health and aandP Flashcards
focuses on primary care first
HMO
Can see specialist without referral
PPO
how are MCOs financed
thru capitation and discounted fees
financed by the military and covers families, dependents, or retired military.
Tricare
VA=
veterans administration
VISN=
Veterans Integrated Service Networks
does Medicare or Medicaid NOT cover Long-Term Care?
Medicare
what % of health care is financed thru employers?
57%
what % of health care is financed thru the government?
43%
SJ focuses on
the community
MJ focuses on
the individual
complete state of knowledge
diagnosis
something that is measurable (ex: BP, temp)
sign
subjective (“my head hurts”)
symptom
According to WHO what is the definition of health
the complete state of mental, physical, and social well being, not merely the absence of disease.
what is the primary purpose of a health care system (according the WHO)
promote, restore, or maintain health
identified by a person’s perception of how they feel
Illness
based on professional evaluation
disease
example of a subacute disease
trauma in a wreck
HCAHCPS
Hospital consumer survey. first standardized survey
a person’s genetic makeup determine what % of health outcomes?
20%
Medical practice determines what percentage of health outcomes
10%
Individual behaviors determine what percentage of health outcomes
50%
social/environmental factors determine what percentage of health outcomes
20%
first asylum was built in what year?
1790
growth and medicare and Medicaid happened in what era
postindustrial
discovery of anesthesia
Horace Wells
aseptic technique
Ignaz Semmelweis
germ theory of disease
Louis Pasteur
father of antiseptic surgery
Joseph Lister
discovery of x ray
William Roentgen
discovered the antibacterial properties of penicillin
Alexander Fleming
interest of the AMA is what
to protect physicians
what report showed how well med schools were doing
Flexner report
first hospital plan
Blue Cross
first physician plan
Blue Shield
when did Blue Cross and Blue Shield merge?
1974
Why did a national insurance plan fail? (4 reasons)
ideological differences, tax aversion, political stability, and institutional instability.
title 18
Medicare
title 19
medicaid
Medicare part A
finances hospital care
Medicare part B
covers physician services (premium)
Kerr Mills Act
income based insurance for elderly people over the age of 65.
Medicare part C
have to already be enrolled in A or B but you get the choice of preferred provider. but is more expensive.
Medicare part D
helps elderly pay for prescription drugs
who oversees medicare/medicaid
CMS
When was the Kerr Mills act entacted
1960
what is the primary vehicle for insurance and delivery
managed care
in 1995, the GATS was signed. what does it do?
allows you to get elsewhere for treatment if you cannot get it in the U.S.
type of doctor that focuses on whole self
Doctor of Osteopathic medicine (DO)
Type of doctor that focuses on neutralizing disease
MD
% of physicians that are DOs
7%
6 main specialties
internal medicine, OBGYN, neurologists, psychiatry, surgery, and radiologists
% of generalists
38%
% of specialists
62%
specialize in drug therapy and work closely with physicians
pharmacotherapists
determine and prepare drugs needed for nutritional therapy
nutrition-support pharmacists
produce radioactive drugs used for patient diagnosis and therapy
Radiopharmacists or nuclear pharmacists
pharmacists that do compounding and mixing
clinical pharmacists
top 3 ways a nurse can lose her license
diverting, breach of privacy, and negligence
area in which materials are manipulated at the atomic and molecular levels for better diagnosis and treatment of disease such as cancer
Nanotechnology
EMR’s are an example of what
Clinical information systems
everyone having access
Interauthroability
this act provided incentives to providers for adopting meaningful use of EHR technology
HITECH Act of 2009
development and dissemination of technology
Technology diffusion
what is driving innovation
Research and development
the desire to have state of the art technology available to use it despite its cost
the technological imperative
authorized to take action only after drugs sold to consumers cause harm
Food and Drugs Act
Evidence of safety is required before new drugs or devices can be marketed
Federal food, Drug, and cosmetic Act
FDA takes charge of reviewing efficacy and safety of new drugs, which can be marketed only once approval is granted
Drug Amendments
Drug manufacturers are given incentives to produce new drugs for rare diseases
orphan drug act
health care facilities must report device-related injuries or illness of patients or employees to the manufacturer of the device, and if death is involved, the incident must also be reported to the FDA
Safe Medical Devices Act
FDA receives the authority to collect application fees from drug companies to provide additional resources to shorten the drug approval process
Prescription Drug User Fee Act
x ray machines, pregnancy tests, and powered wheel chairs are what class of device
2
which two organizations provide financial support to private and public institutions for biomedical research
AHRQ and NIH
the evaluation of medical technology to determine efficacy, safety, and cost effectiveness
Heath Technology Assessment (HTA)
if a product or service actually produces some health benefits
Efficacy
benefits must outweigh any negative consequences
Primary benchmark
do the benefits or initial medical treatment usually exceed costs
Yes
how is value of technology enhanced?
By improving quality and/or reducing cost
