healthcare systems final
Terms
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- substitute
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replaces a service, independent of physicians
ability of PA to fx without direct supervision - complement
- enhances a service, when the performance is directed or determined by a physician
- PA cost effectiveness
- 1pa:.83 physician, or about 83% of a physicians job
- productivity values
- PA can increase medical productivity from 49-74%, with a pt count increase of 150-274
- how much can a PA increase office visits?
- 12-37% during first year
- what size practice if optimal for PA to be involved with physiscans?
- 3 or fewer physicians
- delegation
- the % of primary care medical responsibilities that can be safely handled by a PA under optimum conditions
- functionality of PA to residents
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60% of medical directors prefer PA's over residents
PA's used fewer ancillary services for pneumonia, stroke, heart failur - consultation
- the decision to request a physician's counsel on a specific medical scenario.
- consultation rate
- rate=#of consultations of any type per total visits in a given time period
- do new PA's seek out more or less physician consultation?
- MORE - they're new
- supervision
- a state legislated term that has both legal and economic implications
- clinical productivity
- measures changes in output that happen when small changes are incurred in one factor of production, with all other variables remaining constant
- how is clinical productivity measured?
- by number of pt visits
- functional delegation
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the assessment of PA functinoality by
1. the basis of tasks the PA is allowed to perform
2. the full range of tasks performed by a physician - what is the care generated per dollar of salary b/t NPP's and famly physicians?
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NPP = $2.68
family physician $2.62 - what three modes are PA costs evaluated?
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1. fiscla benefit overriding cost of hiring
2. more desirable to hire PA or physician
3. societal concern of how to deliver high-quality care at a minimum cost - compensation
- salary and benefits compared to revenue
- what is the PA compensation value?
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.38, compared to physician of .44, NP, .41
smaller the number, the more the value - value of delivered care in using education cost and timeframe as evaluatin
- PA's will have delivered 405,000 hours worth of care by the time the physician, who started school the same year, is providing care
- what is the substitution ratio of PA's:physicians in primary care?
- .65-.95
- what factors decrease effectiveness of the PA role?
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1. prescritive authority -limitations
2. stipulations on what/how much can Rx
3.requiring a co-signature - approximately how many prescriptions do PA's write in a year?
- 17.8 million, cornering 6% of the total market
- barriers to practice
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1.eligibility for reimbursement
2. prescription favorability
(WA and MT are most favorable) - third party reimbursement- how much does Medicare part B cover for PA's in hospital setting?
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85% of physician fees
100% if physician is on site, and sees all new pts - what is the educational time frame b/t NP's and PA's?
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PA program 24-36months requires at least 2yrs college and some HC exp. for admin. most have earned a bachelor’s degree and have an average of 48 months of HC exp. before admin
o Nurse Practitioners are RNs with a BSN and a master’s degree who complete graduate-level academics, which equals about 2 years additional to the two to four year RN degree