Chapter 8 - Hospitals Flashcards
Discharge
refers to the total number of people that were served
Impatient Day
refers to a night spent in the hospital by a patient
Average length of stay (ALOS)
the average number of days a person spends in the hospital
Who is admitted to the hospital more, men or women?
Women, women also tend to live longer
Who is admitted more, African Americans or Caucasians?
African Americas go to the hospital more than Caucasians
Who is admitted more, poor or non-poor?
Poor people go to the hospital more than non-poor people, don’t have primary care doctors and don’t typically receive preventative care
what is the ALOS?
4.8 days… insurance is driving number down, want patients to stay less and less in hospitals because it’s so expensive
Capacity
how many beds you have TOTAL
Census
how many beds are ACTUALLY occupied
occupancy rate
the percentage capacity used during a given period of time
Public Hospitals
- These hospitals are owned by agencies affiliated with federal, state or local governments
- Just because they are “public” does not mean that anyone can use them
Federal hospitals are for special groups
EX) VA Hospital
Local Hospitals
- open to general public
- Serve mostly in the inner city and indigent and disadvantage populations
- Can be affiliated with medical schools and train other health professionals
- Often provide charity care and suffer a financial hit
Private Nonprofit Hospitals (not-for-profit)
- Also called “voluntary hospitals”
- Owned by non-government entities
- Mission: to benefit the community
- Operating expenses are covered from patient fees, reimbursement from insurance, donations and endowments
-Exempt from federal, state and local taxes
In exchange they have to:
1) provide some defined public good, such as service, education or community welfare, 2) not distribute the profits to any individual
Private for-profit Hospitals
- Also known as “proprietary hospitals”
- Owned by individuals, partnerships or corporations – stockholders.
- Often have a specialty (ortho, cardiac, etc)
- Goal is to provide a return on investment to their shareholders
- Mission: deliver the highest quality of care possible at the most reasonable price
General Hospitals
- Provide diagnostic, treatment and surgical services with a variety of conditions
- Have a broader range of services that they provide for a assortment of conditions
Specialty Hospitals
-Treat specific types of disease or medical conditions
ortho, cancer, cardia, psychiatric, children
Psychiatric Hospitals
- Provide treatment to those who have mental illness
- Must have psychiatric, psychological and social work services
- Written agreement from a general hospital that they will transfer patients for medical care
- Most psych hospitals are state run hospitals
Rehabilitation Hospitals
- Specializes in intensive therapeutic services
- Various conditions such as: stroke/neuro, TBI, etc.
Children’s Hospitals
Treats children with unique medical conditions (chronic or congenital)
Nursing care is at a higher ratio at a children’s hospital than an adult hospital
Rural Hospitals
- Located in a county that is not part of the metro area (EX: St. Paul Hospital)
- Challenges for rural health: location, small size, staffing, physician shortages and inadequate financial resources
- Balanced Budget Act of 1997 Critical Access Hospitals
25 beds or less for Emergency Care; additional 10 may be used for psychiatric/rehab services
Teaching Hospitals
- Offer one or more graduate residency program approved by the AMA
- Unless they are training “physicians” they cannot be called a teaching hospital even though they are teaching other health professionals
- Academic Medical Center: active collaboration between a hospital and a university
Have a teaching and research mission
Often have higher specialty or subspecialties
Osteopathic Hospitals
- Takes a holistic approach to a patients care
- DO and MD’s work side by side of each other, typically treat patients the same
Who do hospitals have to be licensed by? How many times is it checked?
- Licensed by State
- Checked once yearly
Why do hospitals have to be certified?
So they can participate in Medicare and Medicaid programs
