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272 SectiOn ii Public HealtH ScienceS ` PUBLIC HEALTH SCIENCES—HEALTHCARE dELIVERy Public HealtH ScienceS ` PUBLIC HEALTH SCIENCES—QUALITy ANd SAFETy

Medicare and Medicare and Medicaid—federal social MedicarE is for Elderly.
Medicaid healthcare programs that originated from MedicaiD is for Destitute.
amendments to the Social Security Act.
Medicare is available to patients ≥ 65 years old, The 4 parts of Medicare:
< 65 with certain disabilities, and those with ƒ Part A: HospitAl insurance, home hospice
end-stage renal disease. care
Medicaid is joint federal and state health ƒ Part B: Basic medical bills (eg, doctor’s fees,
assistance for people with limited income and/ diagnostic testing)
or resources. ƒ Part C: (parts A + B = Combo) delivered by
approved private companies
ƒ Part D: Prescription Drugs

Hospice care Medical care focused on providing comfort and palliation instead of definitive cure. Available to
patients on Medicare or Medicaid and in most private insurance plans whose life expectancy is
< 6 months.
During end-of-life care, priority is given to improving the patient’s comfort and relieving pain
(often includes opioid, sedative, or anxiolytic medications). Facilitating comfort is prioritized
over potential side effects (eg, respiratory depression). This prioritization of positive effects over
negative effects is called the principle of double effect.

Common causes of death (US) by age
< 1 yR 1–14 yR 15–34 yR 35–44 yR 45–64 yR 65+ yR
#1 Congenital Unintentional Unintentional Unintentional Cancer Heart disease
malformations injury injury injury
#2 Preterm birth Cancer Suicide Cancer Heart disease Cancer
#3 Maternal Congenital Homicide Heart disease Unintentional Chronic
pregnancy malformations injury respiratory
complications disease

Conditions with Readmissions may be reduced by discharge planning and outpatient follow-up appointments. The
frequent hospital table below is based on readmission for any reason within 30 days of discharge.
readmissions
mEdICARE mEdICAId PRIVATE INSURANCE UNINSUREd
#1 Congestive HF Mood disorders Maintenance of Mood disorders
chemotherapy or
radiotherapy
#2 Septicemia Schizophrenia/ Mood disorders Alcohol-related
psychotic disorders disorders
#3 Pneumonia Diabetes mellitus with Complications of Diabetes mellitus with
complications surgical procedures complications
or medical care

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