Review for Final Exam PDF

## Review for Final Exam This is a guideline for the final exam. Make sure to review the presentations discussed in class and your classmates' topics. ### I. Healthcare System Organization and Delivery * **A. Levels of Care in the Healthcare System** * Primary care * Secondary care...

## Review for Final Exam This is a guideline for the final exam. Make sure to review the presentations discussed in class and your classmates' topics. ### I. Healthcare System Organization and Delivery * **A. Levels of Care in the Healthcare System** * Primary care * Secondary care * Tertiary care * **B. Models of Health and Eye Care Delivery** * Fee-for-service model * Managed care model * **C. Vision Care Plans** * **D. Economic Principles in Healthcare** * Case study analysis: Financing and cost control measures ### II. Healthcare Financing * **A. Role of supply and demand in healthcare and optometry** * Demand for Healthcare Services- is driven by factors like population demographics, disease prevalence, and patient preferences. * Supply of healthcare resources- such as physicians, facilities, and medical equipment's, is influenced by factors like regulations, technology, and labor market conditions. * Equilibrium and Market Dynamics- the interaction between supply and demand determines the price and quantity of healthcare services, creating an equilibrium point in the market. * Factors Affecting Equilibrium- Changes in factors like insurance coverage, government policies, and technological advancements can shift the supply and demand curves, altering the market equilibrium. * **B. Methods of healthcare payment** * Direct Payment- patients pay directly for healthcare services out-of-pocket, including fees for doctor visits, procedures, and medications. * Indirect payment-healthcare costs are covered by third-party payers like insurance companies or governments programs, with patients paying premiums or copays. * Shared responsibility- in many cases, healthcare payment is a combination of direct and indirect methods, with patients and payers sharing the costs. * **C. Factors contributing to rising healthcare costs and optometric services** * The rising costs of healthcare in the US are driven by a combination of factors, including the growing cost of medical technologies, the aging population, the prevalence of chronic disease, administrative overhead, and the high cost of prescription drugs. Inefficiencies in the delivery of care and the fragments nature of the healthcare system also contribute to the steady increase in healthcare expenditures. * **D. The economics of vision correction procedures** * Refractive Surgery- procedures like lasik and PRK can correct vision, reducing the need for glasses or contacts. These elective surgeries have complex economic factors. * Pricing Considerations- the cost of vision correction surgery depends on factors like technology, provider experience, and geographic location. Prices can range from $2,000 to $5,000 per eye. * Insurance Coverage- Many insurance plans do not cover elective refractivve surgery, so patients must pay out of pocket. This creates access chaallenges for those with limited means. * Demand Drivers- factors like technologicl advancements, patient demographics, and lifestyle preferences impact the demand for vision correction procedures. * **E. Optometry and Healthcare reform** * Policy changes-healthcare reform has introduced new policies and regulations that impact the optometry field, requiring adaptation and compliance. * Expanded Coverage- reforms have expanded insurance coverage for vision care, increasing patients access to optometry services. * Cost considerations- optometrist must navigate the evolving reimbursement landscape and optimize practice economics in the face of reform. * Interdisciplinary Care- healthcare reform has emphasized team -based, coordinated care, requiring optometrist to collaborate more closely with other providers. * **F. The economics of optometry practice management** * Effective practice management is crucial for the financial sustainability of optometry clinics. Key economic factors to consider include staffing costs, inventory management, billing and collections, and overhead expenses. * Staffing costs- Salaries benefits, and training for optometrists, technicians, and administrative staff * Inventory management- Purchasing, storage, and rotation of eyeglasses, contact lenses, and optical supplies. * Billing and collections- Maximizing reimbursements from insurance providers and patients. * Overhead expenses- Rent, utilities, technology, and other fixed and variable costs of operating the practice. Optimizing these areas can improve profitability and efficiency, allowing optometrist to focus on delivering high-quality patient care. ### US Healthcare System Financing Structure * **Private insurance** * **Medicare** * is a federal health insurance program that provides coverages for individuals aged 65 and older, as well as those with certain disabilities or endstage renal disease. * Is for the elderly and disabled, provides limited coverage for optometry services, primarly for the diagnosis and treatment of eye diseases. * Routine Vision Care- medicare generally does not cover routine eye exams, eye glasses, or contact lenses, except in specific cases such as after cataract surgery. * Specialty Services-medicare may cover certain specialized optometry services, such as diabetic eye exams, glaucoma screenings, and macular degeneration treatment, subject to specific eligibility criteria. * **Medicaid** * Is a joint federal and state program that provides health coverages for low-income individuals, including families, children, pregnant women, the elderly, and people with disabilities. * Is administered by individual states, leading to variations in coverage and eleibility requirements acrros the country. * Medicaid coverage- the federal state health insurance program, provides coverage for essential eye care services, including routine eye exams, eyeglasses, and treatment for certain vision conditions. * Reimbursement Challenges- however, medicaid reimbursement rates for optoemtry services are often lower than private insurance, leading to accessibility challenges for medicaid beneficiaries in finding participationf providers. * Out-of-pocket payments- Patients often face significant out-of-pocket expenses for optometry services, even with insurance coverage. These can include copays, deductibles, and costs for non-covered services like vision correction procedures. ### III. Quality Assurance (QA) and Legal Issues * **A. Quality Assurance in Optometry ** * Designing a quality assurance plan for an optometry clinic * Components of Quality Assurance * Credentialing * Documentation * Patient Satisfaction * Utilization Management * Customer satisfaction in optometry * Patient Satisfaction Surveys * Eyewear Satisfaction Follow-Up * **B. Laws and Legal Issues in Optometry ** * HIPAA (Health Insurance Portability and Accountability Act) * OSHA (Occupation Safety and Health Administration) * **C. Malpractice and Litigation in Eye Care** * **D. Key Healthcare Laws** * Affordable Care Act (ACA) * Optometry and the Affordable Care Act * Impact on Coverage * Preventive Care Focus * Technological Advancements * **E. Optometry Regulations** * Scope of practice * Practice procedures * Billing regulations * Unprofessional conduct * Disciplinary actions ### IV. Eye Care Workforce and Occupational Health * **A. Eye Care Health Workforce** * Demographics & characteristic of workforce * Characteristics of Optometry Workforce * Age Distribution * Gender Composition * Racial/Ethnic Diversity * Employment Settings * Supply and demand analysis * Types of practices * Optometrist Employment Settings * Private Practices * Hospitals and Clinics * Retail Optical Stores * Academic Institutions * Factors affecting optometrist earnings * Geographic location- optometrist salaries can vary significantly based on the region and local cost of living. Practices in urban areas or affluent communities tend to have higher earning potential. * Practice Setting- optometrist in private practice or group settings typically earn more than those in retail or corporate settings due to a greater autonomy and revenue generation. * Specialty services- optometrist who offer specialized services like vision therapy, contact len fittings, or pediatric care can command higher fees and earn more than general practitioners * Years of experience- more experienced optometrist with establised pateint bases and rreputations tend to earn higher incomes compared to recent graduates. * Optometrists education and training * Optometry Education and Training * Optometry Degree * Optometry Curriculum * Clinical Rotations * Residency Programs * **Population and aging trends** * Aging Population- the US population is steadily againg, with the number of adults aged 65 and older expected to nearly double by 2060. * Increasing Vision needs- as the population ages, the prevalence of age -related eye conditions like cataracts, glaucoma, and macular degeneration is projected to rise significantly * Population Growth- The US population is also steadily growing, leading to greater overall demand for comprehensive eye care services. * Diverse Demographics- the increasing racial, ethnic, and cultural diversity of the US ppopulation will require optometrist to provide culturally competent care. * **Challenges affecting optometrist distribution and initiatives to address that** * Impact of technology on Optometry * Telemedicine- virtual eye exams and consultations are enabling remote access to eye care, improving patient convenience and reach. * Telemedicine and Virtual Care * Expanding Access * Convenience and Flexibility * Enhanced Monitoring * Integrated Care * Diagnostic tools- advanced imaging and Al- powered analysis are enhancing the accuracy and efficiency oy eye exams and disease detection. * Custom Eyewear- 3D printing and personalized lens design are revolutionizing the creating of custom eyeglasses and contact lenses. * **B. Ocular Hazards** * Physical hazards * Chemical hazards * Radiation hazards * Infectious hazards * Biological hazards * **C. Eye Injury Prevention** * Leading causes of eye injuries and how to prevent them * Prevention strategies * **D. Safety Standards** * American National Standards Institute (ANSI) standards for dress and safety eyewear * **V. Environmental Eye Health** * Occupational eye safety programs * Comprehensive Approach- occupational eye safety programs take a proactive, comprehensive approach to protecting workers visual health and preventing eye injuries in the workplace. * Risk Assessment- These programs begin with a thorough assessment of job-specific visuals demands and potential. Ocular hazards to identify areas of concern * Hazard Controls- based on the assessment, appropriate control measures are implemented, such as engineering controls, administrative policies, and personal protective equipment (PPE) * Education and Training-workers are provided with comprehensive education and training on eye safety best practices, hazard awareness, and proper use of PPE. * Factors that influence on visual performance. * lighting conditions- improper lighting, glare and high contrast can strain the eyes and decrease visual acuity, leading to fatigue and reduced productivity * temperature and humidity- extreme temperature and high humidity can cause eye irritation, dryness, and discomfort, impacting visual performance and safety. * Air quality and particulates- exposure to dust, fumes, and other airborne contaminants 4can irritate the eyes and increase the risk of eye injuries, hindering visual abilities. * Patient Assessment in Various Environments * Workplace * Home * Recreational settings * Eye Protection Planning * Developing comprehensive eye protection plans for different environments * Materials designed for safety * Implementing control measures- Implement a combination of enginnering, administrative, and personal protective equipment (PPE) controls to mitigate the identified vision-related risks. * Implementing Control Measures * Engineering Controls * Administrative Controls * Personal Protective Equipment (PPE) * Personal Protective Equipment (PPE) * Eye Protection * Protective Clothing * Gloves * Foot Protection * Identifying vision related risks * Refractive errors-uncorrected or improperly corrected refractive errors like nearsightedness, farsightedness, and astigmatism can pose risk in the workplace * Ocular Hazards- identifying potential ocular hazards like bright lights, sharp objects, and chemical splashes is crucial for implementing appropriate safety measure. * Computer Vision Syndrome- Prolonged computer and digital screen use can lead to eye strain, dry eyes, and other vision-related symptoms requiring intervention. * Ergonomic considerations in a workstation * Workstation design- proper workstation setup, including adjustable furniture and equipment, can help reduce strain and improve comfort for prolonged computer use. Is crucial for maintaining visual comfort and performance. Key considerations include adjustable seating, optimized desk height, proper lighting, and minimal glare or reflections on screens. * Lighting and contrast- appropriate lighting and screen contrast settings can minimize glare and eye strain, enhancing visual comfort and productivity. Optimal lighting, ensure adequate, glare free lighting that minimize shadows and provides even illumination across the workspace. Contrast management, optimize contrast between surfaces, displays, and tasks to enhance visual comfort and clarity. Adjustable lighting, incorporate task light that can be positioned and adjusted to suit individual needs and preferences. Ambient light control, regulate ambient light levels and minimize harsh shadows or bright spots that can cause eye strain. * Glare reduction-strategies like anti-glare screens and strategic placement of workstation can help reduce distracting reflections and glare. Filters, specialized filters can reduce glare by blocking or dispersing excessive light. Lighting Design, proper lighting placement and selection of light sources can minimize glare. Anti-reflective surfaces, matter or anti-reflective surfaces on screens, desks, and others work surfaces minimize glare. Window coverings, adjustable shades, blinds, or curtains allow control over natural light and reduce glare. * Computer vision syndrome prevention * ergonomic workstation- optimize desk, chair, and monitor placement to reduce eye strain and neck/back pain from prolonged computer use. * 20-20-20 rule- take regular break, every 20 minnutes, look at something 20 feet away for 20 seconds to reduce eye fatigue. * Anti-glare screens- use screens with anti-reflective coatings to minimize glare and brightness that can cause visual discomfort. * Proper lighting- adjust room lighting to reduce contrast between the screen and surrounding and prevent eye strain