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

LOCATION: Outpatient, Hospital PATIENT: Tom White SURGEON: David Barton, MD RADIOLOGY: Morton Monson, MD PROCEDURE: Transesophageal echocardiogram INDICATIONS: Evaluation of the aortic valve considering the stenosis that was not well-documented angiographically PROCEDURE: The patient received 2 mg of Versed, and …

Low social economic status differences in health status Lower life expectancy (life expectancy is around three years lower for most disadvantaged groups) Higher mortality & Morbidity Higher hospitalisation rates Higher cancer stroke, suicide and respiratory disease rates. Low social economic …

1. Which item below correctly describes the U.S. Bureau of Labor Statistics predictions by 2020? a. Positions that historically required registered nurses will be filled by unlicensed personnel. b. The job growth rate for RNs will surpass job growth in …

Status post below the knee amputation (right) is coded as: Z89.51 Open wound codes are used for surgical wounds, nontraumatic wounds, and ulcers. False WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE …

David from ajethno:

Hi there, would you like to get such a paper? How about receiving a customized one? Check it out https://goo.gl/chNgQy