Healthcare Systems
What is a system?
A group of individual parts that work together to for a united whole
What are the components of a healthcare delivery system?
Services, Consumers, Healthcare Personnel, Payment for Services
What purpose does an organizational structure serve?
Helps a facility to run smoothly by outlining the responsibilities of the employees
What percentage of the US gross domestic product is made from healthcare spending?
18%
What are the four most common types of managed care plans?
Health Maintenance Organizations, Preferred Provider Organizations, Exclusive Provider Organizations, Point of Service
What are the components of a theory?
Input, throughput, output, feedback loop, controls, environment, goal and mission
In what way do hospitals vary?
Size, Ownership, Servies
What are the four divisions within a healthcare facility?
Informational, Support, Diagnostic, and Therapeutic
Health Insurance companies
What are public health insurance programs?
healthcare services funded by the federal government for eligible groups of the population
How is a system evaluated?
The key to evaluating a system is to determine if the mission is fulfilled
Mental disorders, substance abuse and addiction, victims of abuse and domestic violence
Explain what interdependence is...
Since all members of the team are dependent on each other, if one worker does not fulfill the required duties, the entire team is negatively affected, and patients do not receive quality care.
What is indemnity insurance?
When the patients pay for all healthcare expenses out of their own pockets and are later reimbursed by the insurance company
Medicaid, Medicare, Military health systems, TRICARE, Veterans' Health Administration
What are two different ways that countries fund their healthcare systems?
Publicly funded and privately funded
Name three examples of specialty medical and dental services
Cosmetic surgery, pulmonology, chiropractic, orthodontics, surgical
What does line of authority do?
Determines a worker's position in a facility's organizational structure and establishes levels of supervision.
What is reimbursement?
When health insurance repays what the patient has paid out-of-pocket
What is Medicare and who qualifies?
A federal government entitlement program. Everyone over the age of 65 as well as some people under 65 with disabilities. Medicare covers 80% of the expenses once the yearly deductible has been met.
How does a mixed system work?
If the country is primarily a private system, it may have govn't-funded medical assistance. If the country is a public system, citizens may have to pay out-of-pocket for certain procedures or treatments.
3 examples of delivery systems
Emergency care
Laboratories
Hospice
Home healthcare
3 guidelines that you should follow when reporting an issue in the workplace.
1. Follow your facility's process
2. Research the existing process
3. Develop a thoughtful plan to address the problem
4. explain your concern and ideas with your supervisor
5. Be tactful and confident
What act had the goal of reducing the number of uninsured individuals in the US?
The Patient Protection and Affordable Care Act of 2010 (ACA)
What is TRICARE?
Health insurance program of the military health sysem.