Chapter 8 Flashcards
Hospital
An institution with at least 6 beds. Delivers diagnostic and therapeutic services for medical conditions. Must be licensed
Inpatient
Overnight stay when the patient is formally admitted with a physician’s order.
Outpatient
Services provided while the patient is NOT staying overnight in the health care institution.
Medical Center
A hospital that has achieved specialization and offers a wide scope of services. Often engage in teaching and research.
Evolution of the Hospital
6 Stages
1.Before 1850. Almshouses as primarily institutions of social welfare.
2. Community owned private hospitals as charitable institutions supported by donors
3. Institutions of medical practice and training serving the needs of all members of society, and able to make profit. (anesthesia, germ theory, x-ray)
4 Emergence of relatively small number of physician owned proprietary hospitals.
5. University based centers of medical research. Discipline
6. Emergence of medical systems providing a large array of health services.
Factors contributing to the downsizing of hospitals
Change in medicare reimbursement to hospitals from retrospective to prospective leading to shorter stays
Hospital closings
Managed care emphasis on cost containment and use of services such as outpatient, home health, skilled nursing care.
PPS
Access
the total number of patient discharges per 1,000 population
Utilization
Inpatient Day, a night spent in the hospital by a patient
Access and Utilization measures
ALOS- Average Length of Stay
Days of care- Total number of patient days incurred by a population over a given period of time.
Capacity- number of beds set up staffed and made available by a hospital for patient use
Days of Care
number of discharges X ALOS
Capacity
number of beds set up, staffed, and made available by hospitals for inpatient use.
Census
refers to the number of patients on a hospital on a given day
Average Daily Census
average census over a given period of time
patient days over a defined period / number of days in the period
Occupancy Rate
the percentage of capacity used during a defined period of time.
average daily census / capacity
Hospital Employment
2010: 16.4 million jobs in US Health care system
4.7 million in hospitals 29%
Between 2000-2010 employment grew 18.5%
