HCAD 730 Chapter 2 QUESTIONS AND ANSWERS 2022

HCAD 730 Chapter 2 QUESTIONS AND ANSWERS 2022Acute Care: Pre-Hospital Care - EMS - Primary Care - Chronic Care Acute Care: SECONDARY (specialty Care) - referred by primary care - care given in most US hospitals 00:02 01:39 Acute Care: TERTIARY - complex problems - 2 or 3 specialist working on condition - higher level of specialty - referral from one specialist to another Acute Care: QUATERNARY care - experimental treatments - highly specialized - rare conditions, unique treatments - ex. Shriners Acute Care: Subacute In-Patient Care - not acute, more long term - SNF units, rehab units - stroke, ventilator Rehabilitative Care - Services are aimed at restoring a person to his or her original state of health (or as close as possible) - Ex: PT, OT Long Term Care - non medical services - routine ADL -Encompasses a range of services and support provided to meet personal care needs on a long-term basis, most of which is not medical care (Focus on ADLs and instrumental ADLs) End of Life Care: Palliative Care - symptom relief - treatment for discomfort, symptoms, and stress of serious illness, providing relief from pain, fatigue, nausea, shortness of breath, loss of appetite, or problems with sleep End of Life Care: Hospice Care - Government provision - end-of-life care used when a patient is expected to live 6 months or less; includes respite care (allows caregiver to take a break from the care) - inpatient, outpatient, in home Hospitals -An institution primarily engaged in providing to inpatients, by or under the supervision of physicians, diagnostic and therapeutic services for medical diagnosis, treatment, and care of injured, disabled, or sick persons; can include rehabilitation services for injured, disabled, or sick persons Care can be in-patient of out-patient (ambulatory) -Can be categorized in a number of ways, such as by purpose, size, ownership, location (urban or rural), teaching status, or system affiliation Primary categories for hospitals according to AHA -Community -Special -Rehabilitative and chronic disease -Psychiatric Physician organizations -Physicians may be employed by others (e.g., hospitals, government, medical schools) or be self-employed (i.e., in private practice). -Solo practice -Single specialty group practice -Multi-specialty group practice -Corporate medical practice (illegal in some states) -Urgent care centers -Community health centers Ambulatory surgery centers - Provide outpatient surgical services - 90% partnered with physicians - Procedure-driven - Have drained resources from hospitals (like FedEx and the postal service) Long-term care organizations -Operate facilities for individuals who are not able to manage independently in the community -Independent living facilities -Assisted living facilities (ADLs and iADLs) -Skilled nursing facilities (SNFs; 24-7 chronic care - Funded by private payers, Medicare (<60 days) and Medicaid (60% of patients) Rehabilitation organizations -Inpatient facilities •Freestanding hospital •Unit in acute care hospital •Transitional care Rehabilitation organizations -outpatient facilities •Rehabilitation agencies •Rehabilitation clinics •Public health agencies The Triple Aim To improve the delivery of health care in the United States, organizations must simultaneously pursue three dimensions: -Improve the patient experience of care, -Improve the health of populations, and -Reduce the per-capita cost of health care. Five system components necessary for Triple Aim fulfillment 1) Focus on individuals and families 2) Redesign primary care services/structures - care focused 3) Population health management - prevention/wellness 4) Cost control platform - integration of providers (closed panels) 5) System integration and execution (Ex: Signature HC) Patient centeredness (IOM Report) Patient-centered care is "care that is respectful of and responsive to individual patient preferences, needs, and values and ensures that patient values guide all clinical decisions Six dimensions to patient-centered care 1) Respect for patients' values, preferences, and expressed needs 2) Coordination and integration of care 3) Information, communication, and education 4) Physical comfort 5) Emotional support 6) Involvement of family and friends Population health management -Managing provider networks -Helping patients navigate physician and specialty care visits -Managing transitions of care Accountable care organizations - Groups of providers that share risk/profits - managed care arm of Medicare Community-based solutions - designed to keep patients out of hospital through public health Clinical Integration: Physician-hospital alignment Align incentives, joint venture and Co-management agreements, best in capitation Clinical Integration: Physician employment models - controls physician behavior; - prone to decreased productivity Domain in acute Care: Trauma Care & Acute Care Surgery Treatment of individuals with acute surgical needs, such as life-threatening injuries, acute appendicitis, or strangulated hernias Domain in acute Care: Emergency Care Treatment of individuals with acute life- or limb-threatening medical and potentially surgical needs, such as acute myocardial infarctions or acute cerebrovascular accidents, or evaluation of patients with abdominal pain Domain in acute Care: Urgent Care Ambulatory care in a facility delivering medical care outside a hospital emergency department, usually on an unscheduled, walk-in basis (e.g., evaluation of an injured ankle or fever in a child) Domain in acute Care: Short-term Stabilization - EMS - Treatment of individuals with acute needs before delivery of definitive treatment (e.g., administering intravenous fluids to a critically injured patient before transfer to an operating room) Domain in acute Care: Pre-Hospital Care Care provided in the community until the patient arrives at a formal health care facility capable of giving definitive care (e.g., delivery of care by ambulance personnel or evaluation of acute health problems by local health care providers) Domain in acute Care: Critical Care - ICU - Specialized care of patients whose conditions are life-threatening and who require comprehensive care and constant monitoring, usually in intensive care units (e.g., patients with severe respiratory problems requiring endotracheal intubation and patients with seizures caused by cerebral malaria) Health As Defined by WHO: "A state of complete physical, mental and social 'well-being' and not merely the absence of disease or infirmity." Health System -Includes all organizations, institutions, and resources that have a primary purpose of promoting, restoring, and/or maintaining health -Includes care delivered through traditional clinical and public health settings and contributions to health from community organizations that have a stake in or can affect the health of individuals and communities Health Systems Purpose contribute to improved health or to the diagnosis, treatment, or rehabilitation of sick people Health Systems Services include prevention, cure, rehabilitation, and palliation efforts oriented to either individuals or populations. Health Systems Services - Prevention - focus on health systems - major focus of ACA Clinical prevention - delivered by a health care provider - focuses on diseases/conditions Community-based prevention - delivered by non-health care providers - Holistic view incorporates cultural, social, and environmental changes - Often difficult and expensive than Prevention - Public Health - addresses concerns affecting the public at large