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List the different classifications of health care technology (by industrial group)
Pharmaceuticals, Medical devices, Medical equipment, Medical processes and procedures, Health care Information Technology.
Acute illness last how many days?
5 - 7 days Short-term.
Chronic diseases is
Long-term
There are three perspectives in the American Health Care System. Name them
A. Public policy
B. Management
C. Clinical
The fastest growing segment of the population is
The Elderly
Name five components of a Basic Healthcare System (Do not confuse with the what insurance pays for. Some are the same some are not.
Health Promotions, Dental Services, Longterm Care, Inpatient care, Ambulatory Care
People are living longer due to
Medical Technology Intervention, Vaccinations
Clinical trials are composed of how many phases?
Pre-Clinicals, I, II, III, IV
What country has the highest life expectancy?
Japan
Medicare has four parts. List what each part pays for.
a. Part A : Hospital Insurance
b. Part B : Supplemental Insurance
c. Part C : Medical Advantage
d. Part D : Drugs
Who consumes most of the Medicaid budget?
Disabled
Health Administrators are responsible for two major things. What are they?
Making money for the company.
Keeping the physicians out of jail.
What is the difference between mortality and mobidity?
Mortality is death
Morbidity is about to die
What does GDP stand for?
Gross Domestic Product
Where does third party reimbursements come from?
Insurance companies ex: Blue Cross Blue Shield
What are some factors of Disproportionate Growth in Health Care Expenditures?
Aging population
Lack of competitive forces in the healthcare system
Maldistribution of physicians and other providers.
What are four payment sources in health care?
Private health insurance
Out-of-pocket payment
Philanthropy and other private sources (donations)
Federal, State, and local government (Medicare & Medicaid)
What is Moral Hazard?
You are more likely to goto the doctor with insurance than without it.
What is Insurance Premium?
Whats taken out by your employer.
What is a Deductible?
Long hospital stay
What is Co-payment
Doctors stay
Give some examples of Voluntary Health Insurance.
Blue Cross Blue Shield
Private or commercial insurance companies
Health maintenance organizations
What is Coinsurance?
Percentage of the total charges incurred and is paid by the patient.
What is Private Health Insurance?
Linked with inpatient hospitalization Most policies cover : Physicians office visits Outpatient mental health care Prescription drugs DME (Durable Medical Equipment Ambulance Service, etc
What is Insurance?
Mechanism for managing the financial exposure to risk via two basic principles:
Transferring risk from an individual to a group.
Sharing losses on an equitable basis by all members of a group.
What are the Health Insurance funding mechanisms?
Fully Insured
Partially Insured
Self-funded or self-insured
What is Health Savings Accounts?
Gives consumers financial incentives to choose their healthcare provider and manage their own health expenses.
Employees contributions are tax deductible.
What are some Objectives of Managed Care?
- Enhance cost containment
- Implement some forms of rationing
- Promote administrative and clinical efficiency
- Reduce duplication of service
- Enhance appropriateness of care
- Promote comprehensive contracting mechanisms
- Manage care processes by managing provider and consumer behavior.
What does NIH stand for?
National Institution of Health
What does PPO stand for?
Preferred Provider Organizations
Fee-for-service health plans
Within the book
What does HMO stand for?
Health Maintenance Organizations
Members receive all medical care through one group of providers.
What companies provide Staff Model service?
Milliken, Michelin, and BMW provide staff model services by providing service through their own physicians and specialist.
What are some areas of Management in Managed Care?
Provide contracting and network management Utilization Management Quality management General administration Health Information systems Sales and marketing management
What is the Gatekeeper Concept?
One physician provides all primary care for a patient to control the use of expensive resources, to reduce patient-initiated use of specialists, and to ensure overall coordination of care. (HMO’s)
What are some Characteristics of the Uninsured?
Working uninsured
Nonworking uninsured
Medically uninsured
What are the Levels of Prevention?
Primary, Secondary, Tertiary Preventions
What is the Structure of Organized Public Health Efforts?
Assessment
Surveillance (look), Identifying the public need, Analyzing the causes of problems (why)
Policy development
Establishing ways to achieve these goals, Allocating resources
Assurance
Ensure that necessary services are provided in order to reach established goals, Involves implementation of legislative mandates and the maintenance of statutory responsibilities
How many FED Government Public Health Activities are there?
8
How Many in Government Public Health Activities are there in State and Local?
State 6
Local 5
What are the Physicians barrier to health promotion and disease prevention?
Physicians willingness and ability to perform these activities.
Ability of the population to access physicians services.
What is Ambulatory care?
Services provided to noninstitutionalized patients, includes a wide range of services, from routine treatment to complex therapies including surgery.
