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US Health Care Systems, Week 5

by: Samantha Notetaker

US Health Care Systems, Week 5 HSA3111

Marketplace > University of Florida > HSA3111 > US Health Care Systems Week 5
Samantha Notetaker
GPA 3.8
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About this Document

This covers Chapter 7, Outpatient and Primary Care that we covered in class this week.
Dr. Marlow
Class Notes





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This 5 page Class Notes was uploaded by Samantha Notetaker on Saturday September 24, 2016. The Class Notes belongs to HSA3111 at University of Florida taught by Dr. Marlow in Fall 2016. Since its upload, it has received 40 views.


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Date Created: 09/24/16
USHealthCareSystems Chapter 7: Outpatient Services and Primary Care Introduction Some changes from the past:  Outpatient care today, offers a lot more than it used to  Hospitals now have a bigger role  physicians now practice in groups  The government covers a lot (including outpatient services) for those who can’t afford it What is Outpatient Care? Outpatient = ambulatory Patient can come to them or they can go to the patient Outpatient services do not include overnight stays Exhibit 7.1 on page 168 of the book you can find a list of outpatient settings and services Scope of Outpatient Services Check out Exhibit 7.2 on page 170 of the book to see actual percentages  Access to this care is still difficult for some people to get Before, many surgeries could only be performed in hospitals. Now, lots of those surgeries are being done in outpatient care  Hospitals are now competing with places such as private practice offices for outpatient services  Therapies and “self-care” have become more popular even though most are not covered by insurance Reimbursement  Outpatient cost less  People are released faster  Hospitals added more outpatient services due to them losing inpatient people Technological Factors New technology has allowed many inpatient services to be done for outpatients Procedures are less intense and have less recovery time Utilization Control Factors Payers such as insurance companies aren’t fond of inpatient hospital stays Social Factors People like being home and receiving their health care in their home where it is more comfortable Outpatient Care Settings and Methods of Delivery More on the list from Exhibit 7.1 on page 168 Private Practice Most outpatient care is done through physicians Only a small amount of time spent with physician Most physicians work in group practices (offers good benefits to be in a group rather than individual) Hospital Outpatient Clinics Safety net! Hospitals can send their inpatients into their own outpatient units $$$$  Also makes things easier for the patient just to go to another part of the hospital Five types  Clinical  Women’s health  Surgical  Traditional emergency care  Home health care Freestanding Facilities Walk-ins and urgent care Do a lot of the same (routine) stuff as primary doctor but more convenient Better locations, better hours of operation, and no appointments needed Mobile Facilities for Medical, Diagnostic, and Screening Services Where the service comes to you! Includes: mammography, x-ray, dental, and optometric Thank you, non-profit organizations! Telephone Triage These are the people to talk to when the normal offices are closed  Staffed by nurses Home Care Services are brought to a person’s home  This helps people who need a lot of help stay out of hospitals and nursing homes They help with medical problems as well as daily activities and transportation Hospice Care For the people who are flirting with death   Medical, psychological, and social services Palliative care – management of pain and symptoms Outpatient Long-Term Care Services Mostly nursing homes “adult day care” Public Health Services Local health departments Mostly for baby care, diseases, vaccines, mental health, and family planning Community Health Centers A lot of preventive care Also a safety net! Meant to help the less fortunate and homeless Free Clinics Non-government clinics run by volunteers to help the needy Alternative Medicine Clinics Other health care resources not provided by physicians and not covered y insurance Stuff like yoga and acupuncture Primary Care The regular doctors  (not specialists) What is Primary Care? Three levels Primary Secondary Tertiary the routine consultation highly specialized and basic from expert and stuff specialists expensive WHO Definition Primary care is the “foundation” and “first level of contact” IOM Definition Too long and wordy… Check it out on page 178 in the textbook Point of Entry This is where to start  Primary care people help do only what is really necessary Community Based Primary care is close by, easy to access, and inexpensive Coordination of Care Primary providers are good for advice Check out Figure 7.1 on page 179 of the textbook for a visual Essential Care Essential care = Primary care Having a primary physician has shown to lower death rates  Why? Because you have a specific person looking after your health. They know your record, they know you, and they know what needs to be done to keep you healthy. Integrated Care It helps maintain a process of care by addressing health problems throughout the cycle of a person’s life  Continuity – the same individual provider or provider group delivers care to the same person over time Accountability Everybody is accountable. Including patients AND providers. is important to have between a patient and their primary physician Community-Oriented Primary Care Looks to find community health problems  Takes the importance of individual health and makes it important to community health Effectiveness of Primary Care The more primary physicians the better!  One big factor: preventative care  Making community health ca priority helps make health better for individuals Hospitalizations and Use of Emergency Care People that have primary care are less likely to go to the hospital Cost of Care The more primary care offered, the lower prices tend to be  Either way specialists are still more expensive Morbidity Those who have better primary care report better health  Including babies Mortality Same was found here.  More primary care makes for healthier people  Lower rates in stroke, postnatal and total mortality  Higher life expectancy The Medical-Home Strategy Having only one main physician makes a person more “wholly” cared for  Offers long-term  Could improve primary care and save money Assessment of Community Health Centers CHC Quality of Care People like it Focuses on helping people who do not have insurance The health centers do a really good job CHC Access to Care Having access to things like primary care and preventative services lowers the risk of many health problems  CHCs have also been seen to be helpful in reducing racial/ethnic health disparities  They have also helped get care to many low-income families CHC Cost-Effectiveness People who use CHCs are known to have less visits to medical offices and hospitals  CHC help with a lot of preventative care such as screening for breast cancer and showing people how to have a healthier diet CHCs and the Affordable Care Act The ACA has helped with CHCS funding  Although they still have financial troubles and may not continue to expand


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