Textbook Chapter 8 - HOSPITALS Flashcards
define hospital
an institution with at least 6 BEDS whose primary function is to deliver patient services (diagnostic and therapeutic) for particular or general medical conditions
true or false
hospitals are one of the largest employers
TRUE
_____% of federal healthcare expenditures are spent on hospitals
53%
what is the LARGEST ELEMENT OF THE HEALTHCARE SYSTEM
hospitals
hospitals employ ____% of healthcare workers
75%
hospitals account for ____% of state and local healthcare expenditures
40%
what year was the flexner report?
explain what it said and accomplished
1910
it was a commentary on the condition of medical education in the early 1900s.
it gave rise to modern medical education
who is the flexner report named after?
Abraham Flexner (who prepared it)
name 4 different ways in which hospitals can be classified
-length of stay
-type of service
-ownership
-other characteristics
explain how hospitals can be classified based on their length of stay
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
give examples of some chronic conditions which would cause someone to stay in a long term hospital
psychiatric conditions, tuberculosis
explain how hospitals can be classified based on the type of service
general hospital vs specialty hospital
general = wide range of services
specialty = care for a specific disease or a population group
give an example of a specialty hospital based on a specific disease
memorial sloan kettering cancer center
give an example of a population group that a specialty hospital would treat
a childrens hospital or a maternity hospital
explain how hospitals can be classified based on ownership
public
private for profit
private not-for-profit
explain a public hospital
can be owned by the federal government OR nonfederal government
owned by AGENCIES
federal, local, or state
a military, veterans, or native American hospital is owned by whom??
the federal government
who would own a mentally ill hospital or a hospital for contagious diseases?
the state
who owns the LARGEST segment of hospitals – federal, state, or local?
LOCAL
city or county hospitals in large urban areas are usually associated with……
med schools
high tax
minority/poor
90% charity
which usually require heavy tax subsidied:
city/county hospitals in rural areas OR
city/county hospitals in urban areas
urban
city/county hospitals in rural or urban areas serve poor and minorities and 90% are charity care?
urban
a “private for profit” hospital is also known as _____ owned, or ____
investor-owned or proprietary
are private for profit hospitals prevalent today?
they were prevalent around 1900
they are growing in the sense that large, multi-hospital chains are buying existing small hospitals
private not-for profit hospitals are owned by….
community
religious
name the 5 flexner reccomendations
- reduce the number of medical schools and poorly trained physicians
- increase the prerequisites to enter medical school
- train physicians to practice in a scientific manner and engage them in research
- give medical schools control of clinical instruction in hospitals
- strengthen the state regulation of medical licensure
what were the findings of the flexner report
students subjected to extremely long lectures and recitations. if they were lucky enough to get into a hospital, they observed more than they participated
what school did flexner use as the “ideal” to create his proposed solutions
the john hopkins school of medicine
what is another name for the Hill-Burton Act
the Hospital Survey and Construction Act of 1946
explain what the Hill-Burton Act did
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
who accredits and certifies health care organizations (like hospitals) and programs in the US?
the joint commission
true or false
the joint commision is an independent, for-profit organization
FALSE – non-profit
what is the nation’s oldest and largest standards-setting and accrediting body in healthcare?
the joint commission
true or false
being accredited by the joint commission is voluntary
true
what is the goal of the Joint Commission
to improve the quality of care
according to Joint Commission Accreditation, standards focus on __________, not just structure and processes
CLINICAL OUTCOMES
COMMUNITY HOSPITALS include all…….
NONFEDERAL, short-term hospitals
true or false
noncommunity hospitals are not open to the general public
true
give 2 examples of noncommunity hospitals
military hospitals
VA hospitals (veteran)
true or false
community hospitals account for the majority of existing hospitals, the majority of admitted patients, and the majority of out-patient visits
TRUE
Community hospitals provide ____ care for patients with _______
SHORT-TERM inpatient care for patients with acute illnesses and injuries
true or false
the outpatient role of community hospitals is growing
true
community hospitals are expanding to become…….
community health care systems
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?
less seriously ill
shorter length of stay and have limited services
the ____ defines a multihospital system as…..
AHA
2 or more hospitals owned, leased, sponsored, or contract managed by a central organization
multihospital systems are composed of a ___ hospital looking to ___ and a ____ hospital looking to _____
a smaller hospital looking for survival and a larger hospital looking to grow
True or false
The popularity of Physician-owned hospitals is declining
false – major growth since 1965
physician-owned hospitals specialize in ___, ____, or ____
cardiology, orthopedics, and surgery
what does MACRA stand for and explain what it is
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
what are DRGS
diagnosis related groups
a classification system that groups patients with similar diagnoses and treatment patterns for billing and reimbursement purposes
DRGS resemble the shift to _____ reimbursement to prevent overuse of treatments and services
prospective
true or false
medicare adopted DRGs in 1983
true
HRRP
hospital readmission reduction program
sponsored by CMS (centers for medicare and medicaid services)
medicare based value-based purchasing
what is the LARGEST healthcare system in the US?
the hospital system of the department of veterans affairs
there was a recent scandal regarding the department of veterans affairs over…..
wait lists
define AHC
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
what is a major source of clinical research and sophisticated technology
also a training site for all health professionals
AHC (academic health centers)
what are the concerns with physician-owned hospitals?
financial incentives and their competition with community hospitalss
physician-owned hospitals focus on what kind of cases?
less complex, but profitable cases
