19th Century: Ans✓✓✓ germ theory, sanitation and public health
20th century: Ans✓✓✓ explosion of the science and art of medicine; large,
complex health enterprise developed and continues to evolve
A portion of the ACA is dedicated to: Ans✓✓✓ improving quality and health
system performance through funding research, aligning financial incentives with
performance outcomes, and identifying a national quality strategy
academic health center Ans✓✓✓ heavily involved in clinical research and high-
level tertiary and quarternary care, in addition to providing advanced training and
education for clinicians in primary and specialty care
access to health care Ans✓✓✓ not always ensured. many rural areas have
shortages of doctors and other providers and many doctors refuse to see patients
with certain types of insurance because of low payment rates
2. improving access and coverage
Accountable Care Organization (ACO) Ans✓✓✓ groups of providers that share
responsibility and financial accountability for providing high-quality, coordinated
care to medicare patients.
accredidation Ans✓✓✓ voluntary participation that gives a symbol of quality that
indicates the organization has met certain performance standards
,Achieving this triple aim is difficult because: Ans✓✓✓ one organization is rarely
accountable for all three dimensions
acute care Ans✓✓✓ short term, intense medical care providing diagnosis and
treatment of communicable (infections) or noncommunicable diseases, illness, or
injury
May be described as primary, specialty, tertiary, or quaternary in nature, centered
around the care delivered by physicians and other providers in clinical settings
Encompasses emergency care, trauma care, prehospital emergency care, acute
care surgery, critical care, urgent care, and short-term inpatient stabilization
Additional Key characteristics of the US health care system: Ans✓✓✓ Importance
of organizations in delivering care
Role of professionals in running our system
Emergence of new medical technology, smartphones, big data, and new
pharmaceuticals
Tension between "the free market" and "governmental control"
Dysfunctional payment (fee-for-service system; increasing use of payment
approaches that reward valued services)
ADLs Ans✓✓✓ activities of daily living - activities like bathing, dressing, using the
toilet, eating
ALOS Ans✓✓✓ average length of stay; a metric calculated by dividing the total
number of patient days by the number of discharges.
, ambulatory care Ans✓✓✓ health care settings located in areas that are
convenient for people to walk into and receive care; may be provided in hospitals,
clinics, or centers
ambulatory surgery center (ASC) Ans✓✓✓ Provide outpatient surgical services
90% partnered with physicians
Procedure-driven
Have drained resources from hospitals (like FedEx)
centers of care Ans✓✓✓ facilities that provide outpatient rehabilitative services
for patients with a particular specific illness
(multiple sclerosis, parkinson's disease, or stoke)
certification Ans✓✓✓ must receive from federal government for reimbursement
for services provided to medicare and medicaid patients
Characteristics of the US Health Care System: Ans✓✓✓ Health-related activities
are not ordered or organized as a single enterprise
Actors and organizations often work independently
Sometimes little coordination between players who make contributions to
improving health status
System continues to evolve haphazardly (shaped more by economic incentives
and crises than by logical design)
Clear difference between health maintenance and restoring health (medical care
system cares for people even if restoring health is impossible)
Economic and social determinants of health