FIU Health Systems Costs Paper

FIU Health Systems Costs Paper FIU Health Systems Costs Paper 1. Based on the information provided to you in Chapter 8 (Financing Health Care) of your textbook, you are to discuss the following: FIU Health Systems Costs Paper A.Discuss the major factors that affect health care costs. Permalink: https://nursingpaperessays.com/ fiu-health-systems-costs-paper / 2.Based on the information provided to you in Chapter 9 – Long Term Care of your textbook, you are to post a discussion the following : A. Describe the difference between adult living facilities and nursing homes. 3. Based on the information provided to you in Chapter 10 of your textbook, you are to post a discussion on one of the following: A. The historical trends and the forces effecting the distribution and types of mental health services __sultz___young___s_health_care_usa__understa NINTH EDITION Sultz & Young’s Health Care USA Understanding Its Organization and Delivery Kristina M. Young, MS Clinical Assistant Professor Emerita School of Public Health and Health Professions State University of New York at Buffalo Buffalo, New York President Kristina M. Young & Associates, Inc. Buffalo, New York Philip J. Kroth, MD, MS Director, Biomedical Informatics Research, Training and Scholarship Health Sciences Library and Informatics Center Associate Professor and Section Chief for Clinical Informatics Divisions of Translation Informatics and General Internal Medicine University of New Mexico School of Medicine Albuquerque, New Mexico World Headquarters Jones & Bartlett Learning 5 Wall Street Burlington, MA 01803 978-443-5000 [email protected] www.jblearning.com Jones & Bartlett Learning books and products are available through most bookstores and online booksellers. To contact Jones & Bartlett Learning directly, call 800-832-0034, fax 978-443-8000, or visit our website, www.jblearning.com. Substantial discounts on bulk quantities of Jones & Bartlett Learning publications are available to corporations, professional associations, and other qualified organizations. For details and specific discount information, contact the special sales department at Jones & Bartlett Learning via the above contact information or send an email to [email protected] Copyright © 2018 by Jones & Bartlett Learning, LLC, an Ascend Learning Company All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the copyright owner. The content, statements, views, and opinions herein are the sole expression of the respective authors and not that of Jones & Bartlett Learning, LLC. Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise does not constitute or imply its endorsement or recommendation by Jones & Bartlett Learning, LLC and such reference shall not be used for advertising or product endorsement purposes. All trademarks displayed are the trademarks of the parties noted herein. Sultz & Young’s Health Care USA: Understanding Its Organization and Delivery, Ninth Edition is an independent publication and has not been authorized, sponsored, or otherwise approved by the owners of the trademarks or service marks referenced in this product. There may be images in this book that feature models; these models do not necessarily endorse, represent, or participate in the activities represented in the images. Any screenshots in this product are for educational and instructive purposes only. Any individuals and scenarios featured in the case studies throughout this product may be real or fictitious, but are used for instructional purposes only. This publication is designed to provide accurate and authoritative information in regard to the Subject Matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional service. If legal advice or other expert assistance is required, the service of a competent professional person should be sought. FIU Health Systems Costs Paper 11492-8 Production Credits VP, Executive Publisher: David D. Cella Publisher: Michael Brown Associate Editor: Danielle Bessette Production Editor: Vanessa Richards Senior Marketing Manager: Sophie Fleck Teague Manufacturing and Inventory Control Supervisor: Amy Bacus Composition: Integra Software Services Pvt. Ltd. Library of Congress Cataloging-in-Publication Data Cover Design: Scott Moden Rights & Media Specialist: Merideth Tumasz Media Development Editor: Shannon Sheehan Cover Image: © Lightix/Shutterstock Printing and Binding: RR Donnelley Cover Printing: RR Donnelley Names: Young, Kristina M., author. | Kroth, Philip J., author. | Preceded by (work): Sultz, Harry A. Health care USA. Title: Health care USA : understanding its organization and delivery / Kristina M. Young, Philip J. Kroth. Description: Ninth edition. | Burlington, MA : Jones & Bartlett Learning, [2018] | Preceded by Health care USA : understanding its organization and delivery / Harry A. Sultz, Kristina M. Young. 8th ed. c2014. | Includes bibliographical references and index. Identifiers: LCCN 2016044745 | ISBN 9781284114676 (paperback) Subjects: | MESH: Delivery of Health Care | Health Policy | United States Classification: LCC RA395.A3 | NLM W 84 AA1 | DDC 362.10973–dc23 LC record available at https://lccn.loc.gov/2016044745 6048 Printed in the United States of America 21 20 19 18 17 10 9 8 7 6 5 4 3 2 1 This book is dedicated to our parents, Jacob Jay and Marie Young, and Joseph R. Kroth and Nathalie Baszczynski-Kroth. We owe each of them our untold gratitude for the values they instilled and the examples they provided. Contents Foreword. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi Rural Health Networks. . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii Priorities of Health Care. . . . . . . . . . . . . . . . . . . . . . . . . . 15 About the Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiv Tyranny of Technology. . . . . . . . . . . . . . . . . . . . . . . . . . . 15 About the Contributor. . . . . . . . . . . . . . . . . . . . . . . . . xv Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvi New to the Ninth Edition. . . . . . . . . . . . . . . . . . . . . . . xxi Chapter 1?Overview of Health Care: A Population Perspective. . . . . . . 1 Problems of Health Care. . . . . . . . . . . . . . . . . . . . . . . . . . 2 Understanding Health Care. . . . . . . . . . . . . . . . . . . . . . . 3 Why Patients and Providers Behave the Way They Do. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Indexes of Health and Disease. . . . . . . . . . . . . . . 3 Natural Histories of Disease and the Levels of Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Major Stakeholders in U.S. Healthcare Industry. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 The Public. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Employers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Providers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Hospitals and Other Healthcare Facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Governments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Complementary and Alternative Therapists. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Health Insurers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Long-Term Care Industry . . . . . . . . . . . . . . . . . . . 12 Voluntary Facilities and Agencies . . . . . . . . . . . 12 Health Professions Education and Training Institutions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 FIU Health Systems Costs Paper Professional Associations . . . . . . . . . . . . . . . . . . . 13 Other Health Industry Organizations. . . . . . . . 13 Research Communities. . . . . . . . . . . . . . . . . . . . . 13 Social Choices of Health Care. . . . . . . . . . . . . . . . . . . . 16 Aging Population. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Access to Health Care. . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Quality of Care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Conflicts of Interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Health Care’s Ethical Dilemmas. . . . . . . . . . . . . . . . . . .19 Continuing Challenges. . . . . . . . . . . . . . . . . . . . . . . . . . 20 Chapter 2?Benchmark Developments in U.S. Health Care . . . . . . . . . . 23 The Great Depression and the Birth of Blue Cross. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Dominant Influence of Government. . . . . . . . . . . . . 25 Three Major Health Care Concerns. . . . . . . . . . . . . . . 26 Efforts at Planning and Quality Control. . . . . . . . . . . 27 Managed Care Organizations. . . . . . . . . . . . . . . . . . . . 28 The Reagan Administration: Cost Containment and Prospective Hospital Reimbursement. . . . . 28 Biomedical Advances: Evolution of High-Technology Medicine. . . . . . . . . . . . . . . . . . . . 29 Technical Advances Bring New Problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Roles of Medical Education and Specialization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Influence of Interest Groups . . . . . . . . . . . . . . . . . . . . . The American Medical Association. . . . . . . . . . Insurance Companies . . . . . . . . . . . . . . . . . . . . . . Consumer Groups. . . . . . . . . . . . . . . . . . . . . . . . . . Business and Labor. . . . . . . . . . . . . . . . . . . . . . . . . Pharmaceutical Industry. . . . . . . . . . . . . . . . . . . . Public Health Focus on Prevention. . . . . . . . . . 31 31 31 32 32 32 33 v vi Contents Health Insurance Portability and Accountability Act. . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 The Balanced Budget Act of 1997. . . . . . . . . . . . . . . . 34 Health Insurance. . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Medicare and Medicaid. . . . . . . . . . . . . . . . . . . . . 73 Growth and Decline in Numbers of Hospitals . . . . 74 Oregon Death with Dignity Act and Other End-of-Life Legislation . . . . . . . . . . . . . . . . . . . . . . . . 34 Types of Hospitals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Health Information and Technology for Economic and Clinical Health Act . . . . . . . . . . . . . 35 Academic Health Centers, Medical Education, and Specialization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 The Internet and Health Care. . . . . . . . . . . . . . . . . . . . 36 Hospital System of the Department of Veterans Affairs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 The Patient Protection and Affordable Care Act of 2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Judicial Challenges to the Affordable Care Act . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 The Affordable Care Act Implementation Provisions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 New Consumer Protections. . . . . . . . . . . . . . . . . 38 Improving Quality and Lowering Costs. . . . . .38 Increasing Access to Affordable Care. . . . . . . . 39 Holding Insurance Companies Accountable. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Chapter 3?Health Information Technology. . . . . . . . . . . . . . . . . 45 Historical Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Historical Challenges in Implementing Health Information Technology. . . . . . . . . . . . . . . . . . . . . . . 46 The Federal Government’s Response to Health Information Technology Implementation Challenges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 HIT Opportunities: Improving Healthcare Delivery Quality, Effectiveness, and Efficiency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Health Information Exchanges. . . . . . . . . . . . . . . . . . . 56 The Veterans Administration Health Information System. . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Electronic Health Record Adoption Progress in the United States. . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Future Challenges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 Chapter 4?Hospitals: Origin, Organization, and Performance. . . . . . . . . . . . 71 Historical Perspective. . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 Effects of Insurance on the Hospital Industry. . . . . 73 Financial Condition of Hospitals. . . . . . . . . . . . . . . . . . 76 Structure and Organization of Hospitals. . . . . . . . . . Medical Division. . . . . . . . . . . . . . . . . . . . . . . . . . . . Nursing Division. . . . . . . . . . . . . . . . . . . . . . . . . . . . Allied Health Professionals. . . . . . . . . . . . . . . . . . Diagnostic Services. . . . . . . . . . . . . . . . . . . . . . . . . Rehabilitation Services. . . . . . . . . . . . . . . . . . . . . . Other Patient Support Services. . . . . . . . . . . . . Nutritional Services. . . . . . . . . . . . . . . . . . . . . . . . . Administrative Departments. . . . . . . . . . . . . . . . Hotel Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Information Technology’s Impact on Hospitals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 78 79 80 80 81 81 81 82 82 82 Complexity of the System. . . . . . . . . . . . . . . . . . . . . . . .83 Types and Roles of Patients. . . . . . . . . . . . . . . . . . . . . . Rights and Responsibilities of Hospitalized Patients. . . . . . . . . . . . . . . . . . . . . Informed Consent and Second Opinions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Diagnosis-Related Group Hospital Reimbursement System. . . . . . . . . . . . . . . . . . . . . . . 83 84 85 86 Discharge Planning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 Post-Diagnosis-Related Group and Managed Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 Early Market Reforms. . . . . . . . . . . . . . . . . . . . . . . 87 Horizontal Integration. . . . . . . . . . . . . . . . . . . . . . 88 Vertical Integration. . . . . . . . . . . . . . . . . . . . . . . . . 89 Quality of Hospital Care. . . . . . . . . . . . . . . . . . . . . . . . . . 89 Hazards of Hospitalization. . . . . . . . . . . . . . . . . . 89 Variations in Medical Care. . . . . . . . . . . . . . . . . . .92 Nurse Shortage Staffing Crisis. . . . . . . . . . . . . . . 92 Research Efforts in Quality Improvement. . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 Responsibility of Governing Boards for Quality of Care. . . . . . . . . . . . . . . . . . . . . . . . . . . 93 Contents Hospitalists. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Forces of Reform. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96 The Affordable Care Act . . . . . . . . . . . . . . . . . . . . 96 Population Focus. . . . . . . . . . . . . . . . . . . . . . . . . . . 96 Market Consolidations: Hospital Mergers and Acquisitions. . . . . . . . . . . . . . . . . . . . . . . . . 97 Accountable Care Organizations. . . . . . . . . . . . 97 Reimbursement and Payment Revisions. . . . 98 Medicare Access & CHIP Reauthorization Act of 2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102 Continuing Change. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Chapter 5 Ambulatory Care. . . . . . . . . . . 109 Overview and Trends. . . . . . . . . . . . . . . . . . . . . . . . . . . 109 Private Medical Office Practice. . . . . . . . . . . . . . . . . . 111 Integrated Ambulatory Care Models. . . . . . . . . . . . Patient-Centered Medical Homes. . . . . . . . . . Accountable Care Organizations. . . . . . . . . . . Other Ambulatory Care Practitioners. . . . . . . . . . . . 114 115 119 120 vii Delineation and Growth of Medical Specialties. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 Deficient Training of Medical Specialists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148 Certification of Physicians with Board Examinations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149 Accreditation of Graduate Physician Training. . . . 150 Physician Workforce Supply and Distribution. . . . 151 Ratios of Generalist to Specialist Physicians and the Changing Demand. . . . . . . . . . . . . . . . . . 152 Preventive Medicine. . . . . . . . . . . . . . . . . . . . . . . . . . . . 154 Changing Physician–Hospital Relationships. . . . . 155 Evidence-Based Clinical Practice Guidelines. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156 Physician Report Cards and “Physician Compare”. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157 Health Information Technology and Physician Practice. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159 Escalating Costs of Malpractice Insurance. . . . . . . 160 Ambulatory Care Services of Hospitals: History and Trends. . . . . . . . . . . . . . . . . . . . . . . . . . . 120 Ethical Issues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 Hospital Emergency Services. . . . . . . . . . … FIU Health Systems Costs Paper Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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