Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
pn 143 ch9,17,18,15
book anderson
| Question | Answer |
|---|---|
| in US we think of health care as a _________ while other countries view it as ________ | a right; a priviledge |
| contributing factors to runaway costs | administrative inefficiency, high demand for health services, induced demand, changing population, litigation, legislation, technology, scarcity of providers |
| profitability of care provision: what is for profit | mandated to give owner and managers a share, tehy have to pay taxes |
| profitability of care provision: what is not for profit | they are diverted outside of care, no taxing |
| what is the ethical dillema in health care costs | coueefective allocation of scarce health care resources in an acceptable manner for nursing (use standards of practice, knowledge, skill, time, equipment, information systems |
| budgets: what are they | plans to allocate income to pay for anticipated expenses, it looks at missions, financial, unit needs and regulation |
| budgets: they are determined by what | projection of needs (corporate, facility, or unit) |
| budgets: allocation ofresources- what are operating costs | cost to operate salery supplies |
| budgets: allocation ofresources- what are capital expeditures | certain dollar amount has to be in capital budget, and what ever is bought in the budget has to be used for over 1 year |
| budgets: allocation ofresources- what are project revenues/ expenditures | for budget you look ahead and say what will we need and why |
| budgets: ways to control costs | eliminate waste,eleiminate duplication, choice of products cost and effectiveness, evaluation and revision |
| risk management: this area deals with what three things | loss (ex: hearing aide), liability (falls, occurance reports), safety (pt and staff) |
| continuous quality improvement (CQI): it stresses the need for what | to search for new ways to improve the process of pt care, prevent errors, and indentify and fix problems, focus is on the quality of care |
| continuous quality improvement (CQI): quality is indicated by what | pt outcome |
| continuous quality improvement (CQI): this protect both ________ & _________ | pt and agency |
| cost types: what are direct care costs | cost for hands on care (ex: staff and supplies) |
| cost types: what are indirect care costs | money spent on supportive services (clerical, education) |
| cost types: what are fixed costs | stays the same over time not effected by population or census (building costs) |
| cost types: what are variable costs | they increase or decrease usually based on the census |
| cost vs benefit: what is cost effect | services should be worth costs of resources consumed, priority needs are based on cost benefit ratio (ex: one glove per packet) |
| technology and capital expenditures: what does technology do to cost | costs more in beginning, have to prep staff on new tech, adv. is it is helpful w/ cost savings, costs of maintainence |
| how do you eval cost effectiveness | did it reduce lenth of care time, reduce complications, recude cost of care over time, reduce care of resources used |
| nursing and cost containment: what is the nursing role | we are always considered very costly, and con't be charged for services |
| nursing and cost containment: how should we use equiptment and supplies | for designed purpose |
| health insurance terms: what is a premium | monthly fee person must pay |
| health insurance terms: what is a deductable | the yearly amount out of pocket before insurance will start paying |
| health insurance terms: what is a copayment | amount paid at the time of service |
| health insurance terms: what is coinsurance | once the deductable is met it is the percentage of the entire bill you must pay (ex 80% 20 %) |
| financing health care costs: what is fee-for-service | no matter what type of service the insurance co. will pay cost |
| financing health care costs: what is capitation | monthly service by provider for each service, for each member insured |
| goverment sponsered health insurance: medicare: when was it added to social securit | in 1965 |
| goverment sponsered health insurance: medicare: what is purpose | assists in financing healthcare for qualified individuals |
| goverment sponsered health insurance: medicare: what are the qualifications | >65 yo, 10 yrs record in medicare-covered employement, citizen of us, <65 who are permanently and totally disabled and persons with end stage renal disease |
| goverment sponsered health insurance: medicare: what is part A | hospital insureance, assists w/ payement for inpatient hospital care, funded by payroll tax, covers inpatient hos. care, rehab, hospice care |
| goverment sponsered health insurance: medicare: what is part B | similar to major medical plan, funded by monthly fixed rate premiums, pays 80% of charges, helps cover Dr. servuice, outpt hos care, ambulation transportation, diagnostic tests, pt, no Rx coverage |
| goverment sponsered health insurance: medicaid: when was it added to the Soc. secirt act | in 1965 |
| goverment sponsered health insurance: medicaid: what is the purpose | provides medical assistance for eligible families and individuals w/ low income and resources, jointly funded by federal and state goverment |
| diagnosis related groups: akak | DRG |
| diagnosis related groups: what is it | a math formula used to arrive at fee the goverment will pay for hospitalization, flat fee |
| diagnosis related groups: flat fee regardless of what | lenght of stay at hospital |
| diagnosis related groups: hospital than does everything is can to ______ | try to get pt home with out having them come back, to decrease cost |
| resource utilization groups: (RUGS): this is the DRG for _____- | LTC |
| resource utilization groups: (RUGS): what is it | a resident classification system that identifiesthe relative costs of providing care for different types of residents based on their resource use, it is the basis for classificaiton |
| resource utilization groups: (RUGS): how is it implemented wiht a resident | eligibility, care planning requirements, significatn condition changes, reimbursment guidelines, MDS is used to keep track of care needs |
| retropective vs prospective payments: what is retrospective payments | payments fro governemtn based on all the charges that occured during the stay in hosp not outside hosp |
| retropective vs prospective payments: what is prospective mayment | payement is given in advanced for issue (ex DRGs) |
| alternatives in insurance coverage: what is managed care system; what insurances atr under it | healthcare delivery system developed to provide quality care with cost and utilization control; HMO, open access plans, PPO |
| alternatives in insurance coverage: what is an HMO | aka health maintainence organization, encourging wellness and prevention, preventing unneccessary labs, pt can choose doc only in the network |
| alternatives in insurance coverage: whatis open access plan | members can see specialized for tx w/o referral |
| alternatives in insurance coverage: what is PPO | aka preferred provider organization, stricter option of HMO, negotiate discouted fees contract services w/ them for discounted fees |
| what is the current us health care climate | influening factors, effeorts to manage costs, health care agencies, trends in systems |
| current us health care climate : what are influencing factors | demographics, economy, shift in illness care needs,shift to healthcare protection, quality assurance |
| current us health care climate: what are the efforts to manage costs | cost containment, entitlement programs, increase in insurance premiums/deductables, dual eligibles |
| what are chagnes in health care facilities | unlicensed assistive personnel (techs), cross training, minimum nurse to pt ratio, voluntary vs. mandatory overtime, extended care, comm. health centers, school based health, nurse run clinics, home care, adult day care, parish nurses, public health |
| trends in health system | universal coverage, quality improvemetn, merger and consolidation, downsizing/ reorganization, HIPAA, rise of for profit, pt focused care, incremental changes |
| how can nurses become politically involved | register to vote, learn who is elected, meeted officials, keep informed on current legislation, become active in organizations |
| what comes first leadership or management | leadership |
| what is the goal of a manager | to get the work done through others |
| leadership: def | the personal traits necessary to establish vision and goals for an organization and the ability to execute them |
| manager: def | the personal traits necesary to plan organize, motivate, and mangae the personnel and material resources of an organization |
| leadership: it is doing the_____ thing | right |
| manager: it is doing _________ right | things |
| what is an informal leader | one w/out an official title or office, the person on the care team who is respected b/c of personal wisdom and willingness to shore it, and who is a role model |
| managers: they organizw details for who's vision and goals to be achieved | the leaders |
| what is a serious leadership and management problem that can occur | when the leader does alot of managing |
| what is an autocratic leader | task oriented, makes decisions on their own, motivates employees through praise, blame and reward. they make commands |
| for what situation is an autocratic leader good for | in an emergency |
| democratic leader: what is one | focused on individual characteristics, and abilities of each subordinate, uses group process to make all decisions, willing to share information they have and give suggestions, change takes time bc/ of the process of the group decision making |
| what is the laizzez-faire leader | the let alone leader, they refuse to assume the leadership role leaving the workers w/o direction, they do not give praise feedback, or information, tendency for ppl not to work together |
| what is a multicratic or participative leader | a compromise between the autocratic and democratic leader, best way to lead |
| what is power | the ability to influence others through the use of energy and strength |
| what are the 6 bases of power | expert, reward, legitimate, coercion, informational, referent |
| what is the strongest form of power for nursing | expert |
| when is power used negatively | when it is used to promote oneself or one's ideas w/o regard for the larger group |
| what is power struggle | occurs when two ppl want opposite outcomes and refuse to cooperate w/ each other |
| what is horzontal hostility | occurs when nurses do not support each other on issues, when nurses talk about each other in passive agressive ways |
| what is the belief i nsuperiority of decisions | myth that all decisions made at the top are superior to yours |
| what is codependency | need of one person doe the continued support of oanother in order to meet the objective |
| what is delegation | means you are transferring to another person the authority to perform a select nursing act on a select pt for that moment |
Created by:
jmkettel
Popular Nursing sets