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Delivering Health Care in America: A Systems Approach, Third Edition (Delivering Health Care in America: A System Approach)
historically, inpatient care developed _____ outpatient care.
emergency departments, in most cases, are equipped to provide...
primary and secondary services
what is gatekeeping?
process by which primary care physicians refer patients to specialists
countries whose health systems are oriented more toward primary care achieve...
higher satisfaction with heath services among heir populations
which factors help determine the proportion of primary care personnel to specialists needed for the adequate provision of primary care?
- population's rate of utilization of primary care services
- how rigidly health care delivery systems employs gatekeeping
most prominent reason for the decline in the number of procedures performed in hospitals is...
most of these procedures were shifted to outpatient settings
which are reasons for the growth in outpatient services?
- new technology
- patient preference
- managed care
hospice services are primarily for people with...
community health centers serve primarily...
populations which are medially underserved
pain and symptom management
under payment arrangement in which physicians are paid a fixed salary and performance- based bonuses, rick is shifted from MCO to physicians.
the only objective MCO's seek to achieve is cost containment.
care management is mainly .recommended for patients who need secondary and tertiary care more other than primary care.
disease management is highly individualized.
a managed care organization functions most like...
under capitation, risk is shifted...
from MCO to the provider
the term, managed care, refers primarily to management of....
under prospective utilization, if a case is determined to be potentially complex and costly, is it referred to...
PPO's differentiated themselves by offering ______ options to enrollees.
point of service
managed care has emphasized the use of alternative services to acute hospital care whenever appropriate.
on average, in a given population, females incur a greater number of hospital discharges but have shorter stays.
inpatient care means....
health care delivered in conjunction with an overnight stay in a facility
which primary factor was the trigger that made hospitals limit care to the more acute periods of illness rather than the full course of the disease?
pressure to contain costs
what is the meaning of "excess capacity" in the health care inpatient sector?
the hill-burton act was passed to...
relieve the shortage of hospitals
ALOS is an indicator of...
severity of illness
the proportion of a hospital's capacity that is actually utilized...
what financial benefit does a small rural hospital reap by qualifying for the designation, Critical Access Hospital?
it can receive cost-plus reimbursement
which principle of ethics requires caregivers to involve the patient in medical decision making?
for whose financial benefit are proprietary hospitals operated?
most nursing care in the US is financed by Medicare.
subacute care is more technically complex than skilled nursing care.
compared to patients receiving community-based long-term services, those in institutions are more likely to be functionally and/or cognitively impaired.
whats the goal of long-term care?
promote functional independence
why is the assessment of psychiatric illness particularly difficult in geriatric patients?
comorbiditie's can obscure diagnosis
which type of long-tem care service is predominantly used in the US
maintenance rather then restoration of functioning is particularly the domain of...
what role does patient assessment play in determining prospective reimbursement for a SNF?
assessment is used to determine the SNF's case mix
most nursing homes in the US...
are dually certified
a long term care facility must be certified in order to...
admit Medicare and Medicaid patients
the United Nations contends that a greater gender equality will lead to profound and positive impacts on children's well-being and development.
by federal law, all insurance companies are required to cover contraceptives.
rural areas are particularly good places for managed care implementation.
the health status of American Indians no longer lags significantly behind other racial/ ethnic groups.
what does "MUA" stand for?
medically underserved area
what is the primary purpose of the National Health Service Corps?
to recruit physicians to provide services in physicians shortage areas in the US
what does the federal Ryan White CARE Act fund?
development of treatment and care options for persons with HIV and AIDS
which legislation created the SCHIP (state children's health insurance plan)?
balance budget Act of 1997
lack of insurance can result in....
- decreased utilization of lower cost preventative services
- spread of infectious diseases
- increased need for more expensive health care
-increased utilization of emergency services
-inefficient use of health care resources
in the US, which racial/ ethnic group has the highest rate of uninsurance?
what does the COnsumer Price Index (CPI) measure?
what is gross domestic product (GDP)?
a measure of all the goods and services produced by a nation in a given year
what are the main activities of risk management?
proactive efforts to prevent adverse events related to clinical care and facilities operations
a service is cost-efficient when...
the benefit received is greater than the coast incurred to provide the service
what is the primary purpose of certificate-of-need statutes?
to control capital expenditures by health facilities
compared to other nations, the US uses a larger share of its economic resources for health care.
the US has never imposed price controls on the health care industry.
underutilization of health care services is not a problem in the US.
what is the main reason for the lack of success of health care cost control efforts in the US?
cost shifting by providers
administrative costs are the costs associated with management of which aspects of health care?
financing, insurance, delivery, payment
what aspect of health care system is most essential?
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