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health care delivery systems


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define "health care system"
the totality of services offered by all health disciplines
what's another term for "primary prevention"?
health promotion and illness prevention
what's another term for "secondary prevention"?
diagnosis and treatment
what's another term for "tertiary prevention"?
rehabilitation and health restoration
the two primary goals of the US Dept. of Health and Human Service's project "Healthy People 2010"
-increase quality of life and years of health life
-eliminate health disparities
who is eligible for Supplemental Security Income (SSI)?
those who are blind or with disabilities or those who are not eligible for Social Security
What is not covered under Medicare?
it does not cover dental care, dentures, eyeglasses, hearing aids, or examinations to prescribe and fit hearing aids. most preventive care, including physical exams and associated diagnostic tests are also not included
part a of medicare is available to who?
its available to people with disabilities and people 65 years or older
how does part b of medicare work?
it is voluntary and requires a monthly premium. it provides partial coverage of physician services to people eligible for part a
what is "coinsurance" under the medicare plan?
its the 20% share of a government-approved charge that is paid by the client; the other 80% is covered by the plan.
how is medicaid financed?
through tax dollars
what is covered by medicaid?
it differs with each state. some states provide very limited coverage whereas others pay for dental care, eyeglasses, and prescription drugs
when was medicare and medicaid established?
describe "primary nursing" as a framework of care
its a system in which one nurse is responsible for total care of a number of clients 24 hours/d, 7d/wk. associates provide some care, but the primary nurse coordinates it and communicates information about the client's health to other nurses and other health professionals.
what is "diagnosis-related groups" (DRGs)?
a classification system used for reimbursement by medicare

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