US Healthcare Systems Midterm

what is primary care?

-care that deals basic health problems and prevention -ex. primary care physicians

what is tertiary care?

-care that deals with rare/complex disorders -often requires special equipment and can't be done at local hospital -ex. coronary bypass surgery

what is secondary care?

-care that requires more clinical advise -ex. gastroenterologist

what are the three goals of healthcare policy?

-improving cost of care -improving quality of care -improving access to care

what are specific determinants of health?

-income and social status -education -physical environment -social support -genetics -personal behavior and choices -use of healthcare -gender

"Urgent Care" is best described as care that A) deals with acute illnesses and injuries on a walk-in basis. B) mainly absorbs overflows of patients from crowded hospital emergency rooms. C) does not require the services of a physician. D) provides fast treatment of easy-to-diagnose conditions.

a

By definition, economics is the study of A) the choices people make to attain their goals, given their scarce resources. B) supply and demand. C) how to make money in a market economy. D) how to make money in the stock market.

a

Economics is best described as the study of a. the choices people make to attain their goals, given their scarce resources. b. supply and demand. c. how to make money. d. how to make money in the stock market.

a

Hospital patients have rights to all of the following except A) inexpensive elective medical care. B) informed consent for all tests and procedures. C) a complete understanding of their diagnoses, treatment options, etc. D) a second opinion/consult.

a

If we were to suddenly experience an overabundance (or surplus) of physical therapists, which of the following would happen? a. pt salaries would decrease b. many pt clinics go out of business as they can't fill all of their job openings c. salaries for pts increase d. pt currently working part time start to work full time

a

Over time, the significant growth of individuals choosing to practice as specialists and subspecialists has generally caused the overall quality of care to __________ and overall health care costs/spending to __________. a. improve; increase. b. improve; decrease. c. worsen; increase. d. worsen; decrease.

a

Relative to other highly developed countries, the United States spends _____________ on healthcare and has relatively _______ health outcomes. a. significantly more; worse. b. significantly more; better. c. significantly less; worse. d. significantly less; better.

a

Telehealth can best be described as a. a collection of means or methods for enhancing health care, public health, and health education delivery and support using telecommunications technologies. b. 24-hour phone accessibility for physician consultation. c. access to medical information via smartphone apps. d. live, video consultations between a primary care physicians and specialists.

a

The ability to electronically share a patient's medical info and test results would best be described by the Telehealth modality of a. store and forward b. remote patient monitoring c. live video d. mobile health

a

Urgent Care is best described as care that a. deals with acute illnesses and injuries on a walk-in basis. b. mainly absorbs overflows of patients from crowded hospital emergency rooms. c. does not require the services of a physician. d. provides fast treatment of easy-to-diagnose conditions.

a

What was the government primarily hoping to accomplish by transforming the Medicare payment structure from fee-for-service to diagnosis-related groups (DRG) in 1982? a. Reducing medical spending by discouraging unnecessary medical care. b. Reducing medical spending by encouraging shorter hospital visits. c. Improving patient outcomes by discouraging unnecessary medical care. d. Improving patient outcomes by encouraging shorter hospital visits.

a

Which of the following is NOT a major goal of hospice care? a. decreasing costs of care for the terminally ill by avoiding use of expensive technology b. supporting terminally ill patients sense of independence throughout their dying process c. providing an alternative to the curative approach of medical care for the terminal ill d. providing state of the art pain relief interventions while supporting the patient and his/her family through the life-death transition.

a

Which of the following is NOT a way in which the Regionalized Model of health care aims to improve efficiency and control spending? a. By allowing individuals to have complete control over their own healthcare, as they have access to resources that allow them to accurately diagnose their own ailments/conditions and can, in turn, seek appropriate care immediately. b. By taking advantage of the government's significant involvement in healthcare and negotiating lower prices with pharmaceutical and medical equipment companies. c. By requiring patients to obtain referrals before receiving any secondary/tertiary care, in an effort to prevent them from potentially wasting the time of these providers. d. By forcing each individual to register with a general practitioner, in an effort to improve coordination among all of the individual's care providers.

a

Which of the following would best suggest that we're experiencing a surplus of Band-Aids? a. The price of Band-Aids starts to decrease in order to increase sales. b. Band Aids sell so quickly that stores aren't able to keep them stocked for long. c. Band Aids start to become cheaper as the need for them continues to grow. d. You're only able to buy Band Aids on eBay for $50 a box.

a

While a vertically-integrated HMO _______, a virtually-integrated HMO ________. a. consolidates all providers under one owner; consists of various providers who are contractually related to one another. b. describes the Regional Model of care; describes the Dispersed Model of care. c. is relatively easy to organize; is relatively difficult to organize. d. employs salaried care providers; employs providers who are paid on a fee-for-service basis.

a

basic definition of insurance

a form of risk pooling

A more dynamic/proactive view of health suggests that healthy individuals a. never get sick. b. are able to recover quickly whenever they become sick. c. are able to receive appropriate care immediately upon becoming sick. d. never need to see a care provider.

b

A visit to an orthopedist, after first consulting your general practitioner, is an example of a. primary care. b. secondary care. c. tertiary care. d. emergency care.

b

Academic Health Centers (AHCs) must satisfy all of the following criteria EXCEPT a. contain at least one professional program. b. provide services on a not-for-profit basis. c. own/be affiliated with a teaching hospital or health system. d. contain a medical school.

b

Academic Health Centers (AHCs) must satisfy all of the following criteria except A) Contain at least one professional program. B) Provide services on a not-for-profit basis. C) Own/be affiliated with a teaching hospital and/or health system. D) Contain a medical school.

b

All of the following help to explain why estimates of the physician shortage may actually overestimate/exaggerate the problem EXCEPT a. work that had been traditionally done by physicians can now be easily completed/performed by other care providers. b. increases in health insurance coverage are likely to increase the need/demand for secondary and tertiary care in place of primary care. c. eHealth and telehealth services allow physicians to interact with more patients effectively and efficiently. d. patients are often able to receive basic care without necessarily seeing a physician due to the growth of services such as 'minute clinics' and nurse-managed health centers.

b

As the conditions of elderly individuals' worsen, their long-term will logically transition from care provided _________ to care provided __________ and eventually care provided ________. A) within their home; within a skilled-nursing facility; within an assisted-living facility. B) within their home; within an assisted-living facility; within a skilled-nursing facility. C) within a skilled-nursing facility; within an assisted-living facility; within their home. D) within a skilled-nursing facility; within their home; within an assisted-living facility.

b

Dolores, suddenly realizes that she will soon need institutional long-term care. Assuming that she only needs help with three ADLs and doesn't need and specific medical care, which facility should she be in? a. adult day care center b. and assisted living facility c. a nursing home d. a skilled nursing facility

b

Given that they both represent a large share of their markets, monopolies use their power to _____ prices and monopsonies use their power to ______ prices. a. raise; raise. b. raise; reduce. c. reduce; raise. d. reduce; reduce.

b

Historically, the first hospitals were primarily designed to a. support scientific research. b. shelter older adults, the dying, orphans, and vagrants and protect community residents from contagiously sick and mentally ill persons. c. provide training opportunities for nurses. d. provide business opportunities for entrepreneurial physicians.

b

If your insurance plan has a $3,000 deductible and a 20% coinsurance rate, how much would you pay out of pocket of an $8,000 medical bill? a.$4,600 b.$4,000 c.$2,400 d.$3,000

b

Medicale specialty boards were first established after the US ___________ sought to hire specialists but realized that many applicants were lacking the skills needed to practice medicine. a. navy b. army c. coast guard d. air force

b

Over time, the mental health services have drastically improved due to 1. the complete elimination of all stigmas that discouraged those in need from seeking care. 2. the growing ability to effectively identify and diagnose different mental illnesses. 3. the advancements in medicine that enable those with mental illnesses to be treated more effectively a. 1 and 2 only b. 2 and 3 only c. 2 only d. 1, 2, 3

b

The World Health Organization (WHO) defines health as ________. a. the ability to adapt and self-manage b. a state of complete physical, mental and social well-being c. being free from disease or pain d. the ability to never become sick or injured

b

The newest, or 'second,' generation of HMO's are often called virtually-integrated HMOs because A) Providers within the group primarily communicate using technology. B) Providers are connected through contracts instead of shared ownership. C) Advancements in technology allow HMOs to reach more individuals than they could before. D) Advancements in telehealth services allow HMOs to provide more services than they could before.

b

The term 'paradigm shift,' specifically with regards to mental health services, refers to the transition from A) solely diagnosing patients to treating them as well. B) solely treating patients' conditions to helping them also recover and reintegrate. C) treating all 'mentally ill' patients identically to identifying their individual conditions. D) treating only those with the ability to pay for care to treating all those in need.

b

Which of the following is not a way in which the Affordable Care Act sought to expand health insurance access and coverage? A) By creating online insurance markets commonly known as 'exchanges.' B) By allowing young adults to remain on their parents' insurance until age 28. C) By requiring every individual to have insurance through the individual mandate. D) By preventing insurance companies from denying coverage due to pre-existing conditions.

b

Which of the following scenarios is most likely to cause a particular hospital to hire additional registered nurses (RNs)? a. Changes in technology allow nursing assistants to fulfill most nursing responsibilities. b. The aging of the population significantly increases the need for hospital care. c. The hospital contracts with a nearby outpatient clinic in order to give their patients additional options for care. d. Changes in Medicaid eligibility requirements reduce the number of insured individuals in proximity to the hospital.

b

Which of the following would be evidence of a shortage of occupational therapists? A) The number of applications for occupational therapy programs continue to decrease. B) Average salaries for occupational therapists start to increase. C) Average salaries for occupational therapists start to decrease. D) The government reduces funding for scholarship programs geared towards those interested in careers in occupational therapy.

b

While debates about the government's role/involvement in healthcare will likely continue for some time, most of these disagreements stem from personal beliefs about the trade-off between a. increasing access and improving quality. b. having unlimited choices and controlling costs. c. improving efficiency and controlling costs. d. increasing access and having unlimited choices.

b

A health insurance plan's premium is the A) percentage of costs that the insurance company pays. B) amount of any medical bill that the individual must pay before receiving any benefits. C) price one must pay to have health insurance coverage. D) maximum amount of out-of-pocket medical expenses that an individual will pay in agiven year.

c

A(n) ________ is a provider-led organization that manages the full continuum of care and is responsible for the care quality and costs for a defined population. a. integrated medical group b. multispecialty group practice c. accountable care organization d. community health center

c

According to Urick and Meggs, the era in which pharmacists started to de-emphasize prescriptions and increase the provision of other goods and service would best be described as the a. pharmaceutical care era b. lick, stick, pour and more era c. soda fountain era d. post-pharmaceutical care era

c

An example of an activity of daily living (ADL) is _________, while an example of an instrumental activity of daily living (IADL) is ________. A) getting out of bed; getting dressed. B) using the phone; preparing meals. C) getting out of bed; preparing meals. D) using the phone; getting dressed.

c

Economies of scale exist as a hospital expands because of all of the following EXCEPT a. as a larger organization with monopsony power, it can purchase things at lower prices. b. providers and administrators can specialize even further in their tasks. c. as it expands, the profitability of each procedure it offers increases. d. the hospital can afford more sophisticated/advanced technology.

c

For all individuals seeking to practice medicine, a medical license is ____________ and board certification is ____________. a. legally required; legally required b. voluntary; legally required c. legally required; voluntary d. voluntary; voluntary

c

Hospitals are likely to hire care providers who I. provide uncommon treatments/services in order to differentiate themselves from other nearby hospital systems II. have skills/responsibilities that are likely to be replaced by technology III. are able to effectively diagnose and treat newer conditions and diseases A) I only. B) II only. C) I and III only. D) I, II and III.

c

In a pure monopsony, there is only one company that ________ a particular good or service, and it uses its size to negotiate ___________ prices. a. sells; higher b. buys; higher c. buys; lower d. sells; lower

c

In order to provide patients with more control over their own care, hospital patients now have all of the following EXCEPT a. the right to a second opinion. b. the right to reject a physician s advice/recommendation. c. the right to inexpensive medical care. d. the requirement that they consent to all tests, procedures, etc.

c

Medical care that requires highly specialized equipment and expertise, such as quadruple bypass surgery, is an example of A) primary care. B) secondary care. C) tertiary care. D) emergency care.

c

Medical specialty boards were first established in order to A) oversee the construction of new medical schools. B) promote medical school affiliations with hospitals. C) improve the quality of medical education and practice. D) establishing national standards for physicians.

c

Medical specialty boards were first established in order to a. oversee the construction of new medical schools. b. promote medical school affiliations with hospitals. c. improve the quality of medical education and practice. d. establish national standards for physicians.

c

One reason why physicians continue to leave private practice in order to work in hospitals is A) that hospitals offer significantly higher earning potential than private practice. B) that physicians desire to be more involved in teaching medical residents. C) that health insurance and information technology are becoming increasingly complex, making it harder for them to be effectively utilized in private practices. D) that physicians have a desire for the "corporate identity" associated with hospitals.

c

Relative to all other types of insurance, ____________ spends the most on long-term care services because _________. a. medicare; it covers the first 100 days that an individual spends at a skilled nursing facility b. medicaid; it covers the first 100 days that an individual spends at a skilled nursing facility c. medicaid; it covers all long-term care costs for those who are eligible for coverage d. medicare; it covers all long-term care costs for those who are eligible for coverage

c

Relative to not-for-profit hospitals, for-profit hospitals are more likely to a. be funded by charitable contributions b. accept medicare and medicaid patients c. have more advanced facilities and resources at their disposal d. provide as many services and procedures as possible, regardless of how common they may be

c

The health care system in ________ is referred to as socialized medicine, under which the government owns most of the hospitals and employs most of the doctors. a. Canada b. the United States c. the United Kingdom d. Australia

c

Under the Affordable Care Act (i.e. Obamacare), young adults and dependents are able to remain on their parents' health insurance until the age of ____. a. 18 b. 21 c. 26 d. 28

c

Which of the following DOES NOT help to explain why traditionally inpatient medical procedures continue to transition to outpatient procedures? a. Technological advances have allowed smaller facilities to purchase the equipment necessary to perform these procedures. b. Changes in Medicare payments have encouraged hospitals to try to reduce the length of patient stays. c. Medicaid's coverage of home services have increased demand for outpatient care. d. Advancements in anesthetics allow patients to recover more quickly, and in turn return home, following particular procedures.

c

Which of the following are likely to contribute to the expected shortage of registered nurses (RNs) over time? I. The aging of the population and their growing need for medical care II. Decreases in health insurance coverage leading to increased demand for care III. The aging/retiring of current RN's leading to job openings that must be filled. a. I only. b. II and III only. c. I and III only. d. I, II and III.

c

Which of the following has NOT resulted from the continuous specialization of healthcare providers? a. coordination of care has improved, primarily due to the growing number of hospitalists b. hospitals and other care providers are able tot treat more patients than ever before c. healthcare costs have decreased due to lower provider salaries and fees d. patient outcomes have improved as more and more providers continue to focus on particular disease, conditions and organs

c

Which of the following is NOT NECESSARILY a consequence of medical licensing laws? a. They ensure that licensed professionals meet some minimum qualifications. b. They limit the number of individuals who can legally practice medicine. c. They ensure that medical professionals are always implementing the most recent and effective treatment practices. d. They result in higher incomes/salaries for licensed professionals.

c

Chris Traeger, the character who believes that he will be the first person to live to 150, is from what show? a. The Office b. Grey's Anatomy c. Parks and Recreation d. Game of Thrones

c.

What are the social determinants of health?

conditions in which people are born, grow, live, work and age

A copayment, otherwise referred to as a copay, is best described as a. the amount one must pay out of pocket every claim before insurance coverage b. the price one must pay only when using healthcare from and out-of-network provider c. the price one must pay to have health insurance coverage d. the amount one must pay-out of pocket for a 'basic' office visit

d

A patent grants a company gives a firm the exclusive right to a new product for a period of _______ years from the date the product is invented. A) 5. B) 10. C) 15. D) 20.

d

A visit to a cardiologist, after first meeting with your primary care physician, is an example of a. urgent care b. emergency care c. tertiary care d. secondary care

d

A(n) ________ focuses on providing primary/preventive care, is located in a high need area and is governed by a board where the majority of members are its own patients. a. integrated medical group b. multispeciality group practice c. accountable care organization d. community health center

d

A(n) ________ is a provider-led organization that manages the full continuum of care and is responsible for the care quality and costs for a defined population. A) integrated medical group B) multispeciality group practice C) community health center D) accountable care organization

d

According to Health People 2030, which of the following is NOT one of the five categories of social determinants of health? a. Neighborhood and built environment b. Economic stability c. Education access and quality d. Health insurance coverage and affordability

d

As one of the most significant lobbying groups in healthcare today, the American Medical Association aims to mainly promote policies that are in the best interest of a. US pharmaceutical companies, such as longer patents and increase in government research funding b. US citizens, such as ensuring that all citizens have access to affordable, high quality health insurance. c. US insurance companies, such as efforts to scale back government health insurance programs d. US physicians, such as increases in reimbursement rates and reforming malpractice insurance

d

As opposed to individuals covered by traditional health insurance , individuals covered under pre-paid group service plans differ in that a. they pay premiums now so that they do not have to pay future medical bills out of their own pockets. b. they are only eligible to receive care from one specific provider. c. their providers emphasize tertiary care, as opposed to primary or secondary care. d. they actually pay for the specific care they will receive in advance.

d

Historically, the United States government has implemented policy to increase the supply of physicians by a. increasing federal funding to medical schools and programs. b. allowing internationally-trained physicians to practice within the United States. c. Increasing Medicare and Medicaid reimbursement rates for primary care. d. All of the above.

d

In today's hospitals, outpatient clinics frequently provide a. care for those without private physicians. b. teaching sites for medical residents. c. primary-care services organized similarly to private physician offices. d. all of the above.

d

Recent healthcare policies and proposals have all sought to improve the U.S. healthcare system by ________ access to care, __________ the quality of care and ________ the costs that patients have to pay for care. a. increasing; reducing; reducing. b. decreasing; improving; reducing. c. increasing; improving; increasing d. increasing; improving; reducing.

d

Simply put, individuals buy insurance to ______ while providers sell insurance to _____. a. protect themselves from risks; to make money. b. protect themselves from risks; ensure that individuals have access to coverage. c. protect themselves financially from risks; ensure that individuals have access to coverage. d. protect themselves financially from risks; to make money.

d

Suppose the the one available health insurance plan cost $35,000 and that the tax for purchasing it was $15,000. If your employer wanted to offer you $70,000 in salary and this health insurance would cost them _________ and be worth __________ to you. a. $70,000; $85,000 b. $35,000, $50,000 c. $105,000; $105,000 d. $105,000; $120,000

d

Today, the majority of hospitals in the United States are a. for-profit community hospitals. b. owned and operated by state and local governments. c. owned and operated by the Veterans Health Administration. d. not-for-profit community hospitals.

d

Which of the following best explains why less than 9% of emergency room visits in 2016 were classified as either 'emergent' or 'immediate'? a. individuals seeking continuous care are likely only able to find it within emergency departments b. emergency room care is often less expensive than urgent care c. advances in medicine allow more healthcare to be available in an ambulatory setting d. emergency rooms must treat you, regardless of your ability to pay

d

Which of the following best represents a social determinant of health? A) Gender. B) Use of healthcare. C) Income. D) Culture.

d

Which of the following could result from eliminating/reducing inefficiencies throughout the healthcare system? a. Spending would decrease as more technology is incorporated by both care providers and administrators. b. Patients would be able to receive necessary care more quickly as fewer individuals waste providers' time and resources seeking 'unnecessary' care. c. Both health care and health insurance would become more affordable due to the costs of healthcare decreasing. d. All of the above.

d

Which of the following is not a principle of a patient-centered medical home (PCMH)? A) Providing for all of a patient's healthcare needs or appropriately arranging care with other qualified professionals. B) The personal physician leads a team of individuals in the practice who take responsibility for the ongoing care of patients. C) Care is coordinated and integrated across all levels of care. D) Use of electronic health information technology for patient communication is discouraged.

d

Which of the following positions would NOT be described as Allied Health Personnel? a. A physical therapist b. A social worker c. A medical assistant d. A pharmacist

d

Which of the following reasons DOES NOT help to express Huber at al.'s criticism of the word 'complete' in earlier definitions of health? a. It is impossible to actually define/measure complete health. b. Any individual with any ailment/injury, no matter how small, would need constant medical care/supervision to guarantee complete health. c. Individuals are more able to live happily with certain conditions/ailments, despite not being completely healthy, courtesy of continuous advancements in medicine. d. Being in complete health requires having the ability to adapt and self-manage.

d

Which of the following reasons does not help to express Huber at al.'s criticism of the word 'complete' in the WHO's definition of 'health' (which states that health is a state of complete physical, mental and social well-being)? A) It is impossible to actually define/measure 'complete' health. B) Any individual with any ailment/injury, no matter how small, would need constant medical care/supervision to guarantee 'complete' health. C) Individuals are more able to live happily with certain conditions/ailments, despite not being 'completely' healthy, courtesy of continuous advancements in medicine. D) Being in 'complete' health requires having the ability to adapt and self-manage.

d

determinant of health definition

factors that combine together to affect the health of individuals and communities

what is the goal of healthcare?

less spending and better outcomes

what is the dispersed model of care?

more fluid and free flowing

what is the regional model of care?

more structured and ordered

what are the three types of care?

primary, secondary, tertiary

what are the two models of care?

regional and dispersed

how did Huber define health?

the ability to adapt and self manage

what is economics?

the study of choices that people make to attain their goals, given their scarce resources