplinary teams are maintained and expanded upon. Role blurring is accepted.
Capitation
A payment arrangement for health care service providers such as physicians or nurse practitioners. It pays a physician a set amount for each enrolled person assigned to them, per period of time, whether or not that person seeks care.
Diagnostic Related Groups (DRGs)
Descriptive categories that determine the level of payment at a per case rate. (lump sum)
Health Maintenance Organization (HMO)
Most common form of managed care. Enrollees must see only doctors within HMO network.
Preferred Provided Organization
Similar to HMO but offers more choices of providers, but as choices increase, percentage of payment decreases.
Eligibility for Medicare
- over 65
- end stage renal disease
- long-term disability (e.g. ALS) who have received disability benefits for 24 months
- retired railroad workers
