7 - 1 Introduction to US Health Care HS230 Health Care Administration Kaplan University Unit 5: Chapters 7, 8 and 9 Kathy Lantz, MHS, MBA

7 - 2 Introduction to US Health Care Chapter 7 Hospitals in the United States

7 - 3 Components of the Modern Hospitals The Board Management Medical Staff Operational Staff

Multiple Choice The system stage of hospital development focused on which of the following? 1)Great competition 2)Increasing consolidation 3)Changes in payment 4)All of the above 7 - 4

7 - 5 Components of the Modern Hospitals The Board Govern the hospital on behalf of the community, shareholders or constituents

7 - 6 Components of the Modern Hospitals Management Run the organization day-to-day (strategically, financially, and operationally)

7 - 7 Components of the Modern Hospitals Medical Staff Independent practitioners who provide clinical care

7 - 8 Components of the Modern Hospitals Operational Staff Staff who perform nonmedical, clinical and support duties

Critical Thinking Short Answer: What component of hospitals is responsible for day to day operations? 7 - 9

Hospital Costs Increasing Advancement of medical technologies and treatments Cost of prescription drugs Aging population Lifestyle choices Increased governmental regulations and oversight

General and Specialty Hospitals Offer variety of services Treat those that cannot pay Pass costs onto patients that can pay General Hospitals Specialty Hospitals

General and Specialty Hospitals Treat specific group of patients Focused area of care Only treat those who can pay General Hospitals Specialty Hospitals

Critical Thinking Short Answer: What are student health centers?

Hospital Ownership Designation Nonprofit Propriety Federal State or Local

Multiple Choice Which one of the following is NOT criteria for classifying hospitals? Length of stay Number of physicians Type of Service Ownership

Effects of Increased Costs… Provide most intense service to the sickest patients Patients often need increased care after discharge Ambulatory care more demanding Primary care physicians less involved Larger role of the hospitalist

Critical Thinking Essay Question: Discuss factors increasing hospital costs?

Introduction to US Health Care Chapter 8 Ambulatory Care

Increasing Ambulatory Care Advances in technology Financial incentives Patient convenience

Distribution of Visits *Percentage of visits across specialty

Access to Ambulatory Care *Key predictors of access to care include insurance status, race, and age Adults with No Regular Source of Care

Payment for Ambulatory Care

Critical Thinking Short Answer: What determines use of ambulatory services?

Multiple Choice Which of the following is NOT a reason for the growing reliance on ambulatory care? Dramatic advances in technology Changes in financial incentives Shortage of hospital beds Demands for great patient convenience

Ambulatory Care Settings Physician Offices Emergency Rooms/ Outpatient Departments Urgent Care Facilities Same-Day Surgery Centers Community Health Centers / Clinics Student Health Centers Occupational Health Programs

Ambulatory Care Providers Clinical Social Workers Physicians Physician Assistants NursesDentistsPharmacistsChiropractorsPodiatrists Physical Therapists OptometristsPsychologists

Multiple Choice Which of the following is NOT a health care provider in an ambulatory setting? Physician Nurse Respiratory therapist Physician assista nt

Critical Thinking Short Answer: What has made it difficult for PCPs to remain involved in patient care?

Physician Offices Solo Practices Individual physician and other personnel Group Practices Three or more physicians, other professionals Share resources…

Multiple Choice Which of the following is NOT a reason for the shift from solo to group practice? Increasing complexity of medicine Administrative burdens Lack of opportunity Increasing cost of setting up and running a practice

Critical Thinking Short Answer: During the year 2000, each person in the US visited physicians an average of how many times?

Home Health Care Services Skilled Nursing Aide Care Physical Therapy Speech Therapy Occupational Therapy

Social Workers / Home Health Care Education and Referral Financial Assistance Information Psychosocial Assessment Psychosocial Interventions Crisis Intervention / Trauma Support

Long-Term Care Services Ambulatory medical services Inpatient medical services Mental-behavioral services Social services Daily living support services

Primary Users of Long-Term Care People with temporary disabilities People with chronic health problems

Critical Thinking Short Answer: What percent of nursing homes in the US are for-profit?

Personal Care Facilities Assisted living facilities Continuing care retirement communities Congregate care facilities Nursing homes Alzheimer’s /dementia facilities

Terminology: ADL Activities of Daily Living: Fundamental activities of daily care that health care professionals use as a way to describe the functional status of a person. Examples: Eating, bathing, continence, dressing, getting in and out of bed

Personal Care Facilities Assisted living facilities Continuing care retirement communities Congregate care facilities Nursing homes Alzheimer’s /dementia facilities Board-and-care facilities Adult foster care Licensed by the state

Personal Care Facilities Assisted living facilities Continuing care retirement communities Congregate care facilities Nursing homes Alzheimer’s /dementia facilities Self-sufficient communities All personal and medical services Generally only accept healthy seniors

Personal Care Facilities Assisted living facilities Continuing care retirement communities Congregate care facilities Nursing homes Alzheimer’s /dementia facilities Similar to CCRCs but offer no health care services

Personal Care Facilities Assisted living facilities Continuing care retirement communities Congregate care facilities Nursing homes Alzheimer’s /dementia facilities Intermediate-level nursing and personal services Serve those who are temporarily or permanently unable to care for themselves All states require nursing homes

Personal Care Facilities Assisted living facilities Continuing care retirement communities Congregate care facilities Nursing homes Alzheimer’s /dementia facilities Independent unit or component of assisted living facility Provide constant supervision Help with ADLs and personalized care

Critical Thinking Short Answer: What type of facilities are for people who do not need skilled medical care but do need help with ADLs?

Home Health Care Agencies Voluntary nonprofit Government Proprietary Medicare Certified?

Community-Based Care Adult day care Respite care Senior centers Transportation Meals on Wheels Telephone reassurance Area Agencies on Aging

Hospice Care Provide physical care and counseling to terminally ill patients and families Medical personnel Social workers and counselors Clergy Therapists Volunteers

Multiple Choice Palliative care involves which of the following? 1)Chronic disease management 2)ADL training 3)Easing symptoms and discomfort of a terminal condition 4)Temporary disabilities

Terminology Quiz Chronic Care Acute Care Hospice Care Palliative Care Home Health Care Subacute Care Long-Term Care