Lecture 19: Pharmacy Practice Settings

Question 1

Historical Perspective

Answer 1

 Hill-Burton Act to build hospitals
 Scientific Method for Medical Education
 Health insurance as means to access health care
 Chronic diseases instead of infectious disease
 New expensive diagnostic equipment centered in hospitals
 Significant cost – category for any health care payers

Question 2

Capitated payments using diagnostic-related groups (DRGs)

Answer 2

 Complete shift in risk from fee-for-service to capitation

 Huge shift in how pharmacy is handled!

Question 3

Inpatient-Prospective Payment System

Answer 3

 Move some surgeries to outpatient setting

 Only covers acute phase

Question 4

 Value-Based Purchasing

Answer 4

 Measure prescribed processes of care

 Outcomes measured (i.e. mortality post hospitalization)*

Question 5

Hospital Characteristics

Answer 5

 Length of stay
 Acute care versus long-term care
 Type of service
 General versus Specialty
 Ownership
 Federal versus Nonfederal government
 Non-governmental hospitals
 Not-for-profit (non-profit) versus Investor-owned (for-profit)
 Community hospitals (Nongovernmental hospitals)
 Teaching hospitals: Serve as clinical training sites for physicians
 Multi-hospital chains

Question 6

Shifting hospital reimbursement from
fee-for-service to capitation shifted financial risks from:
A. Hospitals to prescribers
B. Hospitals to insurers
C. Physicians to hospitals
D. Insurers to hospitals
E. Patients to hospitals

Answer 6

D. Insurers to hospitals