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INTRO TO PT > HEALTHCARE DELIVERY SYSTEMS > Flashcards

HEALTHCARE DELIVERY SYSTEMS Flashcards

1
Q

A term used to describe how a national, regional, or local health care system is organized, administered, provided, and paid for, sometimes to a circumscribed system such as that under the auspices of a specific medical and hospital insurance carrier or health maintenance organization

A

healthcare delivery systems

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2
Q

all organizations, people and actions whose primary intent is to promote, restore or maintain health (WHO, 2000)

A

healthcare delivery systems

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3
Q

organization of people, institutions, and resources to deliver health care services to meet the health needs of a target population, whether a single-provider practice or a large health care system

A

healthcare delivery systems

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4
Q

private funding by fee-for-service and private initiative and ownership, and has very little state or third-party intervention

A

free-market medicine system

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5
Q

characterized by a two-track system of financing and of healthcare delivery

A

free-market medicine system

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6
Q

Free market medicine system: identify what track system is this.

Based on individual purchasing power

A

Private track

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7
Q

Free market medicine system: identify what track system is this.

Based on welfare provision

A

Public track

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8
Q

Provides healthcare delivery in the form of a state- supported consumer service financed by taxation

A

socialized-medicine system/beveridge

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9
Q

healthcare is purchased, but the buyer is the government

A

socialized-medicine system / beveridge

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10
Q

services available at little or no additional cost to the consumer

A

socialized-medicine system

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11
Q

Free at the point of delivery and funded by general tax

A

beveridge model

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12
Q

Most hospitals are government owned; healthcare workers are employed by the government; salaries are fixed and costs of treatments are standardized

A

beveridge model

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13
Q

In private hospitals that provide a service free at the point of delivery, the hospitals get paid by the government

A

beveridge model

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14
Q

Gov’t can control what the doctor can do and what the hospital can charge

A

beveridge model

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15
Q

These ff. Countries adheres to what model?

Great Britain, Scandinavian countries, New Zealand and Spain

A

beveridge model

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16
Q

indirect government control and management of healthcare delivery

A

Decentralized National Healthcare System

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17
Q

government acts primarily to regulate the system

A

Decentralized National Healthcare System

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18
Q

Model in Germany

A

Bismarck model

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19
Q

funded by an insurance system

A

Bismarck model

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20
Q

Financing is provided by employers and employees through payroll deductions and covers the entire population

A

Bismarck model

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21
Q

tight regulatory control by the Government, there is much better control over costs

A

Bismarck model

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22
Q

Employed people will get additional private insurance to cover the top up reimbursement costs

A

Bismarck model

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23
Q

Unemployed: supported by the government to get complete coverage

A

Bismarck model

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24
Q

healthcare is a state-provided public service

A

Socialist Medicine System

25
Q

state controls, organizes, finances, and allocates healthcare directly to all citizens, free of charge

A

Socialist Medicine System

26
Q

No third-party organizations or insurance companies are interposed between healthcare providers and patients

A

Socialist Medicine System

27
Q

The state owns all facilities and pays a salary to all healthcare workers

A

Socialist Medicine System

28
Q

healthcare is financed through government-mandated contributions by employers and employees, and healthcare is delivered by private providers

A

Socialized insurance system

29
Q

The government subsidizes voluntary mutual-aid societies that insure their members for medical care, death benefits, and, occasionally, some form of old-age assistance, operating entirely independently

A

Socialized insurance system

30
Q

governments create public health insurance programmes that citizens are required to join

A

National Health Insurance

31
Q

government provides finance, but actual care is delivered by private providers

A

National Health Insurance

32
Q

Every citizen pays into a government sponsored insurance program and healthcare is provided in the private sector

A

National Health Insurance Model

33
Q

These ff. countries are part of what model?

A

National Health Insurance Model

34
Q

no need for marketing or any incentives to deny any claims

A

National Health Insurance Model

35
Q
  • drive down costs through negotiations with vendors
  • may not cover every condition; wait longer to be seen or treated
A

National Health Insurance Model

36
Q

financing a tax-supported NHI programme, the government also manages the infrastructure for the delivery of medical care

A

Public contracting

37
Q

-healthcare providers are basically public employees -non-profit, publicly funded and delivered service

A

Public contracting

38
Q

state involvement is more limited but still substantial

A

Pluralistic

39
Q

providing coverage only for certain population groups and giving way for the rest of the population to largely private finance, provision and ownership of facilities

A

Pluralistic

40
Q

-Developing countries
-those with adequate finances can avail of the numerous private hospitals for their healthcare; those who can’t afford: die

A

Private insurance/ out of pocket

41
Q

Corporate social responsibility: big corporate organizations have by law to set aside a sum of money for infrastructure projects such as healthcare

A

Private insurance/ out of pocket

42
Q

-private insurers are for profit: decide to refuse coverage for preexisting conditions or other conditions with a view to minimizing claims and maximizing profit.
-doctors may over investigate or prescribe for insured patients on the assumption that the insurer will pay for it

A

Private insurance/ out of pocket

43
Q

Characteristics:

A range of health services is provided, appropriate to the needs of the target population, including preventative, curative, palliative and rehabilitative services and health promotion activities

A

Comprehensiveness

44
Q

Characteristics:
no undue barriers of cost, language, culture, or geography.

A

Accessibility

45
Q

Characteristics:

close to the people, with a routine point of entry to the service network at primary care level (not at the specialist or hospital level)

A

Accessibility

46
Q

Characteristics:

may be provided in the home, the community, the workplace, or health facilities as appropriate.

A

Accessibility

47
Q

Characteristics:
all people in a defined target population are covered, i.e. the sick and the healthy, all income groups and all social groups

A

Coverage

48
Q

Characteristics:
Service delivery is organized to provide an individual with continuity of care across the network of services, health conditions, levels of care, and over the life-cycle

A

Continuity

49
Q

Characteristics:

effective, safe, centered on the patient’s needs and given in a timely fashion.

A

Quality

50
Q

Characteristics:

Services are organized around the person, not the disease or the financing

A

Person-centeredness

51
Q

Characteristics:

Users perceive health services to be responsive and acceptable to them

A

Person-centeredness

52
Q

Characteristics:
-participation from the target population in service delivery design and assessment
-people are partners in their own health care

A

Person-centeredness

53
Q

Characteristics:
Local area health service networks are actively coordinated, across types of provider, types of care, levels of service delivery, and for both routine and emergency preparedness

A

Coordination

54
Q

Characteristics:
The patient’s primary care provider facilitates the route through the needed services, and works in collaboration with other levels and types of provider

A

Coordination

55
Q

Characteristics:
Coordination also takes place with other sectors (e.g. social services) and partners (e.g. community organizations).

A

Coordination

56
Q

Characteristics:
Health services are well managed so as to achieve the core elements described above with a minimum wastage of resources

A

Accountability and efficiency

57
Q

Characteristics:
Managers are allocated the necessary authority to achieve planned objectives and held accountable for overall performance and results

A

Accountability and efficiency

58
Q

Characteristics:
Assessment includes appropriate mechanisms for the participation of the target population and civil society

A

Accountability and efficiency

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