Tertiary Care Facilities

AHCs exemplify a special type of tertiary care facility. What factors distinguish AHCs from other providers of tertiary care?

What challenges to survival do AHCs face in the ever-changing U.S. health services system?â?¢ Given their tripartite function, AHCs are expensive to operate, and some payers do not want to incur higher costs.

1. Hospice services are generally made available to individuals deemed to be in the last six months of their lives. Data on the utilization of hospice services by Medicare beneficiaries show that their median survival time, after hospice admission, was 36 days. From this one data pointâ?"and any other knowledge or experience you may haveâ?"what might you conclude about the utilization of hospice services? The difficulty in projecting end-of life needs and end-of-life survival times?

2. What is potentially ineffective care (formerly termed futile care)?

3. Why should people with mental illness be any more "special" or particular a population than people with physical ailments?

4. What factors stimulated the movement of the treatment of mental illnesses from largeâ?"often state-ownedâ?"institutions into the community? How successful has this movement been?

5. Seeking mental health services and/or treatment for mental illness remains stigmatized in many parts of our society. What might be done to reduce this stigmatization?

1. Many models of health services delivery are described as managed care. What do these disparate models have in common?

2. What are some advantages or strengths of a managed care system over a fee-for-service system? What are some limitations?

3. What are some of the challenges to satisfactorily measuring the quality of care a patient receives?

4. What federal initiatives over the last three decades have focused on quality of care (i.e., regulating quality, supporting research into quality, or setting standards for quality of care)?