population. It is estimated that about 75%–85% of people in a general population require only
9. What are some of the reasons solo practitioners are joining group practices?
Very few graduates of residency programs are entering solo practice. Several factors account for
this shift: rapid changes in the health delivery system, contracting by MCOs with consolidated
rather than solo entities, competition from larger health delivery organizations, the high cost of
establishing a new practice, the complexity of billing and collections in a multiple-payer system,
10. Why is it important for hospital administrators to regard outpatient care as a key
component of their overall business strategy?
Outpatient services now constitute a key source of profits for hospitals. As hospitals have seen
inpatient revenues steadily erode, they have expanded outpatient services. Under prospective and
11. Discuss the main hospital-based outpatient services.
Hospital-based outpatient services can be broadly classified into five main types: clinical,
surgical, emergency, home health, and women’s health.
• Clinical Services—Clinical services often correspond to the services provided by
private physicians in their offices. Hospitals located in underserved areas often provide
ambulatory services to patients who lack health insurance and do not have routine access to
private practitioners. Centers affiliated with teaching hospitals provide research-oriented
specialized services. Some large teaching hospitals may have 100 or more specialty and
subspecialty clinics.
12. What are some of the social changes that led to the creation of specialized health centers
for women?
Women’s health centers grew out of social changes, which include (1) the market assessment
that women are the major users of health care, (2) a growing concern that research in women’s
13. Why is the hospital emergency department sometimes used for nonurgent conditions?
What are the consequences?
Reasons for emergency department use for nonurgent care include erroneous self-perceptions of
the severity of ailment or injury, the 24-hour open-door policy, convenience, and unavailability
14. What are mobile healthcare services? Discuss the various types of mobile services.
Mobile health care services are transported to patients. Ambulance service and first-aid treatment
provided to the victims of severe illness, accidents, and disasters by trained emergency medical
technicians (EMTs) are the most commonly encountered mobile medical services. Even
specialized ambulance services, such as mobile coronary care units and shock-trauma vans, are
15. What is the basic philosophy of home health care? Describe the services provided
through home health care.
Home health is consistent with the philosophy of maintaining people in the least restrictive
environment possible. Most people would prefer to live and receive health services at home than
be institutionalized. Home health services typically include nursing care, such as changing
16. What are the conditions of eligibility for receiving home health services under Medicare?
Patients are eligible to receive home health services under Medicare if they meet three basic
conditions:
2. The patient is under the care of a physician who will establish a home health plan.
17. Explain the concept of hospice care and describe the types of services provided by
hospices.
Hospice includes a cluster of comprehensive services for the terminally ill with a life expectancy
18. What are some of the main requirements for Medicare certification of a hospice program?
To receive Medicare certification, a hospice must provide the following services: staffing on a
19. Describe the scope of public health ambulatory services in the United States.
Public health services provided by local health departments range from immunization services to
a full range of outpatient services. However, there is no consistent pattern for the scope of
services offered in different geographical sectors of the country. Generally, public health
20. Describe the main public and voluntary outpatient clinics, and the main problems they
face.
Community health centers (CHCs) operate under the auspices of the Bureau of Primary Health
Care, Public Health Service, or Department of Health and Human Services. CHCs provide
comprehensive ambulatory and social services to the poor living in inner cities and rural areas
20. Why do both Republican and Democrat Presidents support the community health
center program?
Community health centers provide effective and efficient primary care to the nation’s
underserved populations such as those who are uninsured. Republicans use health centers as an
21.
Why do both Republican and Democrat presidents support the community health center
program?
Both support community health center program for different reasons. Republicans hope the
health center program would be adequate to address the uninsured population’s access to
22. What is alternative medicine? What role does it play in the delivery of health care?
Alternative medicine (also referred to as “complementary medicine,” “nonconventional
therapies,” or “natural medicine”) refers to the broad domain of all healthcare resources, other
than those intrinsic to biomedicine, to which people have recourse. Alternative therapies are
23. Briefly explain how a telephone triage system functions.
A telephone triage system provides telephone access to bring expert opinion and advice to the
24. Discuss the global trend in primary care.
Around the world, there is little consistency in how primary care services are accessed and how
physicians get paid. The United Kingdom offers the most comprehensive coverage with little