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Behavioral > Public health > Flashcards

Public health Flashcards

1
Q

Disease prevention - primary

A

Prevent disease occurrence

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2
Q

Disease prevention - secondary

A

Screening early for disease

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3
Q

Disease prevention - tertiary

A

Treatment to reduce disability from disease

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4
Q

Disease prevention - quaternary

A

Identifying patients at risk of unnecessary treatment, protecting from the harm of new intervention

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5
Q

Disease prevention - chemotherapy

A

Tertiary Disease prevention

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6
Q

Disease prevention - HPV vaccination

A

Primary Disease prevention

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7
Q

Disease prevention - pap smear

A

Disease prevention Secondary

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8
Q

Medicare and Medicaid

A

Federal programs that originated from amendments to the Social Security Act

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9
Q

Medicaid is joint ….

A

Federal and state health assistance for people with very low income (indigent)

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10
Q

Medicaid - coverage

A 
inpatient and outpatient hospital care 
physician service 
home health care 
Prescription drugs
Long term nursing home care 
dental care, eyeglasses, hearing aids
laboratory test and dialysis 
No co-payment or deductible
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11
Q

Medicare is divided to

A

part A, B, C, D

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12
Q

Medicare is available to

A

patients: 1. >= 65 years old 2. patients with certain disabilities 3. End stage renal disease

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13
Q

Medicare part A coverage

A

inpatient hospital costs
home health care
hospice care

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14
Q

Medicare part B coverage

A

physician fees, dialysis, physical therpay, lab tests, ambulance services, medical equipment

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15
Q

Medicare part C coverage

A

part A and B delivered by approved private companies

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16
Q

Medicare part d coverage

A

Prescription drugs

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17
Q

usa - common cause of death in order - under 1

A
  1. congenital malformations
  2. preterm birth
  3. SIDS
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18
Q

usa - common cause of death in order - 1-14

A
  1. Unintentional injury
  2. cancer
  3. congenital malformation
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19
Q

usa - common cause of death in order - 15-34

A
  1. Unintentional injury
  2. suicide
  3. homicide
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20
Q

usa - common cause of death in order - 35-44

A
  1. Unintentional injury
  2. cancer
  3. Heart disease
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21
Q

usa - common cause of death in order - 45-64

A
  1. cancer
  2. heart disease
  3. Unintentional injury
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22
Q

usa - common cause of death in order - 64+

A
  1. Heart disease
  2. cancer
  3. chronic respiratory disease
23
Q

Hospitalized conditions with frequent readmissions - medicate

A
  1. Congestive HF
  2. Septicemia
  3. Pneumonia
24
Q

Hospitalized conditions with frequent readmissions - medicaid

A
  1. Mood disorder
  2. Schizophrenia/psychotic disorder
  3. DM with complications
25
Q

Hospitalized conditions with frequent readmissions - private insurance

A
  1. maintenance of chemotherapy or radiation
  2. mood disorder
  3. complications of surgical procedures or medical care
26
Q

Hospitalized conditions with frequent readmissions - uninsured

A
  1. Mood disorders
  2. Alcohol related disorders
  3. Diabetes mellitus with complications
27
Q

Readmission means

A

readmission for any reason within 30 days of original admission

28
Q

Safety culture - definition/purpose

A

organizational environment in which everyone can freely bring up safety concerns without fear of censure. –> Facilitates errors identifications
event reporting systems collect data on errors for internal and external monitoring

29
Q

PDSA cycle?

A

Process improvement model to test changes in real clinical setting. Impact on patients:
Plan - define problem and solution
DO - test new process
Study - measure and analyze data
Act - integrate new process into regular workflow

30
Q

Swiss cheese model - definition

A

In complex organizations, flaws in multiple process and systems may align to cause patient harm. Focuses on systems and conditions rather than an individuals error

31
Q

Swiss cheese model - sequence

A

Organizational factors –> unsafe supervision –> preconditions –> unsafe acts –> HARM

32
Q

Types of medical errors may involve

A
  1. patient identification
  2. diagnosis
  3. monitoring
  4. nosocomial infections
  5. medications
  6. procedures
  7. devises
  8. documentation
  9. handoffs
33
Q

medical errors are divided to

A
  1. active error

2. latent error

34
Q

active medical error

A

occurs at level of frontline operator (eg. wrong IV pump dose programmed) –> immediate impact

35
Q

latent medical error

A

occurs in process indirect from operator but impacts patient care (eg. different type of IV pumps used within same hospital) –> accident waiting to happen

36
Q

Medical error analysis are divided to

A
  1. Root cause analysis

2. failure mode and effect analysis

37
Q

Medical error analysis - Root cause analysis - definition

A

Uses records and participant interviews to identify all the underlying problems that led to an error –> categories of causes include process, people (providers or patients), environment, equipment, materials, management

38
Q

Medical error analysis - Root cause analysis - characteristics

A
  • Retrospective approach applied after failure event to prevent recurrence
  • plotted on fishbone (Ishikawa, cause-and-effect) diagram. Fix causes with corrective action plan
39
Q

Medical error analysis - failure mode and effect analysis - definition

A

Uses inductive reasoning to identify all the ways a process might fail and prioritize these by their probability of occurrence and impact on patients

40
Q

Medical error analysis - failure mode and effect analysis - characteristics

A

Forward-looking approach applied before implementation to prevent failure occurrence

41
Q

Quality measurements - appearance

A

Plotted on run and controls charts

42
Q

Quality measurements - outcome - measures and example

A

impact on patients (eg. average HbA1c of patients with diabetes)

43
Q

Quality measurements - Process - measure and example

A

performance of system as planned (eg. ratio of patients whose HbA1c was measured the past 6 months)

44
Q

Quality measurements - Balancing - measure and example

A

impact on other systems/outcomes (eg. Incidence of hypoglycemia among those patients

45
Q

if poor and over 65 - medicare vs medicaid

A

madicare is first use, then medicaid

46
Q

deductible

A

the amount the patient must pay out of pocket before the insurance company begins cover expenses

47
Q

co-payment

A

typically 20% of the total bill that the patient must pay

48
Q

medicaid not cover

A

routine physicals, eye, ears examinations for glasses and hearing aids, immunizations, rootine foot care, most self administrated drugs

49
Q

medicare vs medicaid according to deductible

A

medicare –> applicable

medicaid –> not

50
Q

medicare vs medicaid according to co-payment

A

medicare –> applicable

medicaid –> not

51
Q

LONG TERM CARE - Nursing homes and related facilities are classified and priced according to the level of care that they offer -divisions and definitions

A
  1. assisted living –> limited care, for example meals and houskeeping and typically (36000/year)
  2. skilled nursing home –> proferssional nursing care (at least 75000/year)
52
Q

medicare vs medicaid according to federal and states

A

both federal

medicaid –> federal AND STATES

53
Q

health care expenditures in usa have increased because of the

A

increasing age of the population ,advance in medical technology and availability of health care to the poor and elderly through Medicaid and Medicare, respectively

Behavioral (13 decks)

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