Test Bank For Jonas' Introduction to the U.S. Health Care System 9th Edition By Raymond L. Goldsteen, DrPH, MA; Karen Goldsteen, PhD, MPH; Benjamin Goldsteen, MBA 9780826174024 Chapter 1-13 Complete Guide .

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TEST BANK FOR
JONAS' INTRODUCTION M



M TO THE U.S. HEALTH C
M M M M



ARE SYSTEM, 9TH EDIT
M M M



ION EXAM QUESTIONS
AND ANSWERS
GOLDSTEEN, RAYMOND L. M M



; GOLDSTEEN, KAREN; GO
M M M



LDSTEEN, BENJAMIN Z M M




Authors:M Goldsteen,MRaymondML.;MGoldsteen,MKaren;MGoldsteen,MBenjaminMZ.M
Title:M Jonas'MIntroductionMtoMtheMU.S.MHealthMCareMSystem,M9thMEdition

Copyright M©2021MSpringerMPublishing

>MTableMofMContentsM> MIM-MU.S.MHealthMCareMSystem:MPresentMState M>M2 M-MTheMSettingsMforMHealthMCareMDelivery



2
The Settings for Health Care Delivery
M M M M M




LEARNINGMOBJECTIVES
AfterMcompletingMthisMchapter,MstudentsMwillMbeMableMto:

DifferentiateMamongMambulatoryMcare,MinpatientMacuteMcare,MandMpostacuteMcar

e.MIdentifyMtheMmajorMambulatoryMcareMsettingsMandMtheirMrelativeMsize.

ContrastMtheMkindsMofMhealthMproblemsMtreatedMinMhospitalsMtoMthoseMcaredMforMinMambulatoryMsettings.M
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M DescribeMtheMhistoryMofMhospitalsMandMidentifyMtheMcharacteristics
stem MusedMtoMclassifyMthemMtoday.

DescribeMtheMfiveMtypesMofMlong-termMcareMandMtheirMrolesMinMtheMhealthMcareMsystem.



INTRODUCTION
HealthMcareMisMdeliveredMinMaMvarietyMofMsettings,MwhichMareMgenerallyMdistinguishedMasMinpatientMorMambulatory.MInpatient MsettingsMincludeMgene
ralMandMspecialtyMshort-termMhospitals;Mlong-
termMcareMfacilities,MsuchMasMnursingMhomesMandMskilledMnursingMfacilities;MandMothers.MAmbulatoryMsettingsMincludeMambulatoryMsurgeryMcentersM(
ASCs),MmedicalMgroupMpractices, P.34


communityMhealthMcentersM(CHCs),MdialysisMcenters,MurgentMcareMcenters,MretailMclinics,MimagingMcenters,MsleepMcenters,Mcatheterization Mlabs,Mvas
cularMaccessMcenters,MandMtelemedicineMprovidersM(JointMCommission,M2018).MHealthMcareMprovidedMinMsettingsMthatMareMnotMprimarilyMmeantMfor
Mhealth McareMdelivery,Msuch MasMaMworkplaceMorMschool Mclinics,MisMalsoMconsideredMambulatory. MAMwideMrangeMofMhealth McareMservicesMareM alsoMde

liveredMinMtheMhome,MwhichMisMusuallyMlessMexpensiveMandMmoreMconvenientMforMtheMpatientMthanMtheMcareMprovidedMinMaMhospitalMorMskilledMnur
singMfacilityM(CentersMforMMedicareM &MMedicaidMServicesM[CMS],M2020).MThisMchapterMfocusesMonMtheMsettingsMinMwhichMhealthMservicesMareMdelive
redMbyMhealthMprofessionalsMinMdedicatedMfacilitiesMsuchMasMhospitals,Mlong-
termM careMfacilities,MphysicianMoffices,Mclinics,MandMotherMfacilities,MasMdefinedMbyMtheMJointMCommission.

InMaMthemeMthatMwillMbeMrepeatedMthroughout MthisMbook,MthereMareMnoMdefinitiveM(orMabsolute)MdefinitionsMforMmanyMelementsMofMtheMU.S.Mhealt
hMcareMsystem,MbutMratherManMinterconnectedMwebMofMdefinitionsMdevelopedMbyMstakeholdersMrangingMfromMtheMfederal,Mstate,MandMlocalMgovern
mentMagenciesMtoMtheMprivateMfor-
profitMandMnonprofitMsectors,MincludingMnongovernmental MorganizationsM(NGOs),MindependentMaccreditingMorganizations, MandMhealthMcareMpayers.M
ForMexample,MtheMCMS,MaMfederalMagencyMthatMadministersMtheMMedicareMprogram,MhasMaMspecificMpaymentMmodelMforM“short-
termMacuteMhospitals”,MtheMbulkMofMwhichMareMprivatelyMownedMandMlicensedMbyMeachMstateMandMaccreditedMbyMorganizationsMsuchMasMtheMJointM
Commission.

WhatMconstitutesMaMhospital—and,Mtherefore,MgetsMtheMblueM“H”MsignMalongMtheMroadMthatMguidesMthoseMinMneedMtoMsuchMaMfacility—
andMwhatMrequirementsMitMmustMmeetMvaryMfromMstateMtoMstate.MForMexample,MinMNewMYork,MhospitalsMareMdefinedMandMregulatedMinMtheMPublicM
HealthMLawMasMArticleM28Mfacilities,MwhileMCaliforniaMdefinesMhospitalsMinMTitleM22,MDivisionM5,MinMitsMCodeMofMRegulations.MThus,MtheMrequiremen
tsMforMbeingMaMhospitalMandMwhatMservicesMcanMorMcannotMbeMperformedMinMaMhospitalMdifferMbyMstate,MwithMsomeM commonalityMdueMtoMparticipa
tionMinMfederalMgovernmentMprogramsMsuchMasMMedicareMandMMedicaid M(whichMwillMbeMdiscussedMfurtherMinMChapterM6,MFinancingMtheMHealthMCar
eMSystem).

AlthoughMtheMdetailsMandMtheMavailabilityMofMservicesMandMfacilitiesMdeviateMthroughout MtheMhealthMcareMsystem,MtheMsystemMisMrichMwithMdelivery
MsettingsMandMtypesMofMproviders. MTheMCMS MdefinesM13Mdifferent MmajorMprovider MtypesM(thoseMwith MdistinctMpayment M modelsMorMrateMschedules),

MoverM50Mdistinct M“placesMofMservice,”MoverM100Mprovider/supplier Mtypes,MandMoverM500MproviderMtaxonomiesM(CMS,M2019;MData.CMS.gov, M2019).M

OneMwayMtoMvisualizeMtheMarrayMofMsettingsMforMhealthMcareMisMdisplayedMinMFigureM2.1,MwhichMincludes:

Community-basedM care

Self-care

AmbulatoryMcare

HospitalsM(inpatientMacuteMcare)

PostacuteM care

Long-termMcare:MadultMdayMcare,MhomeMhealthMcare,Mhospice,MskilledMnursingMfacilities,MandMresidentialMcareMfacilities




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AmbulatoryMrehabilitationMcenters

Long-termMacuteMcareMandMotherMspecialtyMhospitals



VerticalMandMHorizontalMIntegrationMinMHealthMCare
AnMimportantMdevelopmentMinMtheMU.S.MhealthMcareMsystemMisMtheMverticalMandMhorizontalMintegrationMacrossMtheMspectrumMofMcare:Mcommunity-
basedMcare,MinpatientMacuteMcare,MandMpostacuteMcare.MTheMtrendMtowardMhorizontal MconsolidationMwasMnotedMwhenMhospitalsMbeganMtoMmergeMi
nMtheM1990sM(CuellarM&MGertler,M2003).MTheMintegratedMsystemsMthatMhaveMemerged
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sinceMtheM2000sMareMbothMhorizontalMandMverticalMandMmayMcontainMmultipleMhospitals,Mclinics,Mlong-
termMcareMfacilities,MphysicianMpractices,MhomeMhealthMcareMorganizations,MandMhospices.MRevCycleMIntelligence,MaMtradeMpublication,MreportsMon
MthisMtrendMasMfollows:



AsMvalue-
basedMreimbursementMputsMfinancial MpressureMonMproviders,MhealthMcareMorganizationsMareMstrivingMforMefficiency,McostMcont
rol,MandMsustainability.MAnMincreasinglyMpopularMstrategyMtoMfulfillMallMtheseMgoalsMisMtoMengageMinMhospital MmergerMandMacq
uisitionM(M&A)Mactivity.MHospitalMmergersMandMacquisitionsMareMincreasingMatMaMrapidMrate.MHealthMcareMorganizationsMannou
ncedM115Mmerger MandMacquisition MtransactionsMinM2017,MtheMhighestMnumberMinMrecentMhistory.M2018MisMlikelyMtoMmeetMorMev
enMexceedMtheMnumberMofMhospital MmergerMandMacquisitionMdealsMmadeMinM2017,MhealthMcareMexpertsMpredict.MRecentMdata
MfromMconsultingMfirmMKaufman MHallMshowsMthat MorganizationsMalreadyM announcedM50MtransactionsMinMtheMfirst MhalfMofM2018

.M(LaPointe,M2019).MSeeMFigureM2.2.


InMthisMchapter,MweMdiscussMeachMofMtheMsettingsMforMhealthMcareMdeliveryMinMtheMU.S.MhealthMsystem,MbeginningMwithMcommunity-
basedMcareMandMendingMwithMpostacuteMcare.




COMMUNITY-BASEDM CARE

Self-Care
AlthoughMtheMhospitalMmayMbeMseenMasMtheMflagshipMofMtheMhealthMcareMsystem— P.36
itMisMtheMlargestMsingleMcategoryMofMNational MHealthMExpendituresMandMtheMsettingMforMmanyMtelevisionMshows—
theMvastMmajorityMofMpeopleMwillMnotMreceiveMinpatientMacuteMcareMinManyMgivenMyear.


OutsideMofMpeopleMwhoMareMunexpectedlyMincapacitated,MtheMfirstMhealthMcareMdecisionMpeopleMmakeMisMwhetherMtoMaccessMtheMdeliveryMsystem
,MatMall,MandManMestimatedM80%MtoM95%MofMhealthMproblemsMareMnever MbroughtMforwardMtoMaMphysicianMorMotherwiseMinvolveMprofessional Mmedical
Mcare. MFrequently, MailmentsMperceivedMtoM beMminorMareMeitherMaddressedMwith M aM“take-no-action,”M“wait-and-see,”MorMself-

medication Mapproach.MFevers,Mheadaches,MandMindigestionMareMamongMtheMmostMcommonMailmentsMtreated MwithMnonprescription MorM“over-the-
counter”M(OTC)MmedicinesM(Dean,M1981).MLevinMandMIdlerM(1983)MprovideMaMconsensusMdefinitionMofMself-careMasMfollows:M“Self-
careM…MrefersMtoMthoseMactivitiesMindividualsMundertakeMinMpromotingMtheirMownMhealth,MpreventingMtheirMownMdisease,MlimitingMtheirMownMillnes
s,MandMrestoringMtheirMownMhealth.MTheseMactivitiesMareMundertakenMwithoutMprofessional Massistance,MalthoughMindividualsMareMinformed MbyMtech
nicalMknowledgeMandMskillsMderivedMfromMtheMpoolMofMbothMprofessionalMandMlayMexperienceM….MTheMgenericMattributeMofMself-
careMisMitsMnonprofessional,Mnonbureaucratic, MnonindustrialMcharacter”M(LevinM&MIdler,M1983,Mp.M181).MAfterMselfdiagnosisMandMpossiblyMadviceMfr
omMfriendsMandMfamily,ManMindividualMmayM decideMtoMbecomeMaM patientMandMenterMtheMhealthMcareMsystem.




AmbulatoryMCare
AmbulatoryMcareMrefersMtoMmedicalMservicesMperformedMwithoutMadmissionMtoMaMhospitalMorMotherMhealthMcareMfacilityMforManMovernightMstay.MAm
bulatoryMcareMisMprovidedMinMmanyMsettings,MbutMweM beginMwithMaMbriefMdescription MofMthoseMwhereM mostMambulatoryMvisitsMareMprovided:Mphysi
cianMoffices,MemergencyMdepartmentsM(EDs),MandMhospitalMoutpatientMclinics.MInM2016,MtheseMvisitsMnumberedM883,725Mmillion,M145,591Mmillion,Ma
ndM125,721Mmillion,MrespectivelyM(National MCenterMforMHealthMStatisticsM[NCHS],M2011;MRui,MKang,M&MAshman,M2016;MRuiM&MOkeyode,M2016).MAfte
rward,MweMdescribeMsomeMsmallerMvolume,MestablishedMambulatoryMcareMsettings:

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PublicMhealthMclinics




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