NURS200 CH 2 THE HEALTH CARE DELIVERY SYSTEM

Question 1

Health Services Pyramid is for

Answer 1

• Managing health instead of illness
• Emphasis on wellness
• Injury prevention programs

Question 2

•National Priorities:

Answer 2

• Patient and family engagement
• Population health
• Safety/eliminating errors as possible
• Care coordination
• Palliative care for advanced illnesses
• Overuse/reducing waste

Question 3

1–Professional standards review organizations (PSROs)

2–Utilization review committees (URs)

Answer 3

1. Created to review the quality, quantity, and cost of hospital care provided through Medicare and Medicaid
2. Review admissions, diagnostic testing, and treatments provided by physicians who cared for patients receiving Medicare

Question 4

Primary care

Answer 4

• Focuses on improved health outcomes for an entire population
• Requires collaboration among health professionals, health care leaders, and community members

Health promotion lowers overall costs:

• Reduces incidence of disease
• Minimizes complications
• Reduces the need for more expensive resources
• Occurs in home, work, and community settings

Question 5

Secondary and Tertiary Care

Answer 5

• •Also called acute care
• •Focus: Diagnosis and treatment of disease
• •Disease management is the most common and expensive service of the health care delivery system.
• •20% require 80% of health care spending.
• •Fastest growing age group of uninsured?
• •Postponement of care by uninsured
• SETTING- intensive care unit

Question 6

Restorative Care

Answer 6

• •Serves patients recovering from an acute or chronic illness/disability
• •Helps individuals regain maximal function and enhance quality of life
• •Promotes patient independence and self-care abilities
• •Requires multidisciplinary approach
• •Settings:

Question 7

Restorative Care: Rehabilitation

Answer 7

• Focus: To restore patients to their fullest physical, mental, social, vocational, and economic potential
• Includes physical, occupational, and speech therapy, as well as social services
• Occurs in many health care settings, both inpatient and outpatient

Question 8

Restorative Care: Extended Care

Answer 8

• Extended care facility
  
  • Provides intermediate medical, nursing, or custodial care for patients recovering from acute illness or disabilities
• Skilled nursing facility (intermediate care)
  
  • Provides care for patients until they can return to their community or residential care location

Question 9

Continuing Care

Answer 9

• For people who are disabled, functionally dependent, or suffering a terminal disease
• Available within institutional settings or in the home:
• Nursing Centers or Facilities
  
  • Assisted Living
  • Respite Care
  • Adult Day Care Centers
  • Hospice
• The need for continuing care is increasing because people are living longer.
• Many of these people do not have family or others to care for them.

Question 10

Continuing Care: Assisted Living

Answer 10

1. Offers a long-term care setting with a home environment and greater resident autonomy
2. Provides services such as laundry, assistance with meals, personal care, housekeeping, and 24-hour oversight
3. Allows residents to live in their own units

• As one of the fastest growing industries within the United States, assisted living offers privacy, independence, and security.
• Some facilities provide assistance with medication administration, although nursing care services are not available directly.
• However, this industry has little regulation, no fee cap. It may not be the most financially sound plan for some individuals.

Question 11

Respite Care

Answer 11

1. •The service provides short-term relief or “time off” for persons providing home care to an ill, disabled, or frail older adult.
2. •Settings include home, day care, or health care institution with overnight care.
3. •Trained volunteers allow family caregivers to leave the home for errands or social time.

The family caregiver usually not only has the responsibility for providing care to a loved one but often has to maintain a full-time job, raise a family, and manage the routines of daily living as well.

Question 12

Hospice

Answer 12

• Family-centered care that allows patients to live and remain at home
• Focuses on palliative (not curative) care: comfort, independence, and dignity
• Provides patient and family support during terminal illness and time of death
• Many hospice programs provide respite care, which is important in maintaining the health of the primary caregiver and family.