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MHA 707 Exam B with Questions and Answers Settings of Healthcare ANSWERV V Community Based Care Hospitals (inpatient acute care) Postacute Care Community Based Care ANSWERV V types of person-centered care delivered in the home and community. A variety of health and human services can be provided. HCBS programs address the needs of people with functional limitations who need assistance with everyday activities, like getting dressed or bathing. Most Frequent Setting of Ambulatory Care ANSWERV ¥ Physician offices Emergency department Hospital outpatient clinics Other Org in Community Based Care ANS WERV V Public Health Clinies FGQHI (neighborhood and community health centers) Work clinics School clinics How CBC is emerging and expanding with ambulatory he settings, Where else do you see CBC? ANSWERVV Telehealth Dr home visits Retail pharmacy Diagnostic imaging and lab centers Ambulatory Surgery Center Urgent care centers Most common visits to the dr ANS WER¥V V Annual exams Prenatal Well baby Medication Hypertension Knees pain Postoperative visit Cough Preoperative visit What type of PC physician/practitioner are mainly seen?(% of OV) ANSWERV 4 General/Family Practice 40% Peds 26% Internal Med 19% OBGYB 15% 47% of all OV were with Prim Care Forms of Payment (% of OV by #) ANSWERV ¥ Private insurance 35% Medicare 22% Medicaid 18% Self pay 12% CHIP/local program 12% Level 5: non urgent Most ED Visits are ANSWERV V Level 3 (32.4%) or Level 4 (24.5%) < 1% are Level | 8% are Level 2 visits 30% unknown What portion of the population visits are an acute care hospital in any given year? ANSWERYV ¥ less than 10% The largest portion of money spent in health care is ANSWERV V For hospitals, 1/3 of the portions AHA classifies hospitals in four types based on the primary function of its diagnostic and therapeutic services ANSWERV V General Special Rehabilitation and chronic disease Psychiatric Hospital are also categorized by ANSWERV ¥ Ownership and control Number of beds Average length of patient stay Annual admissions Average daily census Three Major Categories of Ownership and Control ANSWERV V Government (3% of hospitals) Nongovernment, nonprofit (47.8% of all hospital) Nongovernment, for profit-investor owned (21.3% of all hospitals) Other 11.9% Impatience acute care Percentage of patient in the community hospitals ANSWERV V 85% Percentage of Beds used in a Govt, NFP, and FP ANSWERV V Not FP (68.2%), For Profit (17.8%), Govt(14%) Percentage of Annual Admissions in Govt, NFP and FP ANSWERV ¥ Not FP (72.3%), For profit (15.8%), Govt (11.9%) Postacute Care ANSWER Made to restore pt health and mobility as much as possible after acute injury or illness Provides continuous care for people with chronic conditions who can no longer live at home without assistance Ex:Long term care Hospice ANSWERV ¥ A program of palliative and supportive care services that provide physical psychological and social and spill tra care for dying persons their families and their loved ones About 4,300 hospices 1,426,000 patients Nursing Homes ANSWERV ¥ Skilled nursing facilities Provide a wide raise of health and personal care services the services focus on medical care more than most assisted living facilities these services include nursing care 24 hour supervision three meals a day and assistance with every day activities Residential Care Communities ANSWERV ¥ For people who are unable to live by themselves but do not need 24 hour nursing care they are considered non-medical facilities and are not required to have nurses certified nursing assistance Or doctors on staff Aka assisted living facilities, board and care homes, rest homes and that component of CCRCs Horizontal Integration ANSWERY ¥ system of consolidating many firms in the same level of service (mergers and acquisitions) Ex. Hospital systems and group medical practices Vertical Integration ANSWERV V Adding service lines and/or levels care Ex. Hospital + pharmacy + home health + medical group Similarities between Ilealth Care Occupations (Constantly evoking in response to changes in...) The Trends ANSWERV ¥ Technology Health Policy HC economics Culture Wages for Health Care Practitioners and Technical Occupations ANS WERV ¥ Doctor: $75-$900k NP and PA: 1/2 of what average dr makes. RN: $75.5k wages rising LPN/LVN: $44-$47k (60% of what an RN makes) Health Support Occupations (aids and assistants): $25k-$47k Texas Teacher Avg Salary: $57k Practice Setting for Health Care Workforce (where are they working between 2003-2018) ANSWERY ¥ Ilospital (40%) and Physician officers are pretty stable (9%) Outpatient care center increase 43% Home health increased 26% Demographies or Health Care Workforce ANS WERV V above 70% of women work in healthcare occupations Hispanics working in HC ANSWERV V 17.3% US Employed Population Medical Assistant: 28.6% How is physician work force distributed between general care and speciality care? ANSWERV ¥V Family and General Practitioners: 117k General Internist: 79k General Surgeons: 24k Anesthesiologist: 32k Peds: 57k OBGYN: 34k 440k the rest Q 785k total physicians in active pt care (95%) How many fully accredited allopathic medical schools are in the US? ANSWERV V 154 Accredited by LCMEA compromised of reps from AMA and AAMC How many osteopathic (DO) medical school are there? ANSWERY¥ ¥ 35 Accredited by the AOA How many. Medical school are apart of a state public university? ANSWERV V 60% Remainder is private schools Education Requirements ANSWER¥V V Undergrad GME (includes residency and experience) Medical School Application Statistics ANSWERV ¥ 51% women 48% men 47% White 21% Asian 8% Black 6% Hispanic Medical School Graduates Statistics ANSWERV V 47% women 53% men 56% white 21% Asian 7% African American 5.4% Hispanic Physician Ownership Practice Statistics ANSWERV ¥ Percentage has been declining 54% work in practice that were entirely owned by physicians 26% worked in hospital owned 23% partially owned entities Physicians working in independent/solo practice ANSWERV V Declining (larger groups increasing) 31.5% (use to be 37.2% in 2000) Physicians working in larger practices ANSWERV V Was 61.5% increased to 68.1% Doctoral Degree in Nursing ANSWERV ¥ 354 programs in 2018 State Nursing board establishes licensing Scope of practice by state medical board RN Job Duties ANSWERV ¥ Assess patient conditions Record patients medical history and symptoms Observe patient and record observations Administer patient medicines and treatments Set up plans for patient care, contribute info to plans Consult and collab with doctors Operate and monitor medical equipment Assist with diagnosis testing and results Educate family and patient on illness Go home treatment APN Job Duties ANSWERV V Take and record patient medical hx and symptoms Perform physics exam and observation Create patient care plan, contribute info to existing care plan Perform or order diagnostic test Operate and monitor medical equipment Scope of nursing practice established by state board or hiring and legislative Diagnose health problems Analyze test results or changes Give meds and treatment Evaluate patient response to meds or treatment Consult with doctors and other professionals Counsel and educate patients and their family Conduct clinical research Majority of RNs work ANSWERV ¥ General medical and surgical hospital Majority of NPs work ANSWERV V Office of Physicians In 2006 National labor relation board ANS WERV V Exempt some RNs from union membership Supervisory duties can't unionize or strike PA developed in the US during the ANSWERV ¥V Vietnam war How many accredited PA programs are there in the US? ANSWER¥ ¥ Over 250 PA Roles/Job Duties ANSWERV V Has patients of any age group to collect history, perform physical examination, delineate problem, record and present the data Analyze health status via interview, exam, and lab diagnostic study and delineating healthcare problem in consultation with physician Formulating, implements and monitor a patient treatment or manage a plan for a patient with physician 
