Textbook Chapter 8 - HOSPITALS Flashcards

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1
Q

define hospital

A

an institution with at least 6 BEDS whose primary function is to deliver patient services (diagnostic and therapeutic) for particular or general medical conditions

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2
Q

true or false

hospitals are one of the largest employers

A

TRUE

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3
Q

_____% of federal healthcare expenditures are spent on hospitals

A

53%

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4
Q

what is the LARGEST ELEMENT OF THE HEALTHCARE SYSTEM

A

hospitals

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5
Q

hospitals employ ____% of healthcare workers

A

75%

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6
Q

hospitals account for ____% of state and local healthcare expenditures

A

40%

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7
Q

what year was the flexner report?
explain what it said and accomplished

A

1910

it was a commentary on the condition of medical education in the early 1900s.
it gave rise to modern medical education

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8
Q

who is the flexner report named after?

A

Abraham Flexner (who prepared it)

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9
Q

name 4 different ways in which hospitals can be classified

A

-length of stay
-type of service
-ownership
-other characteristics

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10
Q

explain how hospitals can be classified based on their length of stay

A

short term (acute care hospitals)
stay is less than 30 days. average is 6-7 days

long term – chronic conditions
30 or more days stay.
average = 3-6 months

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11
Q

give examples of some chronic conditions which would cause someone to stay in a long term hospital

A

psychiatric conditions, tuberculosis

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12
Q

explain how hospitals can be classified based on the type of service

A

general hospital vs specialty hospital

general = wide range of services
specialty = care for a specific disease or a population group

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13
Q

give an example of a specialty hospital based on a specific disease

A

memorial sloan kettering cancer center

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14
Q

give an example of a population group that a specialty hospital would treat

A

a childrens hospital or a maternity hospital

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15
Q

explain how hospitals can be classified based on ownership

A

public
private for profit
private not-for-profit

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16
Q

explain a public hospital

A

can be owned by the federal government OR nonfederal government

owned by AGENCIES
federal, local, or state

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17
Q

a military, veterans, or native American hospital is owned by whom??

A

the federal government

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18
Q

who would own a mentally ill hospital or a hospital for contagious diseases?

A

the state

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19
Q

who owns the LARGEST segment of hospitals – federal, state, or local?

A

LOCAL

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20
Q

city or county hospitals in large urban areas are usually associated with……

A

med schools
high tax
minority/poor
90% charity

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21
Q

which usually require heavy tax subsidied:

city/county hospitals in rural areas OR
city/county hospitals in urban areas

A

urban

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22
Q

city/county hospitals in rural or urban areas serve poor and minorities and 90% are charity care?

A

urban

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23
Q

a “private for profit” hospital is also known as _____ owned, or ____

A

investor-owned or proprietary

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24
Q

are private for profit hospitals prevalent today?

A

they were prevalent around 1900

they are growing in the sense that large, multi-hospital chains are buying existing small hospitals

25
Q

private not-for profit hospitals are owned by….

A

community
religious

26
Q

name the 5 flexner reccomendations

A
  1. reduce the number of medical schools and poorly trained physicians
  2. increase the prerequisites to enter medical school
  3. train physicians to practice in a scientific manner and engage them in research
  4. give medical schools control of clinical instruction in hospitals
  5. strengthen the state regulation of medical licensure
27
Q

what were the findings of the flexner report

A

students subjected to extremely long lectures and recitations. if they were lucky enough to get into a hospital, they observed more than they participated

28
Q

what school did flexner use as the “ideal” to create his proposed solutions

A

the john hopkins school of medicine

29
Q

what is another name for the Hill-Burton Act

A

the Hospital Survey and Construction Act of 1946

30
Q

explain what the Hill-Burton Act did

A

gave grants and loans to hospitals to grow and modernize.

in exchange for these grants, the hospitals had to provide services to all people living in the area, regardless of race or creed, and to help ALL patients who couldn’t pay by reducing the cost of care

they must also participate in medicare and medicaid programs , post information about their community service in english and spanish

31
Q

who accredits and certifies health care organizations (like hospitals) and programs in the US?

A

the joint commission

32
Q

true or false

the joint commision is an independent, for-profit organization

A

FALSE – non-profit

33
Q

what is the nation’s oldest and largest standards-setting and accrediting body in healthcare?

A

the joint commission

34
Q

true or false

being accredited by the joint commission is voluntary

A

true

35
Q

what is the goal of the Joint Commission

A

to improve the quality of care

36
Q

according to Joint Commission Accreditation, standards focus on __________, not just structure and processes

A

CLINICAL OUTCOMES

37
Q

COMMUNITY HOSPITALS include all…….

A

NONFEDERAL, short-term hospitals

38
Q

true or false

noncommunity hospitals are not open to the general public

A

true

39
Q

give 2 examples of noncommunity hospitals

A

military hospitals
VA hospitals (veteran)

40
Q

true or false

community hospitals account for the majority of existing hospitals, the majority of admitted patients, and the majority of out-patient visits

A

TRUE

41
Q

Community hospitals provide ____ care for patients with _______

A

SHORT-TERM inpatient care for patients with acute illnesses and injuries

42
Q

true or false

the outpatient role of community hospitals is growing

A

true

43
Q

community hospitals are expanding to become…….

A

community health care systems

44
Q

small community hospitals care for those who are less seriously ill or more?
what does this mean about the average length of stay (LOS)?

what does this mean about the type of services they offer?

A

less seriously ill

shorter length of stay and have limited services

45
Q

the ____ defines a multihospital system as…..

A

AHA

2 or more hospitals owned, leased, sponsored, or contract managed by a central organization

46
Q

multihospital systems are composed of a ___ hospital looking to ___ and a ____ hospital looking to _____

A

a smaller hospital looking for survival and a larger hospital looking to grow

47
Q

True or false

The popularity of Physician-owned hospitals is declining

A

false – major growth since 1965

48
Q

physician-owned hospitals specialize in ___, ____, or ____

A

cardiology, orthopedics, and surgery

49
Q

what does MACRA stand for and explain what it is

A

Medicare Access and CHIP Reauthorization Act of 2015

Two ACO like elements that were designed to IMPROVE QUALITY and REDUCE THE COST OF CARE

MIPS – merit based incentive payment system
APMs – alternative payment models

50
Q

what are DRGS

A

diagnosis related groups
a classification system that groups patients with similar diagnoses and treatment patterns for billing and reimbursement purposes

51
Q

DRGS resemble the shift to _____ reimbursement to prevent overuse of treatments and services

A

prospective

52
Q

true or false

medicare adopted DRGs in 1983

A

true

53
Q

HRRP

A

hospital readmission reduction program

sponsored by CMS (centers for medicare and medicaid services)

medicare based value-based purchasing

54
Q

what is the LARGEST healthcare system in the US?

A

the hospital system of the department of veterans affairs

55
Q

there was a recent scandal regarding the department of veterans affairs over…..

A

wait lists

56
Q

define AHC

A

academic health center

composed of a medical school and one or more professional schools with an affiliated relationship with one or more TEACHING HOSPITALS, health system, or other organized care provider

TECHNOLOGICALLY ADVANCED

57
Q

what is a major source of clinical research and sophisticated technology
also a training site for all health professionals

A

AHC (academic health centers)

58
Q

what are the concerns with physician-owned hospitals?

A

financial incentives and their competition with community hospitalss

59
Q

physician-owned hospitals focus on what kind of cases?

A

less complex, but profitable cases