USheatlhcareexam2review - Chapter 7 Growth of Ambulatory...

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Chapter 7 Growth of Ambulatory Care Ambulatory Care : an individual presenting for personal health services, who is neither bedridden, nor currently admitted to any health care institution. Why has Amb. Cares expand over the past few years b/c of the rapid growth of managed care and the greater emphasis placed on outpatient hospital care. Medicare Prospective Payment System (PPS)- for inpatient hospitalizations. Purpose: more services & shorter lengths of stays Common Problems Based on your review of tables, are you familiar with some of the common disease states that patients see their physician and their pharmacist for? Top Common Diseases: Essential Hypertension, Infant checkup, Acute upper respiratory infections, diabetes mellitus In training high-quality health professionals, should pharmacy schools emphasize education on the common disease states? Yes. Primary Care Providers What types of physicians are known as primary care providers? Physicians, midwives, nurse practitioners, and physician assistants. What non-physician health professionals provide primary care? Types of Medical Practices 2 major types in medical practice: 1. Private-Practice physicians in solo, partnership, and private group practice settings on a fee for service basis 2. Ambulatory Care: provided in organized settings that have an identity independent of that of the physicians practicing in it. This includes HMOs and PPOs. Solo Practice: Is ↓ b/c managed care pressures Physician Perspective: solo practice offers an opp. To avoid organizational dependence and to be self employed. PCP by Solo Practioners= family practice, internal medicine, pediatrics, and obstertrics and gynecology. SPPractitioners care for patients in office space owned or leased by the physicians or in the physicians home. For hospitalized patients physicans seem @ provides care for them in the hosp Group Practice: is an affiliation of 3 or more providers usually physicians who share income, expenses, facilities, equipment, medical records, and support personnel, and who provide services thru a formal org. **basically it’s a formal sharing of resources and distribution of income. The 1 st successful non industrial group practice ws the Mayo Clinic in Minnesota (single specialty group 1887. It later became a mult- specialty group Advantages from Physicains Perspective: Shared operation, joint ownership, centralized administrative fxns, & availability of professional business manager. Financially the group practice relieves the provider of having to scare up large initial investment often req. to est. a practice. Disadvantages from provider perspective: Less individual freedom, less income,weak provider-patient relationship, and greater restrictions on referral practices How has the trend of physicians in solo practice and group practice changed in the last 40 years?
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