HEALTH CARE USA 11
U.S.annual health care expenditures far outstrip those of 7 otherdeveloped nations. In relationship with expenditures, U.S. healthpopulation status ranking on critical indicators in comparison withthose of other developed nations is: Dismally lower
Inthe past, patient behaviors within the health care delivery systemwere formed from the authoritarian positions of better-educatedproviders who expected patients to be compliant and grateful. Todayhealth care providers and consumers: Encourage more proactive rolesfor patients’ participation in health care decisions with “shareddecision-making”.
Ofthe levels of prevention associated with the natural history ofdisease, primary prevention refers to: Health education and specificprotection.
Theservice priorities of the U.S. health care system reflect America’sfascination with dramatic high-tech medicine. As a result: All of theabove
Inits early origins in colonial America, the patient/physicianrelationship can be best characterized as: Personal, confidential andsimple with payments based on patients’ financial capacity.
Asearly as the 19thcentury some Americans carried “health insurance” throughemployers, fraternal orders, guilds, trade associations, unions, orcommercial insurance companies. However unlike health insurance oftoday, these insurance policies only provided for: Fixed payments tocompensate for lost wages due to injury, sickness or disability.
TheAmerican Medical Association’s initial reaction to Blue Crosshospital insurance plans suggested that the plans: Were unsound andunethical.
Themajor health care advances of the second half of the 20thcentury were in the area of: Vaccines and antibiotics to prevent andcontrol infectious diseases, tranquilizers, and the birth controlpill.
Theexplosion of science and technology in the 1970s resulted in:Encouragement of physicians’ specialization, higher costs of healthcare and medical school efforts to attract more students to primarycare.
Acentral provision of the ACA to assure health care coverage for mostAmericans is: The individual mandate.
Amajor challenge of creating health information systems using datafrom many sources is the feature known as “interoperability.” Thesolution applied to achieving interoperability has been thedevelopment of: Health information exchanges (HIEs).
Threeorganizations elements essential for successful health informationsystems implementation are: Technology, policies and procedures, andculture.
Acomputerized decision support system (CDSS) is best described as anelectronic system that: Matches individual patient data with acomputerized knowledge base such as evidence-based clinicalguidelines.
Thesingle most important factor in accelerating health informationtechnology adoption since 2008 has been: Financial incentiveprograms that reward “meaningful use”.
“Meaningfuluse” of electronic health records is best described as: Efficientapplication of electronic health records under internal criteriaestablished within physician practices and hospitals.
Incolonial America, the primary functions of hospitals were to: Shelterolder adults, the dying, orphans, and vagrants and protect communityresidents from contagiously sick and mentally ill persons.
Thedevelopment that contributed most significantly to the decline of thesocial mission of hospitals was the: Enactment of private and publicinsurance reimbursement for hospital care
Themajor obligation of doctors when obtaining informed consent for amedical procedure is to: Ensure that the patient understands therisks and benefits of the procedure.
Untilthe mid-1980s, hospitals were reimbursed for whatever they charged ona “retrospective” basis. Now they are paid a certain amount foreach patient’s care on a predetermined “prospective” basis. Theamount they are paid is based on: Diagnosis related groups (DRGs).
Hospitalsin the future health care system will: Expand as hubs of moretechnologically sophisticated health care systems.
Thetechnological and clinical advances that allow many surgical to besafely performed on an ambulatory basis had what corollary effects onhospitals? Physicians become competitors with hospitals for the samelines of business.
Theprimary organizational mode of the medical care in the United States,in terms of volumes of services delivered, is: Private practicephysicians’ offices.
Intoday’s hospitals, outpatient clinics frequently provide: Care forthose without private physicians, teaching sites for medicalresidents, and primary care services organized similarly to privatephysician offices.
“Urgentcare” is best described as care: Provided on a walk-in, extendedhour basis for acute illness and injury that is either beyond thescope of or availability of primary care practice or retail clinic.
Thepredominant services of local public health departments today are:Child and adult immunizations.
Incolonial America the primary modes of medical education was: A and C
Medicalsocieties were first established for the primary purpose of:Improving the quality of medical education and practice
AcademicHealth Centers may be best described as: Complexes of medical schoolsand other health professional schools – such as nursing, pharmacy,dentistry, and allied health – affiliated with each other and withteaching hospitals and other research and clinical facilities.
Inorder to provide direct patient care, physicians are required to: Complete a 3-7 year accredited residency program and pass a medicalboard exam of the state in which they will practice.
Physicianemployment by hospitals continues on a pathway of steady growth. Onereason why physicians are leaving private practice for hospitalemployment is: Increasingly complex health insurance and informationtechnology demands of private practice.
Healthcare system changes, including advancing technology, will likelyresult in new, more highly specialized health occupations. Which ofthe following is not one of the expected effects of this development?Hospitals’ resistance to employing multi-skilled personnel
States try to protect the public from incompetent care by licensingcertain health professions. Certification from licensing in that,certification: only recognizes special education or training.
Eachyear approximately 6,000 international medical graduates (IMGs) enterU.S. to practice. IMGs are vitally important to the health caredelivery system because: They fill a shortfall in the number ofresidents required by U.S. hospitals.
Thecategory of allied health professionals, “therapeutic sciencepractitioners” concerned with the treatment and rehabilitation ofpatients with all types of diseases and injuries include which of thefollowing professions? Physical and occupational therapists, speechlanguage pathologists,
Unlikemedicine, dentistry essentially remains a “cottage industry”primarily serving only those with dental insurance or who can affordto pay out-of-pocket. For this reason: Many of the population groupswith the greatest need have no access to the services.
Althoughthe ACA will enact sweeping U.S. health care system reforms, onefundamental element of the system that will remain unchanged is: financing of the health care expenditures through a combination ofpublic and private sources.
Thecurrent highest personnel care expenditure in the U.S. is for:Hospital care.
Majordrivers of U.S. health expenditures include: Advancing medicaltechnology, growth in the older population, specialty medicine, laborintensity, and reimbursement system incentives.
Thebasic concept of health insurance is antithetical to the premise onwhich personal or property insurance was historically definedbecause: Other forms of insurance were intended to cover individualsagainst the low risk of unlikely events such as premature death oraccidents while health insurance provides coverage for unlikelyevents in addition to routine and discretionary services.
Themanaged care concept called “capitation” refers to: Physiciansagreeing to provide all medical care an individual requires for aspecific time period, for a prepaid fee.
Long-termcare is best described as: Services provided in both home andinstitutional setting for persons of all ages with varying levels ofmedical, social, and personal care needs.
Whichof the following society factors increases the need for formallong-term care services? Women working outside the home
TheU.S. history of institutional long-term care began with: Communalcare settings operated by charitable community members and governmentsupported almshouses.
Thedevelopment of formal home care services, such as those provided bythe Visiting Nurses Association originated as: A social response toimprove unhealthy living conditions of immigrants residing in crowdedurban tenements and prevent the spread of infectious diseases.
Whichof the following best describes the informal long-term care system? Care and assistance provided in the home by family members andfriends.
Incolonial American, mental health “treatment” consisted of:Confinement in homes, in jails or in almshouses where patientssuffered severely.
Nationalawareness of the needs of the mentally ill rose sharply in theaftermath of WWI because: Thousands of solders returned from the warsuffering from “war neurosis” or “shell shock”.
Duringthe 1960s, one factor that enabled the mentally ill persons to movefrom large institutions to community settings was: The development ofeffective pharmacologic treatments for many disorders.
Theterm “non-parity” as it applies to insurance coverage for mentalhealth services, is best defined as: Insurers using different andequal systems to cover mental health from those used for medicalcare.
WorldHealth Organization ranking of the leading causes of disabilities inthe U.S. and Canada in terms of the total number of years lost toillness, disability or premature death places neuropsychiatricdisorders at what level? Fourth