Chapter 7 VNC Flashcards
Public hospitals
(government)—veteran’s hospitals, nursing homes, military hospitals, etc
Private hospitals
(nongovernment)—private providers, private for-profit or nonprofit health care facilities
Health Care Service
Describes the actual delivery of health care by health care workers, Includes prevention, diagnosis, and treatment of illnesses.
Health care regulation
Methods designed to control quality of health care and cost, developed by governmental bodies.
Health care accreditation
Process of examining operation of a facility using written standards of excellence
Approval and Accreditation of Hospitals
Approval by State Department of Health, Accreditation is a voluntary process.
Approval and Accreditation of Home and Community Health Care Organization
Need a license to operate
Quality Assurance, Peer Review, & Risk Management Programs
Ensure pts receive quality care in a safe environment
-quality assurance and performance improvement plan (QAPI)
-peer review-examining someones work
-risk management programs- prevent financial loss to organization/facility
Private Insurance
Fee-for-service
Prepaid
Government Insurance
Social security act of 1965
(medicare, medicaid, SCHIP (1977) )
Other cost-controlling programs
Utilization review, quality management, critical pathways and care maps, pay for performance, improvements in managed care programs, governmental legislation
The Centers for Disease Control and Prevention (CDC)
Promote health and quality of life by preventing and controlling disease, injury, and disability
The Food and Drug Administration (FDA)
Foods, medicines, and cosmetics
The Health Resources and Services Administration (HRSA)
Improve access to health care by strengthening health care workforce, building healthy communities, and achieving health equity
National Institute of Health (NIH)
Institutes and centers engaged in research
Centers for Medicare and Medicaid Services (CMS)
Administers Medicare, Medicaid, State Children’s Health Insurance Program (SCHIP)
Other agencies
Focus on children and families, research, quality of care, community living, registration of diseases and toxic substances, substance abuse, mental health
Issues and Concerns- Health Care System
Difficult to navigate; too many choices and options
Issues and Concerns- Health Care Providers
-Shortage of primary care providers
-Future role of multipurpose worker and cross-training
Issues and Concerns- Health Care Services
Equal access to health care services for all citizens
Issues and Concerns - Health Care Approval, Accreditation, and Standards of Excellence
Cost of accreditation, Cost and maintenance of standards of excellence certificate
Issues and Concerns- Health Care Facilities
Financial challenges, quality of services, patient safety, lack of training and supervision, care for the uninsured and charity care, and personnel shortages
Issues and Concerns- Health Care Financing
One of the most significant is increased number of elderly—baby boomers, Medicare costs, Expensive treatments.
