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612 Management Exam 1 > Health Care Trends > Flashcards

Health Care Trends Flashcards

1
Q

Scientific Management : Early 1900’s

A 
Grew out of industrial revolution 
Time & Motion Studies 
Worker Efficiency (productivity) 
Monetary motivation 
Process efficiency (cost of therapist vs therapy aids)
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2
Q

Human Relations Movement

A

Studies of work environment
-increase productivity -> lighting & physical condition changes? vs. social relationship?
Maslow’s hierarchy of needs
Lack of empirical research that work productivity and job satisfaction were strongly correlated

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3
Q

Behavioral Science Movement (1950’s)

A

Worked to understand work performance and to study human behavior in organizations

  • redesign routine jobs to allow a broarder range of roles
  • be aware of informal groups and culture of an organization
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4
Q

Groupthink

A

Difficulty w/ autonomus decision making

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5
Q

Pareto Principle

A

20% of what happens in clinic produces 80% of the work.

i.e. nurture long standing relationships w/ physicians who refer to you, you can expand on that realtionship

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6
Q

Peter Principle

A

Next in line gets the job even if they may not be the most qualified

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7
Q

Systems Approach

A

looking at whole and parts : internal & external

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8
Q

Contingency Approach

A

Applying best available info to current situation

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9
Q

Learning Organization

A

Democracy style
Focuses on evolution of an orginization and values transparency, communication, and less hierarchal activity
Works best when everyone is a professional

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10
Q

Medical Model

A

Short term

Includes history, and physical, Dx, and tx to alliviate or cure an underlying medical condition

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11
Q

Educational Model

A

Services are aimed at adaptation and performance w/in the educational setting

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12
Q

Public Health Model

A

Achieve health or populations through

  • prevention of disease: eating nutritious foods to prevent obesity and other related diseases
  • slow progress of disease: to prevent disability and complications (secondary prevention)
  • tertiary prevention used in advance levels of disease to limit disability and other complications
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13
Q

Social Model

A

Longer term maintenance and episodic restorative services (health promotion and prevention of further decline)

  • clients w/ stable health conditions at risk from social isolation, reduced family support
  • focus is on social barriers to prevention
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14
Q

OT Practice Settings Medical Model

A 
Acute hospital (medical or psych) 
Acute rehab 
Subacute rehab
Home health 
Nursing home 
Free standing out pt. or out pt. at a hospital
Private physician office
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15
Q

OT practice Settings Public Health Model

A 
Community Education 
-health insurance company
-Public health agency (CDC, APHA) 
-Private industry 
Research 
-National institute for health
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16
Q

OT Practice Settings Educational Model

A 
School system 
Pre school 
Day Care 
EI home health 
EI out pt. clinic
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17
Q

OT Practice Setting Community Model

A 
Senior center 
Group home , I living center 
Retirement center 
Sheltered workshop
Prevocational programs 
Community mental health center
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18
Q

United States Health Care Now

A

1st in health care spending

37th in overall health care performance

19
Q

Challenges in US health care

A

Rising costs
Emphasis on outcome and accountability
Lack of services to meet specific needs
Imbalance in services available to different populations
Frequent advances in medical terminology
Increase government and public scrutiny of industry practices

20
Q

FDR “Right to Health”

A

Ethical responsibility of an industrialized nation

21
Q

FDR 1930’s

A

Creation of the first insurance company

-Blue cross & blue shield

22
Q

FDR 1944 : Roosevelt’s Economic Bill

A

Set forth fundamental social and political rights part of which was the right to health
Health insurance became an employee benefit

23
Q

Hill Burton Act (1946)

A

Promotes building of hospitals and later free-standing health facilities and later control over-growth and duplication of services (in 70’s & 80’s)

24
Q

1950’s Funds For

A

Encouraging more schools and training of medical personnel

25
Q

1965 National Insurance Established

A 
Medicare (elderly) 
Medicaid (poor) 
Based on FFS initially 
-Fee for service 
-80/20 w/ no limit to costs
26
Q

1972: Amendment to the Social Security ACT

A

Drove focus toward professional standards review to monitor and control costs and quality

27
Q

!966 Allied Health Professional & Personnel Training ACT

A

Grant funding to establish schools

28
Q

1970’s & 80’s Laws Changed d/t spiraling costs of FFS

A

Established Managed Care

  • integrated delivery system between payor (insurance company) & care provider (physician or hospital)
  • Intention to reduce spiraling costs
HMO = health maintenance organization
PPO = preferred provider orginization 
POS = Point of service
29
Q

1983 Amendment to Social Security Act

A

Focused on change to in pt. hospital care costs
Due to rising costs w/ new technology (ordered things like MRI’s that people didnt need to drive up the cost)
Many community hospitals closed

30
Q

1986 PPS

A

Prospective Payment System
Medicare began to look at controlling costs
Predetermined rate is set for tx of specific illnesses in the hospital setting

31
Q

Hospitals now paid for care based on DRG’s

A

Diagnostic Related Groups
-Also known as the product being provided
-467 categories initally
Closely linked to the patients ICD = international Statistical Classification of Diseasses
-in pt. psych issues

32
Q

80’s Prospective Payment System

A

Pushed for less emphasis on hospitalization… incentive to move pt.’s out of hospitals fast as possible encourage expansion of community services

33
Q

1986 Legislation

A

Expanded coverage of out pt. and rehab based OT services by expanding funding for medicare part B
-Medicare part A : in pt
-Part B : Supplementaty medical insurances
Includes OT services furnished in a SNF, rehab agency, public health agency, or by an I practicing therapist

34
Q

1993 Clinton health care plan

A

Failed to Pass
Universal Health care through a national plan
-blocked by lobbyists representing AMA and private health insurance companies

35
Q

1997 State Childrens Health Insurance

A

Program based on H Clinton

Program to cover uninsured children in families w/ too high income to qualify for medicare

36
Q

1996 HIPPA

A

Health Insurance Portability and Accountability Act

  • Assures insurance coverage during time of employment change
  • Gives small businesses insurance options
  • Protects patients privacy rights regarding their medical record
37
Q

1997 IDEA

A

Mandates service delivery in the school system
Part B mandates services to 3-5 year preschool
Part C mandates services for 0-3 years

38
Q

2003 Bush Ea\ra

A

Medicare prescription drug act (Part D)

HSA - Health savings account

39
Q

2006 Massachusetts

A

1st state to require all adult residence purchase health insurance or face legal consequences

40
Q

2008 HIPPA

A

Passed in 1996 but not really enacted until 2008 amendment

  • gave more specific language to assure follow through
  • added Mental Health Parity and Addiction Equity Act (MHPA)
41
Q

2010 ACA -> Obamacare

A

Patient protection and affordable care act

  • signed into lay March 2010
  • goal of full enactment by 2017
  • Requires most US citizens and legal immigrants to have healthcare coverage
42
Q

Primary Practice Settings

A 
61% Medical 
27% Schools & EI 
5% Academia 
3% Mental Health 
4% Other
43
Q

OT’s in Practice Areas : Increase

A

General hospital neonate intensive care
EI centers
Psychiatric units of general hospitals
Rehab units in hospitals and nursing homes

44
Q

OT’s in Practice Areas : Decrease

A

Community mental health & psych hospitals
Voc & pre-vocational programs
Rehab hospitals

612 Management Exam 1 (5 decks)

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