Health Care Systems Flashcards
Inpatient
Patient stays in the medical facility for a least one night (e.g., hospitals, mental institutions, and nursing homes)
Outpatient
Patient is examined, diagnosed, or treated at a medical facility, but does not stay overnight.
Hospital Costs
In 2011 39 million hospital stays totaling $387 billion
Top 5 Conditions that required hospitalization
Septicemia osteoarthritis complication of device (implant or graft) newborn infants acute myocardial infarction
Two categories for hospital ownership
Public and Private
Types of Public Hospitals?
Federal
State
Local
Prisons
What makes up federal hospitals
- Department of Defense
- Indian Health Service,
- Veterans Health Administration
What are 3 types of private hospitals?
- Not for profit
- For profit
- Physician owned
What are some examples of private in patient facilities?
- skilled nursing homes
- Long term acute care hospitals
- Inpatient rehab facilities
Primary Care vs. Secondary Care?
- Primary addresses variety of issues
- Secondary is much more specialized
What are four types of regulators?
- Government
- Insurers
- Private Accrediting Organizations
- Professional Societies
What is a certificate of Need
laws require new facilities (usually hospitals) to prove
that there is a need for such services in the area before construction can be
approved
What are three major accrediting organizations
- National Committee for Quality Assurance (NCQA)
- The Joint Commission for the Accreditation of Healthcare Organizations (Joint
Commission) - Utilization Review Accreditation Commission (URAC)
Difference between state and federal regulators?
- States are more in liscensure, control of services (CON), and insurance qualifcations
- Feds deal with reimbursement
