Informed Consent (What kinds of procedures need it)

-(NOT CONSENT TO TREAT)

            =Surgery

            =Anesthesia

            =Invasive procedures

Designed to cover the cost of care of elderly (entitlement program and federally funded)

            =A: covers hospitalization =B: covers doctor office visits =D: prescription drug coverage

Designed to help the poor (eligibility program only need base—funding is both state and federal)

=SCHIP: State children’s health insurance plan—Connecticut known as HUSKY

The extent to which a person’s behavior coincides with medical or health advice

            =Assuming that the provider knows what is best for the patient—the patient is in a dependent role (“sick role”)

The willingness of the other person to agree to a mutual plan of action that takes into account the meaning of illness in that person’s life

"Patient-as-partner" relationship

-Attain high quality, longer lives free of preventable disease, disability, injury, and premature death

-Achieve health equity, eliminate disparities, and improve health of all groups

-Create social and physical environments that promote health for all

-Promote quality of life, healthy development, and healthy behaviors through all stages of life

Statistical finding--may not occur to you at the same rate; based on the whole population. Data found through causal association (ie. head injury and helmet usage) and longitudinal data.

Care that focuses on treating and controling pain rather than curing the ailment.

Hospice is a type of this care.

Health promotion; education

Specific prevention; vaccination

Early diagnosis and prompt treatment: screening and tests

Diability limitation: preventing the spread of the disease

Rehabilitation: Physical therapy; gain the max use of the remaining capacities

-A Physician supplies the means with the knowledge of the patients use to commit suicide

-Legal in Oregon with strict steps to follow

-written means for communicating care choices

-forms and laws differ from state to state

-offere protection for the patient

Confirming that if cardiopulminary aresst occurs that there will no resucitaion instituted.

** must be written and ordered by MD

-600 men (399 with syphilis, 201 without)

-Suppose to go for 6 months went for 40 years

-provided free health care for themselves and family

-Told that they were being treated for bad blood

-Those with syphilis were not given treatment even when treatment was found to cure.

Sick Role

Talcott Parsons' reasearch in 1940's discovered

When one is unable to fulfill social role and expectations, one is deemed to be sick and one adopts this role

-exempt from fulfilling social roles

-required to take action to end sick roles as soon as possible

-expected to seek treatment and comply with a treatmen

-return to socail roles when MD says that person is no longer sick

Government gave grants and loans to the nation's hospitals so they could reach a 4.5 to 1000 people ratio.  In return the hospitals had to care for people who were unable to pay for treatment

Made easier

-monitoring

-procedures

-diagnosis

-documentation

-patient care

advisement outside of hospitals with the use of technology--phone, computer communication

--home bases primary care, psychiatric care, interpretation of diagnosis, and practitioner-to-practitioner consultations

"those treatments and health practices not presently considered an integral part of conventional medicine"

=Complemenarty Medicine: uses in conjunction with conventional medicine

=Alternative Medicine: CAM used instead of conventional medicine

=Integrative Medicine: Combines conventional and CAM methods

=Evidence based on anecdote and testimonials

=lack of scientific data

=lack of standardization

=cost

=may interfere with effectiveness of conventional therapies

internal: report remains within the facility

external: must be reported to and outside agency--government, regulatory

- Hacking into the system and all the information being leaked

- information being typed in incorrectly

Tax Equity and Fiscal Responsibility Act

Mandated Medicare to move to DRG system of reimbursment

Diagnosis Regulated Groups

-refers to a patient classification system that centers on the types of patients a hospital treats, referred to as its case mix

Generated money from donors fro most highly rated schools--higher standards for medical schools, which in turn lessened the amount of medical schools

-Autonomy: the right to self-govern (make own choices)

-Privacy: confidentiality

-Veracity: Truth tell; tell patient what is going on 

-Beneficence: Do good; difference between what is good and what you think is good

-Non-maleficence: Do no harm

Pays for all doctors' visits

need treatment, get treatment, pay nothing

The study of distribution of health related problems such as disease in populations and the factors that contribute to or determine that distribution

to prevent and control health problems

-Clinical: physical says you're healthy

-Functional: you can function in society

-Adaptive: you are healthy because you are able to adapt (homeostasit constatly challenged by change, stress)

-Eduaimonistic: a state of self-actualization

-object left inside patient during surgery

-Air embolism

-Blood incompatibility

-UTI associated with a catheter

-Bed sore

-Infection caused by IV

-Mediastintis after CABG

-Fall from bed

money given to build education building for health professions and grants were also available to it was accessable to all

Hill-Burton Bill

Nursing Trainging act

Medicare and Medicaid

Health Maintenance organizations

=maintained your health only providers within HMO

Preffered Provider Networks

=providers outside network may cost more