Module 8 lecture, part 3 Flashcards

1
Q

What fraction of total hospital costs is between ages 45 and 84?

A

2/3

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2
Q

What are the two main cost drivers in hospitals?

A

Intensity of svcs (cost per day)
Pop growth

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3
Q

What were the five dominant functions through which US hospitals evolved?

A

Primitive institutions of social welfare
Distinctive institutions of care for the sick
Organized institutions of medical practice
Advanced institutions of medical training and research
Consolidated systems of health svcs delivery

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4
Q

What were the primitive institutions of social welfare?

A

Almshouses and poorhouses

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5
Q

Aspects of consolidated systems of health svcs delivery

A

Organizational integration
Service diversification

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6
Q

What collaboration occurred with advanced institutions of medical training and research?

A

Between hospitals and universities

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7
Q

What were the six factors behind expansion of US hospitals in the late 1800s to mid-1980s?

A

Advances in medical science
Development of specialized tech and surgical svcs
Advances in medical education
Development of professional nursing
Growth of health insurance
Role of gov’t

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8
Q

How did growth insurance contribute to the expansion of US hospitals in the late 1800s to mid-1980s?

A

Insurance allowed ppl to pay for HC
Increased the demand for HC

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9
Q

Role of gov’t in expansion of US hospitals in the late 1800s to mid-1980s

A

Hospital Survey and Construction Act (Hill Burton Act), 1946
-Federal grants to build nonprofit community hospitals
-Charitable care as a condition
-Biggest factor to increase nation’s bed supply
Public health insurance (Medicare and Medicaid)

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10
Q

What contributed to the hospital downsizing from the mid-1980s onward?

A

Changes in reimbursement
Impact of managed care
Hospital closures

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11
Q

How did changes in reimbursement contribute to hospital downsizing in the mid-1980s onward?

A

From cost-plus to prospective payment system (PPS)
Decrease in inpt utilization

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12
Q

How did managed care impact hospital downsizing from the mid-1980s onward?

A

Emphasis on cost containment
Efficient utilization of resources (care in alternative settings)

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13
Q

Describe hospital closures that occurred in the mid-1980s onward?

A

Economic constraints
Many rural and urban hospitals had to close
Other hospitals closed wings or used them for alternative purposes

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14
Q

What are the key utilization measures and operational concepts?

A

Discharges
Inpt days (pt day)
Average length of stay (ALOS)
Avg Daily Census
Occupancy Rate: % of capacity occupied

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15
Q

Definition of discharges

A

of pts discharged in a given time period, including newborns and deaths

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16
Q

What is an indicator of access and utilization in hospitals?

A

Discharges per 1,000 pop

17
Q

Definition of inpt days

A

A night spent by a pt

18
Q

Avg length of stay formula

A

Total days of care/total # of d/cs

19
Q

What is ALOS an indicator of?

A

Severity of illness and resource use

20
Q

What is hospital capacity determined by?

A

of beds set up and staffed

21
Q

What percentage of US community hospitals have <300 beds?

A

84%

22
Q

Avg bed number in 2010

A

161

23
Q

Definition of avg daily census

A

Avg number of beds occupied per day

24
Q

Avg daily census formula

A

Total inpt days/# of days during a given period

25
Q

Definition of occupancy rate

A

Percent capacity occupied

26
Q

Occupancy rate formula

A

(Avg daily census/number of available beds (capacity)) x 100

27
Q

What is occupancy rate a measure of?

A

Performance

28
Q

Days of care definition

A

The cumulative number of pt days over a certain period