Respiratory Care In Alternative Sites

With the impact health care reform, managed care and hospital restructuring are having on the respiratory care profession, this new book will help respiratory care practitioners learn how to meet the needs and demands of care at alternate sites such as pulmonary rehabilitation centers, subacute care facilities or the home.

Foreword

viii

(4)

Preface

xi

(1)

Acknowledgments

xii

(1)

Contributors

xiii

Chapter 1 Health-Care Reform and Its Impact on Respiratory Care

1

(34)

Historical Perspective

2

(1)

Respiratory Care Perspective

3

(1)

Essential Vocabulary and Concepts

3

(21)

Impact on Respiratory Care

24

(7)

Pew Foundation Health Professions Commission

31

(4)

Chapter 2 Past and Current Concepts of Pulmonary Rehabilitation

35

(11)

Key Definitions and Concepts

36

(1)

Pulmonary versus Cardiac Rehabilitation

37

(1)

Historical Perspective

37

(3)

Rationale for Pulmonary Rehabilitation

40

(3)

Goals and Objectives

43

(1)

Program Sequence and Strategy

43

(1)

Rehabilitation Outcomes

44

(2)

Chapter 3 Selecting Patients for Pulmonary Rehabilitation

46

(20)

Basis for Patient Selection

47

(1)

Testing Regimens

48

(12)

Criteria for Inclusion

60

(2)

Criteria for Exclusion

62

(1)

Specific Patient Conditions

63

(3)

Chapter 4 Key Elements of a Pulmonary-Rehabilitation Program

66

(45)

Program Formats

67

(3)

Program Components and Content

70

(36)

National Pulmonary Rehabilitation Survey

106

(5)

Chapter 5 Measuring and Assessing the Outcomes of Pulmonary Rehabilitation

111

(13)

The Process of Outcomes Assessment

112

(3)

Methods of Measuring and Assessing Outcomes

115

(4)

Patient Attendance and Attrition

119

(1)

Program Results and Findings

120

(4)

Chapter 6 Reimbursement for Pulmonary Rehabilitation

124

(15)

Factors Affecting Program and Patient Costs

125

(1)

Patient Charges

125

(1)

Billing Practices and Coding Systems

126

(6)

Third-Party Reimbursement

132

(3)

Problems with Insurance Reimbursement

135

(4)

Chapter 7 Past and Current Concepts of Respiratory Home Care

139

(15)

Basic Definitions

140

(1)

Historical Developments

141

(5)

Goals and Objectives

146

(1)

Basis for Care

147

(1)

Modalities and Procedures

147

(1)

Ethical Standards and Behavior

148

(3)

Current Needs and Recommendations

151

(3)

Chapter 8 Patient Selection and Discharge Planning

154

(16)

Patient Selection Process

155

(2)

Discharge Planning Process

157

(4)

Discharging the Homebound Respiratory Patient

161

(4)

Additional Considerations

165

(5)

Chapter 9 Home Respiratory Equipment and Therapeutics

170

(22)

Oxygen Therapy

171

(6)

Aerosol Therapy

177

(3)

Intermittent Positive Pressure Breathing Therapy

180

(1)

Suction Equipment

180

(1)

Continuous Positive Airway Pressure and Bilevel Pressure Therapy

181

(2)

Home Mechanical Ventilation

183

(9)

Chapter 10 Protocols and Procedures of Care Delivery

192

(11)

Components of a Home-Care Procedure

193

(1)

Generic Home-Care Procedure

193

(2)

Procedure for Home Mechanical Ventilation

195

(2)

Other Respiratory Home-Care Modalities

197

(2)

Diagnostic Testing and Patient Evaluation

199

(1)

Patient Reporting and Documentation

199

(4)

Chapter 11 Home Care Accreditation and State Licensing Requirements

203

(17)

Definition and Historical Perspective

204

(1)

Accrediting Organizations

205

(10)

Peer Credentialing

215

(1)

Legal Credentialing

216

(1)

Other Legislation Impacting Respiratory Home Care

217

(3)

Chapter 12 Reimbursement for Respiratory Home Care

220

(23)

Covered Home-Care Services

221

(3)

Noncovered Home-Care Services

224

(1)

Cost-Effectiveness of Respiratory Home Care

225

(3)

Medicare Reimbursement

228

(7)

Reimbursement for Home Oxygen Therapy

235

(2)

Reimbursement for Other Respiratory Home-Care Equipment

237

(1)

Medicaid Reimbursement

238

(1)

Private Insurance Carriers

239

(1)

Impact of Managed Care

239

(4)

Chapter 13 Subacute Care at Skilled Nursing and Long-Term Care Facilities

243

(11)

What Is Subacute Care, and How Can Respiratory Care Fit In?

244

(1)

Core Elements of an Ideal Subacute-Care Program

245

(2)

What Is Fueling the Growth of the Subacute-Care Industry?

247

(4)

What Will Respiratory Care's Involvement Be in Subacute Care?

251

(1)

Where Is the Subacute-Care Industry Going?

252

(2)

Chapter 14 Clinical and Regulatory Aspects of Subacute Care

254

(11)

Patient Selection and Discharge Planning

255

(1)

Respiratory Care Modalities

256

(3)

Accreditation and Regulation of Subacute Care

259

(2)

Reimbursement for Subacute Care

261

(1)

Outlook for the Respiratory-Care Profession

262

(3)

Chapter 15 Aspects of Patient and Family Education

265

(26)

The Educational Process

266

(13)

Asthma Education

279

(8)

Roles for the RCP

287

(4)

Glossary

291

(8)

Index

299

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Respiratory Care In Alternative Sites

Summary

Table of Contents

Supplemental Materials