HCS Exam 1

3 classes of medical devices

-Class 1-Low risk (bandages/stethoscopes) -Class 2-Subject to labeling and performance standards (pregnancy test/power wheelchair) -Class 3-Support life potential risk of illness or injury, requires pre-market approval (pacemaker/breast implant)

Cons of Medical Technology

-Higher cost -Ethical issues -Medicine toward specialization -Influences organization and financing -Raises consumer expectation and demand

History of Mental Health

-Highly stigmatized, institutionalization was standard practice, experiments and forced sterilization. -Late 1900s began de-institutionalization, cared for in the home or outpatient care

Corporate Era History of Medicine (late 1900s/Y2K)

-Large corporation took over healthcare delivery -Managed Care Organizations (MCO's) -Integrated Delivery Systems (IDs) -Telemedicine/e-health/e-therapy -Globalization/medical tourism/migration of providers -Increased cost

Issues of distance medicine

-Legal liability -Licensure across state lines -Lack of reimbursement -Unsubstantiated cost effectiveness

Pre-Industrial History of Medicine

-Medical training not science based -U.S behind in comparison to Europe -No real requirements to be a med professional -Few hospitals/poor sanitation/no insurance

HITECH Act of 2009

-Provided incentive payments to hospitals and healthcare providers to adopt health IT. -"Meaningful Use"- criteria required to be met that demonstrated meaningful use of electronic health records (EHR). EHR technology must be used to achieve certain objectives.

Post-Industrial History of Medicine

-Urbanization and science innovation -Medical education and prestige -AMA made hospitals a true institution -Health insurance/medicare/medicaid

10 essential benefits of the ACA

1. Ambulatory Patient Services 2. Prescription Drugs 3. Emergency Care 4. Mental Health Services 5. Hospitalization 6. Rehabilitative Services 7. Preventative and Wellness Services 8. Laboratory Services 9. Pediatric Care 10. Maternity and Newborn Care

5 core disciplines of public health

1. Behavioral Science/ health education 2. Biostatistics 3. Environmental Health 4. Epidemiology 5. Health Science Administration

Code of Ethics

1. Beneficence- Patients best interest 2. Non-maleficence- Do no harm 3. Autonomy- Respect patient decision 4. Justice-Making fair decisions 5. Dignity

3 ACA lawsuits

1. Illegal to impose tax penalty for uninsured 2. Unconstitutional to force states to expand medicaid 3. Corporations can be exempt from contraceptive mandate due to religious beliefs

First Health insurance plan for teachers

1929 Baylor University, Dallas, TX./Blue Cross

Which insurance first began covering physician fees?

1939 Blue shield

When did blue cross/blue shield merge?

1974

In the U.S how many people work in delivering healthcare?

2 to 3 million

How many states expanded medicaid in sync with the ACA?

30 to 40 states

Technology Diffusion (spread)

A measure of how widely technology is spread throughout the organization. In healthcare technology (research and development/private sector) is more readily available in the U.S and little is done to limit its expansion. Most other countries practice resource allocation or rationing.

Biologics

Agents naturally produced in animal cells, by microorganisms, or by the body itself (vaccines, blood, tissue, bone, gene therapy, allergenics)

10-Year Plan to Strengthen Health Care

Began in 1979 for the U.S to pinpoint health detriments. 3 goals include: -Collaboration -Empowerment -Measurement

Which medical concept is best defined as acting in the patients best interest

Beneficence

Most common eating disorder

Binge eating disorder

Julie is a 6 year old child whose unemployed parents earn below the federal poverty line, what type of health insurance is she most likely eligible for?

CHIP

The U.S. healthcare delivery system can be described as

Complex and Massive

Moral Hazard

Concept that people will use health insurance if they have health insurance

What is not a barrier in the adoption of tele-medicine?

Convenience and accessibility

Which of the following terms best describes situations in which doctors order more tests, medications or treatments than are medically necessary in an attempt to ward off malpractice suits?

Defensive Medicine

Most mental health problems begin showing signs

During pre-teen/early teens

EHR

Electronic health record

Social Justice

Equitable distribution of health is society's responsibility, need rather than cost based healthcare. (not a popular concept in American culture/requires resource allocation and planned rationing)

Access to medical care is the only factor that contributes to health and well being (T/F)

False

Anesthesia was known for decades before it became standard practice to use in surgeries T/F

False

Do Latin women have the highest maternal mortality rates in the US when compared to other racial groups of women? (T/F)

False

In the US, do women have a higher rate of death by suicide then men? (T/F)

False

In the United States, the public sector (govt) is the dominant player in the healthcare system (T/F)

False

T/F All but 5 developed countries offer Universal Healthcare Programs

False

T/F An integrated delivery system provides coordinated healthcare but is not assessed based on health outcomes in the target population

False

Who funds Medicaid?

Federal and state government

Which scientist is credited with identifying the first known broad spectrum antibiotic, penicillin?

Fleming

What term refers to the avoidable differences between groups of people in their ability to access healthcare, in the occurrence of disease and in their health outcomes?

Health Disparity

HIPPA

Health Insurance Portability and Accountability Act of 1996- protects patients information but can be a problem when delivering quality of care when provider cannot access records

WHO definition of health

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Detriments include: -Structural (governance/unequal distribution) -Socioeconomic position (Education/occupation), -Intermediary (health systems/behavioral)

Nosocomial infection

Hospital acquired infection that account for a large number of deaths and can be preventable

Which was not a major healthcare issue in pre-industrial America?

Hospitals quality (there wasn't many)

One of the ways over utilization of health insurance can be controlled by

Implement central resource planning

To improve the nations health and resolve disparities

It is critical to address the social and medical detriments of health

First created antibacterial sprays to lower infection

Joseph Lister

What is self insurance

Large employers assume risks and budget for medical claims

Healthcare has become more or less corporatized in the last decades?

Less

Equitable Access

Limited resources and how those resources are allocated can cause problems in this

Why is the AMA so powerful?

Lobbying, hold lots of political power

First discovery of airborne organisms (pasteurization)

Louise Pasteur

What is an emerging medical and public health issue related to the misuse of antibiotics?

MRSA

What government based program is intended to cover the eligible poor (determined by income level)?

Medicaid- Covers the poor, children, elderly, pregnant women and disabled. Joint state/federal program/paid through taxes

Under the __________model, health is defined as the absence of illness or disease

Medical

Which public healthcare program covers the elderly?

Medicare-Covers every citizen 65 and older, disabled on social security, people with end stage renal disease. Budget for Medicare was the same as defense at 15%. Federal program paid through social security. Has 4 parts: - A-Inpatient Hospitalization -B-Preventative Care -C-Medi-gap/supplementary through MCO, -D-Drugs

First to provide early anesthesia in the form of ether

Morton

Which type of medical technology is a developing area in which materials are manipulated at the atomic and molecular level?

Nano technology

Is the U.S Healthcare system a true system?

No

Which ethical concept is translated to "do no harm"

Nonmaleficence

Is self injury a sign of suicide?

Not necessarily, it is often a coping mechanism

Community Health Workers

Not professional or licensed health care providers but are community members from diverse backgrounds who receive extensive training to do health outreach work

Which administration was in office during the implementation of the ACA

Obama

MDs are to allopathy as DOs are to

Osteopathy

Upcoding

Overcharging, over prescribing medicine and tests for financial profit not for the purpose of avoiding lawsuit (defensive medicine)

Patient Centered Care

Patient values guide all clinical decisions, care that is respectful and responsive to individual needs

Self-efficacy

Personal feeling of control and empowerment as incentive to make better choices

A law requiring people to use seat belts when riding cars to reduce injury or death is an example of what kind of intervention?

Policy

Historically what prevented the push toward Universal Healthcare?

President Truman supported but the fear of communism/socialism kept the public from acceptance

2 types of insurance

Private and public (medicare/medicaid/VA/Military)

In Canada the supply side of healthcare provision is dominated by

Private providers

Who was given credit for the discovery and medical application of x-rays?

Roentgen

First to put into practice hand washing to prevent the spread of disease and infection

Semmelweis

SES

Socio Economic Status

Are there more specialist or primary care physicians in the United States?

Specialist

What is the general term for the delivery of medical care when the provider and client are separated by distance?

Telemedicine

What act allows students to stay on their parents healthcare insurance until the age of 26?

The ACA

Who is responsible for ensuring drugs and devices are safe and effective for intended use

The FDA (Food and Drug Administration)through the DHHS (Department of Health and Human Services)

ACA (PPACA)

The Patient Protection and Affordable Care Act of 2010, aims to increase the number of insured Americans.

Technology Imperative

The desire for state of the art tech in spite of its cost

Safe Medical Devices Act of 1990

The law requires reporting of all injuries and deaths resulting from medical devices.

Market Justice

The philosophy that market forces should be relied upon to organize the delivery of healthcare services. Demand will balance cost, free economy. (does not consider vulnerable groups/doesn't work in complex system)

Almost all medical providers in England work directly for the English Government through the NHS (T/F)

True

Planned rationing is the process in which decision makers determine how to allocate resources (T/F)

True

T/F The ACA was designed to push healthcare in the U.S. toward more integrated care

True

T/F The CHIP program costs about $5000 per child insured

True

T/F The German healthcare system is administered by the Patient Safety Institute

True

With the exception of any major health care system changes, health service expenditures are projected to continue to increase (T/F)

True

The process of evaluating and rating risks is known as

Underwriting

Which nation spends the largest of its gross GDP on healthcare?

United States

What are examples of medical technology?

Vaccines, Prescription drugs, Electronic Medical Records Systems

First to provide early anesthesia in the form of Nitrous Oxide

Wells

What was the first form of broad coverage health insurance in the U.S?

Workers Compensation Plans

Did the AMA support hospital insurance plans?

Yes, but they opposed insurance covering physician fees

Did the AMA (American Medical Association) support the ACA (Affordable Care Act)?

Yes, they have long advocated for health insurance coverage for all Americans

Pharmoacodynamics

how a drug interacts with the body to cause it effects.

MRSA

methicillin-resistant staphylococcus aureus

What is medical technology?

the practical application of the scientific body of knowledge to improve the delivery of medical care

Co-morbidity

the simultaneous presence of two chronic diseases or conditions in a patient (evolve at the same time)

Pharmacokinetics

what the body does to the drug