Health Care Delivery in the United States
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Chapter Objectives (1 of 3)
After studying this chapter, you will be able to:
Define the term healthcare system.
Trace the history of healthcare delivery in the United States from colonial times to the present.
Discuss and explain the concept of the spectrum of healthcare delivery.
Distinguish between the different kinds of health care, including population-based public health practice, medical practice, long-term practice, and end-of-life practice.
List and describe the different levels of medical practice.
List and characterize the various groups of healthcare providers.
Explain the differences among allopathic, osteopathic, and nonallopathic providers.
Define complementary and alternative medicine.
Explain why there is a need for healthcare providers.
Prepare a list of the different types of facilities in which health care is delivered.
Chapter Objectives (2 of 3)
Explain the differences among private, public, and voluntary hospitals.
Explain the difference between inpatient and outpatient care facilities.
Briefly discuss the options for long-term care.
Explain what the Joint Commission does.
Identify the major concerns with the healthcare system in the United States.
Explain the various means of reimbursing healthcare providers.
Briefly describe the purpose and concept of insurance.
Define the term insurance policy.
Explain the insurance policy terms deductible, co-insurance, copayment, fixed indemnity, exclusion, and pre-existing condition.
Explain what is meant when a company or business is said to be self-insured.
Chapter Objectives (3 of 3)
List the different types of medical care usually covered in a health insurance policy.
Briefly describe Medicare, Medicaid, and Medigap insurance.
Briefly describe the Children’s Health Insurance Program (CHIP).
Briefly explain long-term care health insurance.
Define managed care.
Define the terms health maintenance organization (HMO), preferred provider organization (PPO), and point-of-service option.
Identify the advantages and disadvantages of managed care.
Define consumer-directed health plans and give several examples.
Provide a brief overview of the Affordable Care Act passed in 2010.
Summarize the three cases that have been heard by the U.S. Supreme Court that have had an impact on the Affordable Care Act.
Healthcare delivery in U.S. is unlike other developed countries
Delivered by an array of providers in a variety of settings
Paid for in a variety of ways
Is U.S. health care a “system?”
History of Healthcare Delivery in the U.S. (1 of 2)
Self-care has been a category of health care throughout history and today
From colonial times through late 1800s, anyone trained or untrained could practice medicine
Past medical education not as rigorous as today
Early medical education not grounded in science; experience-based only, prior to 1870
History of Healthcare Delivery in the U.S. (2 of 2)
Most care was provided in patients’ homes
Hospitals only in large cities and seaports
Functioned more in a social welfare manner
Not clean; unhygienic practice
Healthcare Delivery in the Late 1800s – Early 1900s (1 of 2)
Care moved from patient’s home to physician’s office and hospital
Building and staffing better; designed for patient care; trained people; medical supplies
Reduced travel time
Science had bigger role in medical education
Mortality decline due to improved public health measures
Healthcare Delivery in the Late 1800s – Early 1900s (2 of 2)
Early 1920s: chronic diseases passed communicable as leading causes of death
New procedures: X-ray, specialized
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