HEALTH CARE SYSTEMS:
REGULATORY AGENCIES AND
ORGANIZATIONS QUESTIONS AND
ANSWERS WITH SOLUTIONS 2024
Health - ANSWER Defined by the WHO as a state of complete physical, mental, and social well-being and
not merely the absence of disease or infirmity.
Outpatient - ANSWER A patient who is receiving health care services at a hospital without being
hospitalized, institutionalized, or admitted as an inpatient.
American Medical Association (AMA) - ANSWER Professional organization for physicians. Involved in the
accreditation of medical schools, residency programs, and certain allied health programs. Formed in
1847 by a group of physicians for the primary purpose of establishing and supporting a code of ethics for
physicians in their duties to their patients and the profession. Examined the poor quality of medical
education and the questionable ethics of practicing physicians.
American Hospital Association (AHA) - ANSWER Founded in 1898 for the purpose of promoting public
welfare by providing better health care in hospitals.
Flexner Report - ANSWER Identified serious problems and inconsistencies that existed in medical
education that resulted in the closing of many schools and significant curriculum revision in the
remaining schools. Established a model for medical education.
American College of Surgeons (ACS) - ANSWER Founded in 1913 to develop a system of hospital
standards. Adopted the Minimum Standards in 1919 that identified the essential standards for proper
care and treatment of hospital patients. These standards included medical record specifications that
formed the basis of today's medical record standards. Founded the Hospital Standardization Program
(early accreditation program).
The Hill-Burton Act - ANSWER (Hospital Survey and Construction Act) Legislation that provided funding
for the construction of hospitals and other health care facilities on the basis of state need. (1946)
The Joint Commission - ANSWER Founded in 1952 to take over the Hospital Standardization Program
from the overburdened ACS. Private, nonprofit entity whose primary function is to develop and assess
, standards of performance by health care organizations. Provide accreditation services to a variety of
healthcare settings. Redefined the standards to be the optimal achievable, as opposed to minimum
standards. Emphasis on health care functions crucial to patient care.
Medicare - ANSWER Title XVIII, "Health Insurance for the Aged". Established in 1965 when Congress
amended the Social Security Act of 1935. A federally funded program that provides health insurance for
elderly people and other groups.
Medicaid - ANSWER Title XIX, "Medical Assistance Program". Established in 1965 when Congress
amended the Social Security Act of 1935 and extended the Kerr-Mills Medical Assistance Program. A
joint program between the state and the federal governments to provide health care to welfare
recipients and indigents in the different states.
"To Err is Human" - ANSWER Publication released in 1999 by the Institute of Medicine (IOM) that
reported the high rate and cost of deaths per year attributable to medical errors. Brought increased
attention to the issue of patient safety.
Sources of pressure for high quality healthcare for all - ANSWER 1. Federal government- Concerned with
cost and accessibility of healthcare
2. Consumers- More educated and demanding more and better quality
3. Providers- Want to maintain their market share, contain costs, realize a profit
4. Taxpayers- Underinsures or uninsured or who feel overburdened by taxation that finances healthcare
Current changes in health care delivery - ANSWER 1. Shift from inpatient care to outpatient
2. Increased legislation on patient rights
3. Increase in alternative health care systems
Patient-centered care - ANSWER Care that puts the patient in charge and gives him/her as much control
as desired. Allows patients to have more control over their care and access to their health care
information, and gives them choices that allow them to express their cultural traditions, personal
preferences and values, family situations, and lifestyles.
Quality Check - ANSWER Function on the JC website that allows consumers to check on the accreditation
findings of health care organizations (HCOs)
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