sites of care pt 1 hospitals #4 Flashcards
a building in which the sick injured or infirm are received and treated
hospital
where do patients get care
hospitals
home care
ambulatory care facilities
long-term care facilities
an institution building or part of a building where ambulatory patients are cared for
clinic
1st hospital in 200 BC was —– _______ in India
buddhists
1st US hospital in _____ in pennsylvania
1751
in the early 1800s, hospitals originated form _________ and served poor or victims of contagious disease
almshouses
in post civil ear in the late 1800-1900 = medical discoveries and _________ reform, which had to do with cleaner hospitals, more order, better ventilations, skilled nurses
nightindale’s reforms
US hospitals in the 1900s became ______ and ____ centers.
teaching and research centers
health insurance was developed in _____
1929
mid 1900 - 1946 hill burton act
expansion and renovation of facilities
addition of community services nd increased funding (medicare/medicaid), occurs in _______
1960s
the cost containment mechanisms instituted:
1983 medicare DRGs
1990 fee for service
gate keeper, pre-approvals for admission and procedures
era that resulted in efficiency, utilization review evaluation of processes for appropriateness
era of assessment and accountability
what changes did hospital undergo in order to stay in business
horizontal and vertical integration
1995-2010 hospitals offered ____-_____ services in order to stay open
non-hospital
in between 1987-2010, most monies coming to the hospital came from ________
outpatient
between 1975-2010 there was a decrease in hospitals due to
closing and merging
60% of hospital care is paid by the _____, through medicare and medicaid (very important for reimbursement)
government
a hospital must be ______, in order to obtain reimbursement from the government
accreditated
30 % of hospital care is paid by ______ ______
private insurance
what are hospitals classified by?
length of stay: short term 30
type of services
type of ownership
miscellaneous: community, teaching, # of beds
types of hospital ownership
public (government): federal military, veterans, IHS, state-psychiatric, local general services
Private: non-for-profit, for-profit
most abundant type of US hospital
non-gov, non-profit
for-profit
the largest type of hospital
community
individuals get the most care in:
non for profit, and non-gov
hospitals get accredited by
JCAHO - joint commission on accreditation of healthcare organizations
drug distribution systems
floor-stock = multiple patients
unit-dose = one patient
hybrid
what reduces: delivery time decreases med errors better inventory control emergency doses frees pharmacist from dispensing activities
pyxis medstation
most common system used
services originate from a central location
centralized services
satellite pharmacies in patient care areas
pharmacist order review and 1st-dose dispensing refer to _________ services
decentralized services
advantages and drawbacks of centralized services
less personnel, decrease drug cause
delay in getting drug to patient
drawbacks and advantages of decentralized services
double inventory and personnel
pharmacists are on the floor in patient care area
list of medications stocked in the pharmacy is called
formulary
purpose of formulary system
to ensure appropriate drug therapy and control cost
types of formularies
open and closed
a formulary advisory group
pharmacy and therapeutics committee (P&T)
Intravenous Admixture Services:
Pharmacists working in hospitals prepare IV dosage forms. Large volume parenteral= IV _____ & ______. Small volume parenteral = IV ________, chemotherapy Hospital formulary system
nutrition and electrolytes
small: antibiotics
