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在臨床醫學中2HealthCareDeliverySystemsHistoryofMedicineandHealthcareDeliveryContinuumofCareHealthCareFacilityOwnershipHealthCareFacilityOrganizationalStructureLicensure,Regulation,andAccreditation3IntroductionHealthcaredeliveryhasbeengreatlyimpactedbyescalatingcosts,resultinginmedicalnecessityrequirements,reviewofappropriatenessofadmissions,andrequirementforadministrationofqualityandeffectivetreatments.4MRXO在臨床醫學中,進行手術時同時使用磁振造影並整合各種影像技術是目前最熱門的醫療概念。新式的「未來手術室」中,安裝有全球首套MRXO解決方案,即完全整合磁振造影(MR)、X光及電腦斷層掃描(CT)系統,大幅減少病患危險並簡化醫師的手續,可望提高手術成功率。這項由日本東海大學、飛利浦醫療系統事業部合力推動的「未來手術室」,已經由日本東海大學的松前教授、津具醫師、山本醫師共同在手術室同時使用MR(磁振造影)和X光影像技術,來進行神經外科手術。5MRXO在「未來手術室」中執行手術,可依執刀醫師與病患狀況,在數分鐘內將病患從手術臺搬移到磁振造影、電腦斷層掃描或X光診斷系統,增加手術精密度與成功率。在磁振造影和電腦斷層掃描區域有拉門。6HistoryofMedicine&HealthCareDeliveryHistoryofmedicineEvolutionofhealthcaredeliveryintheUnitedStates7HistoryofmedicineIn1994,scientistsdiscoveredthegenesresponsibleformanycasesofhereditarycoloncancer,inheritedbreastcancer,andthemostcommontypeofkidneycancer.8EvolutionofhealthcaredeliveryintheUnitedStates1991TheWorkgrouponElectronicDataInterchange(WEDI)wascreatedtoreducehealthcareadministrativecoststhroughimplementationoftheelectronicdatainterchange(EDI),whichusesnationalstandardstotransmitdataforreimbursementpurposes.9EvolutionofhealthcaredeliveryintheUnitedStates1996TheHealthInsurancePortabilityandAccountabilityAct(HIPAA)waspassed.Itmandatesadministrativesimplificationregulationsthatgovernprivacy,security,andelectronictransactionstandardsforhealthcareinformation.10EvolutionofhealthcaredeliveryintheUnitedStates1996TheHealthcareIntegrityandProtectionDataBank(HIPDB)wascreatedwhichcombatsfraudandabuseinhealthinsuranceandhealthcaredeliverybyalertinguserstoconductacomprehensivereviewofapractitioner’s,provider’s,orsupplier’spastactions.11HealthcareIntegrityandProtectionDataBankAccesstoinformationintheHIPDBisavailabletoentitiesthatmeettheeligibilityrequirementsdefinedinSection1128EoftheSocialSecurityActandtheHIPDBregulations.Inordertoaccessinformation,eligibleentitiesmustfirstregisterwiththeDataBank.HIPDBinformationisnotavailabletothegeneralpublic.However,informationinaformthatdoesnotidentifyanyparticularentityorpractitionerisavailable.12HealthcareIntegrityandProtectionDataBank/Estimatesofannuallossesduetohealthcarefraudrangefrom3to10

percentofallhealthcareexpenditures--between$30

billionand$100

billionbasedonestimated1997expendituresofover$1trillionand2.5trillionfor2009.13ContinuumofCareAcompleterangeofprogramsandservicesiscalledacontinuumofcare,withthetypeofhealthcareindicatingthehealthcareservicesprovided.PrimarycareSecondarycareTertiarycare14PrimarycareservicesIncludepreventiveandacutecare,arereferredtoasthepointoffirstcare,andareprovidedbyageneralpractitionerorotherhealthprofessionalwhohasthefirstcontactwithapatientseekingmedicaltreatment,includinggeneraldental,ophthalmic眼科的,andpharmaceuticalservices.15PrimarycareservicesAnnualphysicalexaminationsEarlydetectionofdiseaseFamilyplanningHealtheducationImmunizationsTreatmentofminorillnessesandinjuriesVisionandhearingscreening16SecondarycareservicesProvidedbymedicalspecialistsorhospitalstaffmemberstoapatientwhoseprimarycarewasprovidedbyageneralpractitionerwhofirstdiagnosedortreatedthepatient.17TertiarycareservicesProvidedbyspecializedhospitalsequippedwithdiagnosticandtreatmentfacilitiesnotgenerallyavailableathospitalsotherthanprimaryteachinghospitalorLevelI,II,IIIorIVtraumacenters.18TraumacentersLevelI:providesthehighestlevelofcomprehensivecareforseverelyinjuredadultandpediatricpatientswithcomplex,multi-systemtrauma.LevelII:broadrangeofsub-specialistsareon-callandpromptlyavailabletoprovideconsultationorcare.19TraumacentersLevelIII:physiciansareadvancedtraumalifesupport(ATLS)trainedandexperiencedincaringfortraumaticallyinjuredpatients;nursesandancillarystaffarein-houseandimmediatelyavailabletoinitiateresuscitativemeasures.20TraumacentersLevelIV:criticallyinjuredpatientswhorequirespecialtycarearetransferredtoahigherleveltraumasystemhospitalinaccordancewithpre-establishedcriteria.1、病毒性肝炎:由病毒造成的肝炎按照其病毒系列不同分為甲、乙、丙、丁、戊和庚共六種類型病毒性肝炎。能引起肝臟細胞腫脹,是世界上流傳廣泛,危害很大的傳染病之一。

1908年,才發現病毒也是肝炎的致病因素之一。1947年,將原來的傳染性肝炎(infectioushepatitis)稱為甲型肝炎(HepatitisA,HA);血清性肝炎(serumhepatitis)稱為乙型肝炎(HepatitisB,HB)。1965年人類首次檢測到乙型肝炎的表面抗原。我國經濟和科學技術日益發展,學術文化領域百家爭鳴,(df高血壓958心臟病983u6糖尿病87fr)特別是思想家的革新精神,為中醫學理論的創新和突破性進展,提供了有利的文化背景。宋代陳無擇著《三因極一病證方論》一書,(45傳染病q566丙肝964jo乙肝28jgsx甲肝gh)提出三因學說;并產生了最具盛名四大學派,劉完素倡導火熱論;張從正力倡“攻邪論”;李杲提出“內傷脾胃,百病由生”的理論;朱震亨創造性地闡明了相火的演變規律。編輯本段明清時期(df肺25s血液f369血小板t5172紅血球gdf55m白血球fd2)是中醫學理論綜合匯編、深化發展,臨床各科辨證體系豐富、提高階段。如明代樓英的《醫學綱目》和王肯堂的《證治準繩》,清代吳謙等編著的《醫宗金鑒》和陳夢雷主編的《古今圖書集成·醫部全錄》等。王清任著《醫林改錯》,注重實證研究,(df高血壓958心臟病983u6糖尿病87fr)糾正了古醫籍中關于解剖知識的某些錯誤,肯定了“腦主思維”,發展了瘀血理論。溫病學說的形成和發展,標志著中醫理論的創新與突破,吳有性著《溫疫論》,葉天士著《溫熱病篇》,吳鞠通著《溫病條辨》等,在藥物學研究方面,(45傳染病q566丙肝964jo乙肝28jgsx甲肝gh)李時珍著的《本草綱目》,總結了16世紀以前我國藥物學研究的成就。醫的診察疾病能參考現代醫學的微觀分析,將辨證與辨病相結合,實現宏觀與微觀的統一,使中醫診斷客觀化,即把分析與綜合相結合的方法引入中醫理、法、方、藥的研究,使二者有機結合,互相借鑒、補充,避免各自的片面性、局限性,這將有利于中西醫學的優勢互補,“和而不同”,多元發展。近年來,中醫藥在防治非典、禽流感和艾滋病方面發揮的獨特作用也證實了二者的有機結合,具有肯定的臨床療效。編輯本段東西方醫學交融不管是中醫學還是西醫學,從二者現有的思維方式的發展趨勢來看,均是走向現代系統論思維,中醫藥學理論與現代科學體系之間具有系統同型性,屬于本質相同而描述表達方式不同的兩種科學形式。可望在現代系統論思維上實現交融或統一,成為中西醫在新的發展水平上實現交融或統一的支撐點,希冀籍此能給中醫學以至生命科學帶來良好的發展機遇,進而對醫學理論帶來新的革命。編輯本段現代中醫史上個世紀末,本世紀初,1996年,清華學界對中醫氣本質,經絡實質,陰陽,五行,藏象,中醫哲學觀等都有了新的全面整體創造性的認識和解說。如,鄧宇等發現的:氣是流動著的‘信息-能量-物質’的混合統一體;分形分維的經絡解剖結構;數理陰陽;中醫分形集:分形陰陽集-陰陽集的分形分維數,五行分形集-五行集的分維數;分形藏象五系統-暨心系統、肝系統、脾系統、肺系統、腎系統;中醫三個哲學觀-新提出的第三哲學觀:相似觀-分形論等。還包括近代針灸經絡的發展史,近代中醫氣的進展簡史,中西醫結合史,中醫中藥史等.六種類型的病毒性肝炎遺傳因子不同,除乙型肝炎遺傳因子是DNA外,其余幾型肝炎遺傳因子均為RNA。其中甲型肝炎的傳播途徑是糞口傳播,乙型肝炎的傳播途徑是血液傳播、性傳播和母嬰傳播。疫苗。

2、酒精性肝炎:酒精性肝炎早期可無明顯癥狀,但肝臟已有病理改變,發病前往往有短期內大量飲酒史,有明顯體重減輕,食欲不振,惡心,嘔吐,全身倦怠乏力,發熱,腹痛及腹瀉,上消化道出血及精神癥狀。體征有黃疸,肝腫大和壓痛,同時有脾腫大,面色發灰,腹水浮腫及蜘蛛痣,食管靜脈曲張。從實驗室檢查看,有貧血和中性白細胞增多,紅細胞容積測定(MCV)大于95FL,血清膽紅素增高,可達17.1μmoL/L或以上,轉氨酶中度升高,常大于2.0,測定線粒體AST(mAST)及其與總AST(tAST)的比值,其升高可達12.5+5.2%。并有γ-GT,谷氨酸脫氫酶和堿性磷酸酶活力增高,凝血酶原時間延長。此外,病毒性肝炎還有丙型肝炎、丁型肝炎、戊型肝炎和庚型肝炎。過去被定為己型肝炎病毒的病毒現在被確定為乙型肝炎病毒的一個屬型,因此己型肝炎不存在。在病毒肝炎的疫苗,A型、B型、D型的疫苗已研發成功;C型、E型、F型的目前無編輯本段宋金元時期精品課件文檔,歡迎下載,下載后可以復制編輯。更多精品文檔,歡迎瀏覽。22TertiarycareBurncentertreatmentCardiothoracicandvascularsurgeryInpatientcareforAIDSpatientsMagneticresonanceimaging(MRI)NeonatologylevelIIIunitservicesNeurosurgeryOrgantransplant23TertiarycarePediatricsurgeryPositronemissionstomography(PET)RadiationoncologyServicesprovidedtoapersonwithahigh-riskpregnancyServicesprovidedtoapersonwithcancerState-designatedtraumacentersTraumasurgery24Positronemissionstomography(PET)buildsimagesbydetectingenergygivenoffbydecayingradioactiveisotopes.Isotopesareatomsofanelementwiththesamenumberofprotons(positivelychargedparticles)inthenucleus,butadifferentnumberofneutrons(neutralparticles).Becauseradioactiveisotopesareunstable,astheydecay,theythrowoffpositronsthatcollidewithelectronsandproducegammaraysthatshootoffinnearlyoppositedirections.25PETPETsystemsusethepathsofthetwodetectedgammaraystodeterminetheoriginatingcollisionpoint,aprocesscalledelectroniccollimation(瞄準).Thescannersuseacircularseriesofgammaray-detectorstoenvelopethepatientsobothgammascanbedetectedsotheinstrumentcanuseelectroniccollimationtopredictwheretheenergysignaloriginated.Thissignalisthenconvertedintoathree-dimensionalimageslice.26臺灣醫院分類診所地區醫院(497/2005)區域醫院(80/2005,65/2006,64/2007)醫學中心(23/2005,18/2006,19/2007,14/2009)27醫學中心在衛生局登記開放的急性一般病床與急性精神病床合計須達五百床以上至少應能提供家庭醫學、內、外、婦產、兒、骨、神經外、泌尿、耳鼻喉、眼、皮膚、神經、精神、復健、麻醉、放射線、病理、核醫、牙等十九科之診療服務。28醫學中心專任主治醫師人數(包括主任在內)每八床應有一名。專任護理人員每2床至少1名。加護病房:每床2.5名。手術室:每班每臺2.5名。手術恢復室:每班每床0.5名。產房及待產室:每床2名。嬰兒室:每床0.4名。急診室:觀察室每床0.5名;診療室每12人次1名。門診:每班每診療室0.5名。血液透析室:每4人次1名。行政、教學、研究及其他護理人員(如院內感染控制、公衛、供應中心等護理人員)另計,應佔總人數百分之六。應有受過感染控制訓練之專任護理人員,每300床應設1名。29醫學中心藥事人員每40床至少1名。每60張門診處方至少1名。特殊藥品處方每15張至少1名。藥事人員總數至少四分之三為藥師。藥事人員至少有4名負責藥品管理諮詢及臨床等工作。30區域醫院應設置250床位以上急性病病床數每床所擁有的樓地板面積應在50平方公尺以上每9床至少應擁有一名主治醫師每2.5床至少應擁有一名護理人員等。至少應能提供家庭醫學、內、外、婦產、兒、骨、耳鼻喉、眼、精神、復健、麻醉、放射線、病理、牙等十四科之診療服務。31區域醫院Nurse加護病房:每床2名。手術室:每班每臺2名。手術恢復室:每班每床0.5名。產房及待產室:每床1.2名。嬰兒室:每床0.4名。急診室:觀察室每床0.5名;診療室每12人次1名。門診:每班每診療室0.5名。血液透析室:每4人次1名。行政、教學、研究及其他護理人員(如院內感染控制、公衛、供應中心等護理人員)另計,應佔總人數百分之四。應有受過感染控制訓練之專任護理人員,每300床應設1名。32區域醫院藥事人員每50床至少1名。每70張門診處方至少1名。特殊藥品處方每15張至少1名。藥事人員總數至少四分之三為藥師。藥事人員中,至少有2名負責藥品管理諮詢及臨床等工作。33地區醫院在衛生局登記開放的急性一般病床需20床以上,急性一般病床及急性精神病床合計249床(含)以下。34地區醫院專任員工總人數每床應有1名。專任主治醫師人數以及專任護理人員應符合醫療機構設置標準。藥事人員每50床至少1名。每80張門診處方至少1名。每增加100張處方應增加1名。應有藥師1人以上。35評鑑分級設施總樓地板面積病房設施安全設備及一般設備保險病床比率36評鑑分級人員員工總人數醫師總數麻醉科醫師放射線科醫師核醫科醫師病理科醫師復健科醫師精神科醫師護理藥事醫事檢驗醫用放射線技術復健技術精神科社會工作營養師病歷管理37評鑑分級醫療業務及設備醫療業務急性病床數診療科別急診業務手術及麻醉作業產房嬰兒室加護病房藥事作業檢驗作業輸血作業放射線診療作業病理作業復健醫療作業精神科核子醫學牙科特殊醫療服務醫務社會服務工作營養部門病歷部門社區衛生服務員工健康檢查38評鑑分級品質保證醫療品質審查感染控制人體試驗藥事作業品質護理服務品質檢驗作業品質管制輸血作業品質管制病理作業品質管制放射線診療品質管制核子醫學品質管制病歷管理醫院管理業務醫病關係之促進39評鑑分級指定項目評估住院診斷處置用藥手術病歷寫作40評鑑分級教學訓練教學師資教學訓練與研究設備教學訓練活動與其他醫院(醫學院)交流合作情形研究情形及論文發表教學進修研究經費41新制教學醫院評鑑基準教學資源教學訓練計畫與成果研究執行與成果臨床師資培育及繼續教育學術交流與社區功能及角色管理行政42財團法人醫院評鑑暨醫療品質策進會.tw/Identify.asp?catid=2343HealthCareFacilityOwnershipGovernment(not-for-profit)25%Proprietary(for-profit)15%Voluntary(not-for-profit)60%44MedicalStaffIntern:aphysicianinthefirstyearofgraduatemedicaleducation,whichordinarilyimmediatelyfollowscompletionofthefour-yearmedicalcurriculum.Resident:aphysicianwhohascompletedaninternshipandisengagedinaprogramoftrainingdesignedtoincreasehisorherknowledgeoftheclinicaldisciplinesofmedicine,surgery,oranyoftheotherspecialfieldsthatprovideadvancedtraininginpreparationforthepracticeofaspecialty.45MedicalStaffChiefresident:aphysicianwhoisinhisfinalyearofresidencyorintheyearaftertheresidencyhasbeencompleted.VisitingStaff(VS):主治醫師46HealthCareFacilityOrganizationalStructureGoverningboardAdministrationMedicalstaffDepartments,services,andcommitteesContractedservices47GoverningboardThegoverningboard(boardoftrustees,boardofgovernors,boardofdirectors)serveswithoutpay,anditsmembershipisrepresentedbyprofessionalsfromthebusinesscommunity.48AdministrationServesasliaisonbetweenthemedicalstaffandgoverningboardandisresponsiblefordevelopingastrategicplanforsupportingthemissionandgoalsoftheorganization.CEO:chiefexecutiveofficeCFO:chieffinancialofficerCIO:chiefinformationofficerCOO:chiefoperatingofficer49MedicalstaffConsistsoflicensedphysiciansandotherlicensedprovidersaspermittedbylaw(e.g.,nursepractitionersandphysicianassistants)whoaregrantedclinicalprivileges.50physicianassistantsExamine,diagnose,andtreatpatientsunderthedirectsupervisionofaphysician.51MedicalstaffmembershipcategoriesActive:deliversmosthospitalmedicalservices,performssignificantorganizationalandadministrativemedicalstaffdutiesAssociate:advancementtoactivecategoryisbeingconsideredConsultingCourtesy:admitsanoccasionalpatienttothehospitalHonorary5253Hospitaldepartments,Services,andCommittees54HealthInformationDepartmentDepartmentadministrationCancerregistryCodingandabstractingImageprocessingIncompleterecordprocessingMedicaltranscriptionRecordcirculationReleaseofinformationprocessing5556CodingInvolvesassigningnumericandalphanumericcodestodiagnoses,procedures,andservices;thisfunctionisusuallyperformedbycredentialedindividuals.CodersassignICD-9-CMcodestoinpatientcasesandCurrentProceduralTerminology(CPT),HealthCareProcedureCodingSystem(HCPCS)LevelII(National),andICD-9-CMcodestooutpatient,emergencydepartment,andphysicianofficecases.57CancerregistryPerformedbyindividualswhoarecredentialedascertifiedtumorregistrarsandincludeusingcomputerizedregistrysoftwaretoconductlifetimefollow-uponeachcancerpatient,electronicallytransmitdatatostateandnationalagenciesforuseatlocal,regional,state,andnationallevels,andgeneratereportsandinformationforrequestingentities.58CurrentProceduralTerminology(CPT)PublishedannuallybytheAmericanMedicalAssociationandcodesare5-digitnumbersassignedtoambulatoryproceduresandservices.E.g.90663Influenzavirusvaccine,pandemicformulation59ICD-9-CMTheInternationalClassificationofDiseases,Ninthrevision,ClinicalModificationisusedintheUnitedStatestocollectinformationaboutdiseasesandinjuriesandtoclassifydiagnosesandprocedures.NationalCenterforHealthStatistics(NCHS).60/1.INFECTIOUSANDPARASITICDISEASES(001-139)TUBERCULOSIS(010-018)Includes:infectionbyMycobacterium分枝桿菌tuberculosis(human)(bovine牛)Excludes:congenitaltuberculosis(771.2)lateeffectsoftuberculosis(137.0-137.4)Thefollowingfifth-digitsubclassificationisforusewithcategories010-018:0unspecified1bacteriologicalorhistological組織學的examinationnotdone2bacteriologicalorhistologicalexaminationunknown(atpresent)3tuberclebacilli結核桿菌found(insputum)bymicroscopy4tuberclebacillinotfound(insputum)bymicroscopy,butfoundbybacterialculture5tuberclebacillinotfoundbybacteriologicalexamination,buttuberculosisconfirmedhistologically6tuberclebacillinotfoundbybacteriologicalorhistologicalexamination,buttuberculosisconfirmedbyothermethods[inoculation預防接種ofanimals]61/010PrimarytuberculousinfectionRequiresfifthdigit.Seebeginningofsection010-018forcodesanddefinitions.011PulmonarytuberculosisRequiresfifthdigit.Seebeginningofsection010-018forcodesanddefinitions.Useadditionalcodetoidentifyanyassociatedsilicosis矽肺病(502)012OtherrespiratorytuberculosisRequiresfifthdigit.Seebeginningofsection010-018forcodesanddefinitions.Excludes:respiratorytuberculosis,unspecified(011.9)013Tuberculosisofmeninges

腦脊膜andcentralnervoussystemRequiresfifthdigit.Seebeginningofsection010-018forcodesanddefinitions.62/014Tuberculosisofintestines

腸,peritoneum

腹膜,andmesentericglands

腸系膜腺Requiresfifthdigit.Seebeginningofsection010-018forcodesanddefinitions.015TuberculosisofbonesandjointsRequiresfifthdigit.Seebeginningofsection010-018forcodesanddefinitions.Useadditionalcodetoidentifymanifestation,as:tuberculous:Arthropathy關節病(711.4)Necrosis壞死ofbone(730.8)Osteitis骨炎(730.8)Osteomyelitis骨髓炎(730.8)Synovitis滑膜炎(727.01)Tenosynovitis腱鞘炎(727.01)63/016Tuberculosisofgenitourinary

泌尿生殖器的systemRequiresfifthdigit.Seebeginningofsection010-018forcodesanddefinitions.017TuberculosisofotherorgansRequiresfifthdigit.Seebeginningofsection010-018forcodesanddefinitions.018Miliary

粟粒狀的tuberculosis

Includes:tuberculosis:Disseminated彌散性Generalized全身性的miliary,whetherofasinglespecifiedsite,multiplesites,orunspecifiedsitePolyserositis漿膜炎ICD-10TheInternationalStatisticalClassificationofDiseasesandRelatedHealthProblems10thRevisionisacodingofdiseasesandsigns,symptoms,abnormalfindings,complaints,socialcircumstancesandexternalcausesofinjuryordiseases,asclassifiedbytheWHO.Thecodesetallowsmorethan14,400differentcodesandpermitsthetrackingofmanynewdiagnoses.Usingoptionalsubclassifications,thecodescanbeexpandedtoover16,000codes.64USICD-10CMTheInternationalversionofICDshouldnotbeconfusedwithnationalClinicalModificationsofICDthatincludefrequentlymuchmoredetail,andsometimeshaveseparatesectionsforprocedures,sothenewUSICD-10CMhassome155,000codes.6566HCPCSTheHealthCareProcedureCodingSystemiscomprisedofLevelI(CPT)andLevelII(National)codes.LevelIIHCPCScodesaredevelopedbytheCentersforMedicare&MedicaidServices(CMS)andusedtoclassifyreportproceduresandservices.67CPT(CurrentProceduralTerminology)anumericcodingsystemmaintainedbytheAmericanMedicalAssociation(AMA).TheCPTisauniformcodingsystemconsistingofdescriptivetermsandidentifyingcodesthatareusedprimarilytoidentifymedicalservicesandproceduresfurnishedbyphysiciansandotherhealthcareprofessionals.68LevelIoftheHCPCS,theCPTcodes,doesnotincludecodesneededtoseparatelyreportmedicalitemsorservicesthatareregularlybilledbysuppliersotherthanphysicians.69LevelIIHCPCSCodesarereportedtothird-partypayers(e.g.,insurancecompanies)forreimbursementpurposes.70LevelIIHCPCSLevelIIoftheHCPCSisastandardizedcodingsystemthatisusedprimarilytoidentifyproducts,supplies,andservicesnotincludedintheCPTcodes,suchasambulanceservicesanddurablemedicalequipment,prosthetics假體,orthotics矯形器,andsupplies(DMEPOS)whenusedoutsideaphysician'soffice71LevelIIHCPCSLevelIIalphanumericHCPCSprocedureandmodifiercodes,theirlongandshortdescriptions,andapplicableMedicareadministrative,coverage,andpricingdata.TheLevelIIHCPCScodes,whichareestablishedbyCMS'sAlpha-NumericEditorialPanel,primarilyrepresentitemsandsuppliesandnon-physicianservicesnotcoveredbytheAmericanMedicalAssociation'sCurrentProceduralTerminology-4(CPT-4)codes;Medicare,Medicaid,andprivatehealthinsurersuseHCPCSprocedureandmodifiercodesforclaimsprocessing.72/MedHCPCSGenInfo/A1001007DRESSINGFORONEWOUNDDressingforonewoundC2002070120020701N

A2001007DRESSINGFORTWOWOUNDSDressingfortwowoundsC02002070120020701NA3001007DRESSINGFORTHREEWOUNDSDressingforthreewoundsC02002070120020701N73AbstractingPerformedtoentercodesandotherpertinentinformationutilizingcomputersoftware.Togeneratestatisticalreportsanddisease/procedureindexes,whichareusedforadministrativedecision-makingandquality-managementpurposes.74IncompleterecordprocessingIncludestheassemblyandanalysisofdischargedpatientrecords.Afterapatientisdischargedfromanursingunit,therecordisretrievedandreportsareassembledaccordingtoahospital-andmedicalstaff-approvedorderofassembly.75MedicaltranscriptionInvolvestheaccurateandtimelytranscriptionofdictatedreports.76RecordcirculationIncludestheretrievalofpatientrecords,forthepurposeof:InpatientreadmissionScheduledandunscheduledoutpatientclinicvisitsAuthorizedquality-managementstudiesEducationandresearch77Licensure,RegulationandAccreditationCodeofFederalRegulations(CFR)FederalRegisterAlegalnewspaperpublishedeverybusinessdaybytheNationalArchivesandRecordsAdministration(NARA)inpaperform,microfiche,andonline.AccreditationStandardsandSurveys78RegulationAregulationisaninterpretationofalawthatiswrittenbytheresponsibleregulatoryagency.E.g.theConditionsofParticipation(CoP)areregulationswrittenbytheCentersforMedicare&MedicaidServices(CMS).Congresswritesandpassesanact,thePresidentsignstheactintolaw,andCMSinterpretsthelawcreatingaregulation.79AccreditationAvoluntaryprocessthatahealthcarefacilityororganizationundergoestodemonstratethatithasmetstandardsbeyondthoserequiredbylaw.80StandardsAccreditationorganizationsdevelopstandards,whicharemeasurementsofahealthcareorganization’slevelofperformanceinspecificareasandareusuallymorerigorousthanregulations.81SurveyAsurvey(evaluation)processisconductedbothoff-siteandon-sitetodeterminewhetherthefacilitycomplieswithstandards.82AccreditingOrganizationsAccreditationAssociationforAmbulatoryHealthCare(AAAHC)CommissiononAccreditationofRehabilitationFacilities(CARF)CommunityHealthAccreditationProgram(CHAP)83AccreditingOrganizationsJointCommissiononAccreditationofHealthCareOrganizations(JCAHO)NationalCommitteeforQualityAssurance(NCQA)NationalCommissiononCorrectionalHealthCare(NCCHC)84Bringinganewdrugtomarket5000compoundsevaluated5compoundsenterclinicaltrials1compoundapproved2345678910111213141516yearsDiscoveryandpreclinicaltesting:Compoundsareidentifiedandevaluatedinlaboratoryandanimalstudiesforsafety,biologicalactivity,andformulation.ReviewandapprovalbyFood&DrugAdministrationPhaseIII:Confirmseffectivenessandmon

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