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CI

STUDY
PLAY
The U.S. health care system is Based on the:
market justice principle
The government program designed to provide health care to people who are 65 years of age or older is called:
Medicare
Baring major system changes, health service expenditures are projected to continue to decrease. (True or False)
False (Health care costs are exploding and are out of control.)
The U.S. safety net is for the nation's most vulnerable populations. Whic of the following is not considered a vulnerable population?
Persons 45-60
A primary motivation in the development of managed care was to:
contain costs and expenditures of health care
The U.S. government plays a limited role in the health delivery system. The government's role in this arena is to:
to organize and be responsible for care delivery for Medicare and Medicaid programs
The U.S. health care delivery system is complex and massive. (True or False)
True
Which one of these choices is not a characteristic of managed care?
manages to take care of those only in financial need
The financing of a managed care organization is based on
capitation
Medicare is a government program for the
elderly
: Why is the US health care market considered to be "imperfect"?
prices are determined by health plans rather than the interaction of the forces of supply and demand
True or False: Managed care is the most dominant health care delivery system in the US today
True
What is the main role of the government in the US health delivery system?
To be the major financier of health care delivery through Medicare and Medicaid programs
In a socialized health insurance system, health care is financed through
government-mandated contributions by employers and employees
In a free market, ______ and ______ act independently.
buyers and providers
True or False: The national health care model for Germany, Israel and Japan is the national health system.
False
The social justice emphasizes
the well-being of the community over that of the individual
Medicaid is a government program for the
Poor
Which party does not act as a the key players in the US health services system?
Poor
What is the primary reason for employers to purchase insurance plans to provide health benefits to their employees?
Due to the fact that the U.S. does not have a universal health care system, employers purchase health insurance plans as a fringe benefit for their employees.
True or False: The tax-supported national health care program in a national health insurance system is financed by private providers rather than the government.
False
Over the last decade, the hallmark of the US health care industry has been
organizational integration to form integrated delivery systems or networks
America's safety net is for
the nation's vulnerable populations
True or False: Capitation is a payment mechanism in which all health care services are included under one set fee per covered individual.
True
The military medical care system is _______ to active military personnel of the
Free
Vulnerable populations does not include which of the following poor, uninsured, minority status, insured employees
insured employees
Growth in science and technology
creates demand for new services
The US health care system is based on the social justice principal (True or False)
False
The United States spend more than any other developed country on health care, and costs have
continued to rise
Health care managers are needed to
manage and coordinate various types of health care services
There are no racial and economic disparities in the health care system (true or false)
False
The World Health's Organization's definition of health is
state of physical and mental well-being that facilitates the achievement of individual goals
Illness is different from a disease in that illness
is the person's own perceptions and evaluation of how he or she feels
: One of the purposes of the Healthy People Initiative is to
integrate medical care with preventive services
True or False the system of health care delivery in the US is predominantly private
True
In a social justice system, the equitable distribution of health is
The society's responsibility
Demand-side rationing means the
rationing the quantity and type of health services
Policy interventions use _______ to affect the health of the population
social/public policy
True or False: Under the social justice system, inability to obtain medical services because of a lack of financial resources is considered unjust.
True
An acute condition is not
long
IT IS severe, short, treatable
Community health assessment is a method used for conducting
of broad assessments of populations at the local or state level
True or False: From an economic perspective, curative medicine seems to reproduce decreasing returns in health improvement while health care expenditures increase.
True
An epidemic occurs when
a large number of people get a specific disease
In the United States, the principles of market justice and social justice
complement each other
Which answer is not one of the four major determinants of health? (Environment, Religion, Heredity, Behavior)
Religion
True or False: Quality of life refers to the overall satisfaction with life during and following a person's encounter with the health delivery system
True
What type of health insurance is based on the market justice?
private, employer-based health insurance
Community-based strategies have the particular benefit of
as a whole person
Healthy behavior can be modified through
Edu programs and incentives
True or False: A chronic condition is more severe than an acute condition
False
What is the role of health risk appraisal?
To evaluate risk factors and their health consequences in individuals
The medical model emphasizes
Clinical and medical interventions
True or False: Heredity is a key determinant of health because genetic factors predispose individuals to certain diseases.
True
Morbidity is defined as
disease or disability
Which of the following has been the primary factor that has shielded the U.S. health care system from a major overhaul?
Beliefs and values
Educational reform for training physicians in the Postindustrial era was based on:
European Model
Private health insurance emerged as a result of
economic necessity
Which of the following was not a factor that led the rapid expansion of employer-based health insurance? (The Supreme Court ruled that employee benefits were a legitimate part of union-management negotiations, Employer-provided health coverage became nontaxable, The Congress mandated that employers offer health insurance, OR Employers offered health insurance to compensate for loss of raises in salaries during World War II
The Congress mandated that employers offer health insurance
Medical Malpractice
One of the most clinical present threats to practicing physicians
During the Preindustrial era, medical practice was extremely competitive. What caused this intense competition?
Anyone, untrained or trained, could be a physician
The American Medical Association (AMA) played a dominant role in:
Protecting the interests of physicians
What was one of the main reasons for the failure of national health insurance proposed by President Clinton in 1993?
Americans were unwilling to pay higher taxes for such a program
WHich of the following programs is means tested?
Medi-Care Part B
In 1964, health insurance for the aged and the poor became a top priority for President Johnson's administration. In 1965, Medicare was created as:
a two-part program for the elderly that provides health insurance-regardless of income
Which of the following illustrates corporatization in the American health care delivery system?
Managed Care Organizations
True or False: Because the factors that shape health care delivery are easily identifiable, it is often easy to trace a change to the factor responsible for bringing about the change.
False
Which of these factors has primarily shielded the U.S. health care system from a major overhaul?
Beliefs and Values
True or False: Medical practice in the U.S. emphasizes specialization while basic care is given only secondary importance.
True
Which factor has mainly prevented the expansion health insurance to all Americans?
Cost
Fundamental reforms in the financing and delivery of health care will require
A change in mind set of middle-class Americans
The first medical schools were opened by
physicians
Medical schools in the US were first opened
to supplement physicians' incomes
Why was medical practice characterized by intense competition in the preindustrial era?
Anyone could practice medicine
True or False: In Europe, hospitals had developed much earlier than they did in the United States.
True
True or False: The early health care institutions in the U.S. served mainly a charitable purpose.
True
What was the main purpose of a pesthouse?
Serve as isolation facilities
Organized medicine
Concerted activities of physicians through the American Medical Association
True or False: The AMA was the first organization to support salaried employment of physicians by hospitals.
False
Physicians began to play a dominant role in hospitals mainly because
they could decide where to hospitalize their patients
Health insurance in America was born
during the Great Depression
True or False: Private health insurance began in the form of hospital plans that did not include outpatient services.
True
Which of the following triggered employer-based health insurance as a benefit? (Union-management negotiations, The World War, Wage Freezes, Supreme Court Ruling)
Wage Freezes
What has primarily kept national health insurance from taking roots in America?
The American Public
True or False: Medicaid was created as a public insurance program to cover the elderly
False
Medicare was created as
a two part program for the elderly
True or False: The Medicaid program varies from state to state.
True
Means test
Eligibility is determined by income level
HMOs were initially created to
lower health care costs
What is the latest addition to the Medicare program?
Prescription drug benefit
The health care subdivision of the U.S. economy continues to grow because
immigration continues to rise leading to a growth in population & baby boomers hit retirement age and are receiving Medicare
Which answer does not describe a negative consequence of specialty maldistribution? (a. high volume of intensive, expensive medical services, b. specialist services have less impact in improving overall health status, c. there are access problems by the underserved, d. more predictable hours and higher prestige for specialists)
more predictable hours and higher prestige for speciaists
Studies have shown that Nurse Practitioner services
improve access to primary care & concentrate more time with patients than physicians
A health or hospital administrator does which of the following? (A. helps patients receive medical care but only if they have insurance, B. organize the operational, clinical, and financial outcomes of the entire health system, C. increase health care spending to help make a profit for their hospital, or D. attract specialists, which increases the maldistribution of physicians in rural areas)
organize the operational, clinical, and financial outcomes of the entire health system
A doctor of osteopathic medicine is different from an MD in that they have training in:
preventive and holistic medicine
True or False: Most MDs are specialists and most DOs are in primary care.
True
The allied health professional
constitutes approximately 60% of the U.S. health care work force and complements physicians and nurses in delivering health care
True or False: Most DOs are specialists and most MDs are generalists
False
The health care sector of the US economy continues to grow due to
Aging of the population & growth of the population
The physician's role is to
Evaluate a patients health condition and diagnose abnormalities
A doctor of osteopathy emphasizes
preventive and holistic medicine
Specialists must
Do additional years of advanced residency training in their speciality and seek certification in an sara of medical specialization only
True or False: The differences between primary and specialty care are by the time, focus, and scope of services provided to the patients
True
Why is there an imbalance and maldistribution of physicians?
Geographic maldistribution, speciality maldistribution, and aggregate physician oversupply
Which answer is not a negative consequence of specialty maldistribution? (high volume of intensive, expensive medical services, Specialist services have less impact in improving overall health status, Access Problems by the underserved, OR More predictable hours and higher prestige for specialists)
More predictable hours and higher prestige for specialists
True or False: Physicians are more likely to concentrate in rural and inner-city areas than metropolitan,suburban areas
False
Which answer does not belong to the four main categories of nurses? (Clinical, NP, Technicians, Certified Nurse Midwives)
Technicians
True or False: Advanced Practice Nurses have attained education and training beyond the RN level
True
What are the values of NPP services?
Improve access to primary care & Better communication and interviewing skills than physicians
Allied Health Professionals constitute
60% of US health care workforce
Physical therapists and occupational therapists are considered
technicians and assistants
A health service administrator job is to
organize, coordinate, and mange health care services delivery
True or False: Nonphysician Practitioners practice in many of the areas in which physicians practice and also have an MD or DO degree
False
Maldistribution refers to
a surplus of health providers in a given area & a shortage of health providers in a given area
Specialty care tends to be limited to
disease process, illness episodes, and organ system
To alleviate the maldistribution problem, which of the following has been done?
Financial support for family medicine programs & expansion of nurses' roles
True or False: Pharmacists do not need a state license to dispense medicines prescribed by physicians
False
Which type of doctor encounters the greatest proportion of ambulatory care visits?
General/family practice
Psychologists need _______ to practice
either a psyD or phD
True or False: Health Services administrators can only work if they have a Master of Business Administration
False
Which acts increased federal support of nursing education after WWII?
More than a RN
The Health Insurance Portability and Accountability Act (HIPAA) was enacted to address which of the following?
Confidentiality of patients' health information
What is meant by the term technological imperative?
using technology despite its cost
In the U.S., competition among providers results in
duplication of services and equipment
Current legislation regarding new drugs in the U.S. requires that
the FDA review the safety and effectiveness of a new drug before it is marketed
Capitalism and lack of government intervention play a major role in the desire to have the state-of-the-art technology. What three qualities are necessary to determine effectiveness of technology regarding patient care?
does it work; is it valuable; is it safe
True or False: In addition to drugs and devices, the FDA also has the authority to review medical and surgical procedures for their safety and effectiveness.
False
True or False: It is accurate to say that high-technology medicine equates to high-quality care.
False
Quality of life is measured by
the patient's overall satisfaction with life
What is the primary benchmark for satety with regard to medical technology?
Benefits must outweigh any negative consequences
Which of the following has not taken central stage in U.S. health care delivery?
incorporation of cost-effectiveness into clinical practice
Medical technology leads to
increased costs of delivering medical care
True or False: Countries that have national health insurance programs end up limiting the use of medical technology.
True
True or False: In a general sense, medical technology can include scientific advances from any branch of science.
True
Which of the following is not included in the broad definition of medical technology?
Training
Privacy of patient information is regulated by the
Health Insurance Portability and Accountability Act
Information technology cannot be used to
access personal information for purposes not related to medical care
True or False: The U.S. develops most new technology, but, on a per capita basis, other advanced nations employ more technology than the United States does.
False
Technological imperative
Use of high technology without regard to its cost
True or False: Specialists use more technology than primary care physicians but only because specialists treat more complex conditions.
False
Which of the following is true about the FDA's role in approving new drugs today?
The FDA recalls drugs only after harm has occurred.
The Orphan Drug Act
provides incentives to develop new drugs for rare conditions
True or False: Accleration of the drug approval process by the FDA has resulted in a higher number of drug recalls due to safety concerns.
True
Sale of new medical devices classified as Class III requires
premarket approval by the FDA
True or False: Medical and surgical procedures are not subject to FDA review and approval.
True
True or False: High-technology medicine results in high-quality care.
False
Quality of life is assessed in terms of
the patient's overall satisfaction with life
True or False: New technology often increases labor costs
True
True or False: Telemedicine is now widely available in rural America
False
Technology assessment
Evaluation
Commonly used process to assess whether or not a new drug is safe.
Clinical Trial
In the U.S., most technology assessment is carried out by
the private sector
Efficacy
Some health benefit is derived
Cost-effectiveness
Benefits exceed costs
True or False: Most medical care delivered in America is wasteful.
True
Medical practice guidelines
Standardized protocols
Health insurance desensitizes both consumers and providers against
Price
Consumer behavior that leads to a higher utilization of health care services when the services are covered by insurance
Moral Hazard
In addition to assuming risk, managed care plans assume responsibility for
delivering health care
True or False: Medicare Part A is primarily financed through payroll deductions
True
Medicare Part A primarily pays for
Hospitalization, short term rehab and home health
Medicare Part B is primarily financed through
Taxes and Premiums
The Medicaid program is financed by
State and federal governments
In order to make a profit under the DRG method of reimbursement, a hospital must
control its cost
What type of reimbursement method involves a fixed monthly sum per enrollee?
Capitation
WHich of the following groups of beneficiaries has the largest proportion enrolled in managed care plans? (Medicare beneficiaries, Workers in employer-sponsored plans, Medicaid beneficiaries, OR members of unions)
Workers in employer-sponsored plans
Which of the following is an example of retrospective utilization review? (a. Medical records are examined to assess whether the care was appropriate, b.A hospital discharge planner determines that a patient can safely return home and receive ongoing care through a home health agency, c. A patient's health plan determines that outpatient surgery would be appropriate and denies admission to the hospital, OR d. A nurse and a physician determine that a patient's condition requires at least one more days stay in the hospital)
Medical records are examined to assess whether the care was appropriate
True or False: Medicare's managed care option is called Medicare Advantage.
True
under Medicare Part A or B? (vision care, outpatient rehab, limited home health, inpatient hospitalization)
vision care
Which of these is not directly associated with financing of health care?
Determines how much hospitals will spend on treating each patient
Moral hazard
Higher utilization of services due to insurance coverage
Providers deliver unnecessary services
Provider-induced demand
National health insurance would lead to uncontrolled health care expenditures unless
Supply-side rationing is implemented
Protection against financial loss.
Insurance
True or False: For a large group, risk can be predicted with reasonable accuracy.
True
An 80:20 ratio of cost sharing when health care services are used is an example of
coinsurance
Cost sharing
controls overutilization
Employers function as insurers
self-insurance
One main characteristic of public insurance programs in the U.S. is that they are
categorical
True or False: Medicare is a state-run program
False
True or False: Medicare Part B covers outpatient services
True
Medicare is a comprehensive program
False
Supplemental medical insurance
Medicare Part B
Medicaid is also called title 19 (true or false)
True
The fee-for-service method of payment
Induced providers to deliver nonessential services
True or False: Capitation removes the incentive for provider-induced demand
True
Fixed payment per member per month
Capitation
The retrospective method of reimbursement is cost based (true or false)
True
The prospective payment system based on DRGs
pays hospitals according to the patient's principal diagnosis
True or False: Money spent on health care research is included in national health expenditures
True
True or False: The US government spends relatively little on health care delivery in the US
False
Once premiums have been collected, an MCO functions like
An insurance company
Capitation
Fixed premium
Under capitation, an MCO shares risk with the
provider
Under discounted fee arrangements
providers agree to discount their regular fees in exchange for the volume of business an MCO brings
The concept of managed care evolved out of earlier
prepaid plans
During the 1980s, employers started switching from traditional health insurance to managed care plans because
health insurance had become less and less affordable
True or False: Compared to publicly insured beneficiaries in the Medicare and Medicaid programs, a greater proportion of privately-insured individuals are enrolled in managed care plans
True
Gatekeeping
Coordination of health care services by a primary care physician
In concurrent utilization of review
decisions regarding appropriateness are made during the course of health care utilization
Underutilization
Medial necessary care is not delivered
True or False: Commerical insurance companies have been forbidden by law from developing managed care plans.
False
True or False: HMOs were the first type of managed care plans to appear on the market.
True
True or False: Compared to other types of managed care plans, HMOs place considerable emphasis on preventive services.
True
____ require that services be obtained from in-network providers.
HMOs
Physicians are salaried employees and deliver services to the enrollees.
Staff model
In the group model HMO, physicians are employed by
a group practice
An independent practice association (IPA) is
an intermediary between physicians and HMOs
True or False: PPOs allow their members to obtain services from out-of-network providers.
True
Comprehensive research shows that health care quality has declined in managed care. (True or False)
False
Health networks have been formed mainly by
Hospitals
One critical management challenge in health networks has been
Physical relation
True or False: In a merger, the acquired company ceases to exist as a separate corporation
False
In a joint venture, two or more institutions continue to conduct their main businesses independently. (True or False)
True
Resource sharing while assets remain independently owned
Alliance
A virtual organization
is an independent organization based on contracts
The main objective of horizontal integration is to
achieve geographic expansion
To increase the comprehensiveness and continuity of services, the appropriate strategy is
vertical integration
Which of the following is listed as one of the main reasons why outpatient services have increased in popularity over the past 15 years? (Increase in hospital technology budget, Private/public insurance reimbursement, Increase in staff at acute care hospitals, and Decrease in MCOs)
Private/public insurance reimbursement
True or False: Compared to general hospitals, specialty hospitals offer services that are clinically superior
False
True or False: Most older adults live in assisted living centers or nursing homes in the U.S.
False
What type of care is described as "end of life care"?
Hospice
Small hospitals owned and operated by physicians were known as proprietary hospitals. These hospitals were...
For Profit
Which of the following is credited with having the greatest impact on the expansion of hospital beds in the US?
Hill-Burton Act
What triggered the downsizing phase in the U.S. hospital industry during the 1980s?
Competitive pricing and discounted fees
Which of the following is not considered a community hospital? (VA hospital (Department of Veterans Affairs), Hospitals with patient stays of less than 30 days, Private for-profit hospitals, OR local or state governmentally owned and operated hospitals)
VA hospital (Department of Veterans Affairs)
Which of the following is not considered a long-term care service? (Respite for caregivers, Dealing with death and dying issues, pain management, treatment for acute illness)
Treatment for acute illness
In a short stay hospital, the average length of stay (ALOS) is which of the following:
Less than 30 days
True or False: Areas in which primary care is stronger have much lower total health care costs than areas that exclusively focus on specialized care
True
Ambulatory care
refers to outpatient services
True or False: Community health centers are required by law to be located in medically underserved ares
True
Who is the gatekeeper?
The primary care physician
Primary care focus on services
services such as prevent and therapeutic services
Which factor does not contribute to the growth of group practices rather than solo practices? (the simplicity of billing and collections in a multi-payer system, rapid changes in the health delivery system, contracting MCOs with consolidated rather than solo entities, high cost of establishing a new practice)
the simplicity of billing and collections in a multi-payer system
True or False: In a gatekeeping system, patients can visit specialists without a referral from their primary care physicians.
False
Why is outpatient care considered an important key component of overall business strategy?
Outpatient services now constitute a key source of profits for hospitals
The growth of non-hospital-based ambulatory services intensified competition for outpatient services between
hospitals and community-based providers
Which service is not one of the five main hospital-based outpatient services? (Clinical, Surgical, Emergency, OR None of the Above)
none of the above
True or False: Primary care is the point of entry into the health services system
True
Outpatient care refers to health services
that does not require an overnight stay
Which of the following is not one of the key changes that have been important in shifting the balance between inpatient and outpatient services? (Reimbursement, utilization control, technological factors, none of the above)
None of the above
What are mobile health care services?
Health care services transported to patients
Both private and public payers have a clear preference for outpatient treatment because it costs less than inpatient care (Truth or False)
True
A telephone triage system
provides telephone access seven days a week
Home health care
is based on the philosophy of maintaining people in the least restrictive environment possible
Hospice care is for
patients with terminally ill disease with a short life expectancy
True or False: Development of new diagnostic and treatment procedures and less invasive surgical methods has made it possible to provide services in out-patient settings that previously required inpatient stays in hospitals.
True
Urgent Care Services
accept patients without appointments
Public health services
do not directly compete with the services provided by private practitioners
Many hospital outpatient clinics, particularly those in inner-city areas
Function as the community's safety net
True or False: Patients generally have a preference for receiving health care in home and community-based settings.
True
Alternative medicine refers to
nontraditional medicine and treatments
True or False: Higher primary care physician supply has been associated with lower low-birth weight percentages and lower infant mortality.
True
A hospital's governing body is
legally responsible for the conduct of the hospital
Hospitals evolved from
Almshouses
Pesthouses were
places for those with contagious diseases
The first community hospitals were funded mainly through
private donations
Hospitals began to attract well-to-do patients when
Hospitals began to attract well-to-do patients when
Proprietary hospitals
for profit
A health system is mainly characterized by
a large array of health care services
Which of the following was not a primary factor that contributed to the growth of hospitals in the United States? (population growth, technological advances, health insurance, Hill-Burton Act)
population growth
Prospective payment system based on DRGs.
Fixed rate per admission
One effect of the PPS reimbursement method was
quicker discharge of patients
Managed care
curtailed inpatient utilization
True or False: Implementation of the prospective payment system slowed down the growth of national spending on hospital care.
True
Average number of days per patient spent in the hospital.
Average Length of Stay
Truth or False: Discharges rather than admissions more accurately measure the number of people served by a hospital.
True
True or False: Women are admitted to hospitals more often than men, and also incur longer stays than men.
False
True or False: Hospital utilization among blacks is higher than that among whites.
True
Census
Number of patients in a hospital on a given day.
True or False: A 200-bed hospital has an average daily census of 120. Based on these figures the hospital's occupancy rate is 66%.
False
Which of the following is not a characteristic of a community hospital? (Short stay, Federal, private or government owned, or general or speciality care)
Federal
True or False: The majority of U.S. hospitals are private for profit.
False
True or False: Public hospitals are those that are open to the general public.
FALSE
Voluntary hospitals
Nonprofit
True or False: Nonprofit hospitals are prohibited from making a profit.
False
True or False: A general hospital is distinguished from a specialty hospital in that the former does not provide specialized medical care.
False
True or False: Specialty hospitals provide only a narrow range of services for specific medical conditions.
True
What is the primary role of a teaching hospital?
Train Physicians
True or False: Osteopathic hospitals have been built because osteopaths can no longer practice alongside traditional physicians.
False
True or False: Hospitals are licensed by state governments rather than the federal government.
True
True or False: Hospitals are not required to be certified.
True
True or False: Licensure allows a hospital to participate in the Medicaid and Medicare programs.
False
Which of the following is not voluntary? (Accreditation, Certification, Licensure, Serving Medicare and Medicaid patients)
Licensure
Deemed status is conferred on a hospital that is
Accredited
Beneficence
Do everything possible to alleviate suffering
True or False: A patient has the right to refuse treatment.
True
A breach of public trust occurs when
The community's best interest are not served
Most of the long term care in the US is provided by
informal caregivers
True or False: The elderly are the primary clients of long-term care
True
True or False: Most elderly need of long-term care
True
True or False: Generally, all LTC patients require serves that are very similar
False
The primary goal of preventive long-term care services is to
prevent or delay institutionalization
The need for long-term care is most closely associated with
A inability to function independently
True or False: Generally, as a person ages, a decline in ADLs sets in later than a Decline in IADL's.
True
In relation to a pateint's fucntional limitations, the main goal of LTC is to
promote independence
Palliation
Relief
Which of the following is not a goal of community-based long-term care services (respite care, establish an administrative network of LTC, prevent of delay institutionalization, supplement informal care)
establish an administrative network of LTC
These programs may specialize in delivering medical, nursing, and rehabilitation services for patients who may be recovering from some acute episode.
Adult Day care
What common purpose is served by senior centers
Socializing
Retirement facilities are best characterized as
physically supportive
Clinical services offered by personal care homes are best characterized as
Custodial
The main distinction between personal care homes and assisted living is that the latter provide
Nursing Care
Paraprofessional
Certified nursing assistant
Subacute care is mainly characterized by
active monitoring and treatment
It is illegal to operate a nursing facility without
license
The Life Safety code deals with
building and fire safety rules
True or False: SNF certification allows a facility to admit both Medicare and Medicaid patients
False
Medicare allows a maximum of ____ days of care in a skilled nursing facility
100
Which facility provides special programming and care modules for patients suffering from mental retardation and associated disabilities?
ICF/MR
True or False: To be certified, a nursing home must comply with federal rather than state standards.
True
True or False: Unless a facility is certified, it cannot legally admit any patients
True
True or False: Which facility provides special programming and care modules for patients suffering from mental retardation and associated disabilities?
True
Services that relieve caregiving stress and burnout
Respite
True or False: Most nursing homes in the U.S. are private, for-profit
True
Nationally, the main source of payment for nursing home care is
Medicaid
Health vulnerability is defined as
combined factors overwhich individuals have little or no control which predispose them to illness and disease
Which of the following is characteristic of this ethnic group?- Black Americans
Higher neonatal, infant and post-natal mortality rates
Minorities generally receive poorer quality, less access and greater deficits in health status. What is a reason this occurs in Hispanic Americans?
Nearly 1/3 have less than a 9th grade education
True or False: Women are twice as likely to experience anxiety and depression as men.
True
Which of the following is a major health concern for women? (higher chance of developing more acute and chronic illnesses, poorer health outcomes, greater morbidity, all of the above)
all of the above
Amy's family is typical of the state of the economy in Texas. Her parents are recently unemployed and are living with a family member until things get better. Amy has been displaced from her home and is sleeping on the floor at her aunt's apartment. She receives two meals a day at school and eats little on the weekend. Amy's story is an example of:
Dependency
It is estimated that over 20 million Americans live in areas with primary care shortages. What is a principle reason that rural citizens cannot access health care services? (Physicians won't set up a practice unless it can be financially viable, they lack transportation to get to services when available, rural citizens lack health care insurance, work in small businesses or part-time with no benefits, they are typically poorly educated and have few economic resources, OR all of the above)
All of the above
True or False: 30% of the homeless population consists of families with children
True
True or False: Significant health differences exist across the various racial and ethnic groups in the U.S.
True
True or False: The vulnerability model is an integrated approach to studying the susceptibility of certain populations experiencing good health
True
The Health Care for the Homeless Program is financed by
the Bureau of Primary Health Care
Disability refers to
impairments of bodily functions& restrictions of performing activities of daily living
The Healthy Schools, Healthy Communities Program became
the first federal program that encouraged the development of new, comprehensive full-time school-based primary care programs serving vulnerable children
True or False: The mental health system is composed of one system that provides services to individuals with only insurance coverage
False
Vulnerability represents
the interaction of multiple factors that individuals have little or no control over.
Who are the AAPIs
Asian Americans and Pacific Islanders
True or False: Minorities are more likely to be economically disadvantaged than Whites.
True
Which of the following is not a health concern of women (greater morbidity, poorer health outcome, higher chance of developing more acute and chronic illnesses, higher chance of receiving second-rate health services)
Higher chance of receiving second rate health services
True or False: Health concerns of children include lack of insurance, vaccinations, and delayed access to medical care
True
Developmental vulnerability refers to
the rapid and cumulative physical and emotional changes that characterize childhood
: What is one of the challenge faced in rural health?
poverty/poor economic conditions
Which of the following tends to be insured?
Full time workers
True or False: Women constitute about 20% of the U.S. homeless adult population
True
How is mental health provided in the U.S.?
Through only private resources & Through only public services
Who is not one of the major mental health professionals (Social workers, Medical students, Therapists, psychologists)
Medical Students
What causes AIDS?
HIV
True or False: Effective January 1, 2003, the United States Office of Management and Budget announced seven official racial categories
True
Black Americans are more likely
to have higher age-adjusted death rates for leading causes of death
True or False: The differences between men and women are equally pronounced for mental illness
True
"New morbidities" include (drug abuse, alcohol abuse, family and neighborhood violence, or all of the above)
all of the above
True or False: There are no significant differences across the various racial/ethnic groups on health
False
Mental Illness are
common psychiatric illnesses affecting adults
True or False: Women in the U.S. enjoy a life expectancy almost eight years longer than that of men, but they suffer greater morbidity and poorer health outcomes.
True
The Community Health Center Program was established in
1969 to improve access to health care services for low-income families
Third party payments increase health care costs because
patients are shielded from the true cost
The rate of growth in health spending in the U.S. slowed to its lowest level during
1993-2000
If a physician orders more tests and services that are NOT medically justified because of the threat of malpractice lawsuits, this is called
defensive medicine
Central health planning is a characteristic of what type of national healthcare system?
socialized health
Diagnostic related groups (DRGs) were put in place to decrease costs by
Creating certain procedure/service codes to streamline payment to hospitals
Healthcare access is best predicted by
Race, income and occupation
True or False: Defensive medicine is a cost reducing strategy
False
True or False: Growth of technology is a reason for increased health care costs in the U.S. but not in other countries
True
According to Donabedain, in order to help define and measure quality in health care organizations, there are 3 domains that are equal in importance that must be evaluated collectively. Which of the following is NOT one of the 3 domains? (Risk, Structure, Process, or Outcomes)
Risk
Which process improvement area deals with reviewing unusual occurrences in the health care organization and then focuses on implementing strategies to decrease those events? (Cost Efficiency procedures, patient care plans, Risk Management, Continuous quality improvement programs)
Risk Management
What are the three major cornerstones of health care delivery?
Access, cost, and quality
Macroperspective of costs
is a widely used measure for national health expenditure of the proportion of the gross domestic product a country spends on the delivery of health care services
True or False: In the 1970's, health care spending spiraled downwards at double-digit rates
False
Trends in national health expenditures are evaluated by
direct transactions between provider and patient & comparing changes in national health spending to changes in the GDP
Third-party payment contributes to
provider-induced demand
True or False: The health care sector will remain one of the fastest growing components of the US economy
True
An imperfect market is based on
the utilization of health driven by need rather than economic need
Defensive Medicine
is when a doctor orders additional tests and services as a protection against lawsuits
True or false: The elderly population consume more health care than younger people
True
"Health Planning" refers to
an undertaking by the government to align and distribute health care resources that would achieve desired health for all people
In 1971, Nixon imposed what program that placed limits on the amount hospitals could raise their prices annually?
Economic Stabilization Program
What is peer review?
A general process of medical review of utilization and quality carried out by physicians
True or False: The administrative costs in a multi-payer system are nearly double of what they would be in a single payer system
True
Access to care can be defined as
the ability to obtain needed, affordable health services
Micro Quality Indicators determine quality by focusing on
medical errors, patient satisfaction, and quality of life
Administrative Costs
are costs associated with the management of financing, insurance, delivery, and payment
True or False: Population-based surveys supported by federal statistical agencies are the major data sources for conducting analyses on access to care
True
Demand-side incentives
refer to the cost-sharing mechanisms that place a larger cost burden on consumers
Why should the U.S. control the rising costs of health care?
Rising health care costs can erode the competitive position of American businesses in international markets
Which of the following is not one of the nine major factors contributing to high costs of health care
Lack of growth in technology
One reason why past attempts to bring universal access to health care is the
concern that such a move would be extremely costly in terms of national health care expenditures
True or False: Health care is among the few services for which a third party, not the consumer, pays the lion's share for most of the services used.
True
New technology
is expensive to develop & increases demand for its use
Risk management consists of
proactive efforts to prevent adverse events leading to medical malpractice
True or False: During the past 100 years, life expectancy in the U.S. has risen substantially
True
Due to a competitive employee environment, the Supreme Court ruled in the post WWII days that employers could use _____________ in the collective bargaining process.
Health Insurance
What type of allocative tool spreads benefits throughout society?
Distributive
When it comes to healthcare funding/financing in the US, which sector plays a larger role?
Private sector
How does healthcare policy making operate in the U.S.?
Incrementally
Which of the following is NOT an essential role that individual states play in healthcare policy making?
Providing all funding for graduate medical residents
What two main concerns dominate the debate today over Medicare reform policy?
Decrease spending; comprehensive coverage
True or False: The health care system is centrally controlled
False
True or False: The SCHIP program is focused on the health care of the elderly
False
True or False:Redistributive policies focus on taking power from one group and giving it to another
True
True or False: AARP would be an example of a politically motivated interest group
False
What are some of the principal features of U.S. health policy?
fragmented, piecemeal policy
pluralistic
decentralized role of the state
True or False: Health Policy refers to public policy that pertains to or influences the pursuit of health
True
What is the major concern of federal and state governments in regards to health care?
Cost Containment & Access to care
What is the most important decentralized role of the states
financial support for the care and treatment of the poor and chronically disabled
Which of these choices does not belong to the five components important for formation and implementation of health policy?
Public support financing
True or False: Special population groups such as veterans, Native Americans, and members of the armed forces have coverage provided directly by the federal government
True
Regulatory Tools call on the government to
call on the government to prescribe and control the behavior of a particular target group
What is the major concern of consumers regarding health care?
access to care and quality of care
True or False: : In 1965, the adoption of the Medicare and Medicaid legislation expanded the health sector by providing publicly subsidized health insurance to the upper and middle classes only
False
The recently enacted State Children's Health Insurance Program allows
States to use Medicaid expansion to extend insurance coverage to uninsured children who are not qualified for existing Medicaid Programs
The policy agenda of interest groups is typically reflective
of their own interests
True or False: Employer-provided health insurance benefits grew rapidly in the middle decades of the 19th century
True
American Association of Retired Persons advocates programs
To expand financing for long-term care for the elderly
The health policy concerns of American employers are shaped by
the degree to which employers are involved in the provision of health insurance benefits for their employees
True or False: The government plays a subsidiary role to the private sector in the health care field
True
The purpose of policy intervention is to
Identify situations in which markets fail or do not function efficiently
Healthy policy concerns regarding medical technology are driven by
The important role it plays in rising health costs
The health benefits provided to people
The utilization of medical technology to provide economic benefits aside from health benefits
True or False: Government spending for health care has been largely confined to filling the gaps in the private sector
True
States can
license and regulate health care facilities and restrict marketing and price of health insurance
The greater control states have over health care policies
Means that it is more difficult to coordinate a national strategy
The Hill-Burton Hospital Construction Act was passed under
Truman
True or False: Health policies in the United States have been incremental and piecemeal
True
Federal Support of HMOS occurred in
1970s
The making of health policy in the United States is a
complex process involving both an dprivate sectors
True or False: States are vested with limited legal authority to regulate almost every facet of the health care system
False
Which state implemented a universal coverage program in 2007?
Massachusetts
Managed care relaxed tight controls because of
Backlash from consumers and providers
Managed care's ability to squeeze excesses from the health care system has been:
Stalled
Beneficiaries' premiums cover roughly __ of the medicare Part D program costs
25%
Employers are passing on the rising costs of health care to employees by:
Increasing cost sharing of health care services
Ever-Increasing health care costs will require __ at some point in the future
Government Intervention
What brought the importance of public health to the forefront of the United States
Globalization
If a comprehensive health insurance reform is to occur in the US which of the following is the least likely to be adopted?
Single player
In a defined benefit plan
Employers pre-select health plan that employees can choose from
In future, the imbalance between __ is expected to persist
primary and specialty physicians
True or False: The US does not have universal health insurance because most Americans are opposed to expanding coverage to the uninsured.
False
True or False: Most middle class Americans are not prepared to meet long-term care expenses
True
True or False: Consumers have no incentive to be prudent purchaser of health insurance in a defined benefit plan
True
True or False: Reducing costs generally translate into lower quality
False
True or False: New infectious diseases must be viewed from a ___ perspective
Global
The primary factor that has kept national health care at bay.
American beliefs and values
Which single factor will dramatically increase health care expenditures starting around 2013?
Retirement of baby boomers
As health insurance reform moves forward, at least initially who is likely to bear an increasing burden of high premiums?
Employees
To lower health insurance premiums what type of a plan will be necessary?
Liberal
Fixed dollar commitment =
Defined contribution
True or False: A medical savings account is managed by the employee, not by the employer.
True
These enable individuals in poor health to purchase affordable health insurance.
High Risk Pools
Assuming that a major health care reform occurs in the U.S., which proposal is the least likely to be adopted?
Single-Payers
In which program, prospective budgets are used to control national health expenditures?
Single-Payers
Employer Mandates
This approach is generally opposed by small businesses.
True or False: Since most infectious diseases have now been conquered, the health care system must pay particular attention to chronic disease management.
False
Globalization has increased the threat of deadly infectious diseases in the US
True
True or False: Medical graduate who pursue residencies in primary care continues to increase.
False
True or False: The demand for nurse practitioners has slowed down.
False
True or False: Working in a managed care organization is particularly appealing to female physicians.
True