What was the first major stage of the hospital evolution?
answer
Almshouses
question
When did hospitals begin to attract well-to-do patients who could afford to pay privately?
answer
When hospitals offered superior medical services and surgical procedures that could not be offered at home.
question
Who opened the first proprietary hospitals?
answer
Physicians
question
What contributed to the growth of hospitals from 1930-1980?
answer
Hill-Burton Act, Health Insurance, Technological advances
question
What were the main factors in the growth of hospitals in the United States?
answer
Hill- Burton Act, private insurance, Medicare and Medicaid
question
What is credited with having the greatest impact on the expansion of hospital beds in the U.S.?
answer
Hill-Burton
question
What triggered the downsizing phase in the U.S. hospital industry during the 1980's?
answer
Prospective Payment System
question
DRG-based reimbursement necessitated hospitals to do what?
answer
Discharge patients quicker than before
question
What are 'days of care'?
answer
The total number of patient days
question
T or F: 19th century almshouses provided mainly rehabilitation services
answer
False
question
T or F: PPS and managed care had the desired effect of reducing the growth in hospital expenditures.
answer
True
question
T or F: Women are admitted to hospitals more often than men even after adjusting for childbearing
answer
True
question
T or F: Federal hospitals are classified as public hospitals, but they are not community hospitals because they do not serve the general public.
answer
True
question
T or F: The Internal Revenue Code forbids nonprofit hospitals to make a profit.
answer
False
question
T or F: Compared to general hospitals, speciality hospitals offer services that are clinically superior.
answer
False
question
T or F: Most mental health care in the United States is delivered in psychiatric hospitals
answer
False
question
T or F: To refuse treatment is one of the basic rights of patients.
answer
True
question
What type of reimbursement method involves a fixed monthly sum per enrollee?
answer
Capitation
question
What is one aspect in which managed care differs from conventional insurance?
answer
Responsibility for delivery of services
question
The CMS uses ________ as an overall measure of a health plan's quality.
answer
A star-rating system
question
What was the main purpose of the Health Maintenance Organization Act of 1973?
answer
Provide an alternative to fee for service
question
Which group has the largest proportion enrolled in managed care plans?
answer
Workers in employer- sponsored plans
question
Which among the following employs tighter utilization controls than the other plans?
answer
HMO's
question
In the gatekeeping method, who makes referrals to specialists?
answer
Primary care physician
question
In which type of management utilization is a primary care physicians opinion necessary in referring or not referring a patient to a specialist?
answer
Gatekeeping
question
Pre-certification is associated with which type of utilization review?
answer
Prospective
question
Monitoring a patient's progress prognosis for recovery becomes important in which type of utilization review?
answer
Concurrent
question
T or F: MCO's are accredited by the federal government
answer
False
question
T or F: Medicare's managed care option is called Medicare Advantage
answer
True
question
T or F: All Medicaid beneficiaries are required to enroll in managed care plans.
answer
False
question
T or F: Most medicare beneficiaries receive their health care through managed care plans.
answer
False
question
T or F: States can make it mandatory that their Medicaid beneficiaries enroll in managed care plans.
answer
True
question
T or F: Discharge planning and retrospective utilization review go hand in hand
answer
False
question
T or F: One main objective of retrospective utilization review is to examine excessive utilization or underutilization
answer
True
question
T or F: Group model HMOs employ their own physicians
answer
False
question
T or F: HMO plans were created by insurance companies in response to the growth of PPO's
answer
False
question
What is long term care mainly associated with?
answer
Chronic conditions
question
Long term care services often interface with what type of care?
answer
Various non-long term care services
question
Long term care services are characterized as:
answer
Individualized
question
Severe ADL limitations often indicate the need for what service?
answer
Institutionalization
question
What type of care is the end of life care?
answer
Palliative Care
question
What is the main goal of LTC as it relates to a patients function?
answer
Promote independence
question
In the _________, a patients physical, mental, social, and spiritual needs are addressed
answer
Holistic Approach
question
When living in a long-term care facility, a patients personal dignity is part of _________
answer
Quality of Life
question
Objectives of community based LTC services?
answer
Respite to family members, supplement informal care, prevent institutionalization
question
What is the single source of payment for home health services?
answer
Medicare
question
T or F: Most elderly people reside in nursing homes or other types of long term care facilities
answer
False
question
T or F: Most LTC services are provided informally by family and friends
answer
True
question
T or F: All elderly require services that are very similar
answer
False
question
T or F: The LTC delivery system is a self-contained system of comprehensive health care services
answer
False
question
T or F: The IADL scale incorporates activities that are necessary for living independently in the community
answer
True
question
T or F: Medicare pays for full time skilled nursing care for home health services
answer
False
question
T or F: Long term care hospitals (LTCHs) must be certified as skilled nursing facilities to render subacute care
answer
False
question
T or F: Certain subacute care services can be provided in a patients own home
answer
True
question
T or F: It is illegal to operate a nursing facility without a license
answer
True
question
T or F: Standards for licensing nursing homes vary from state to state
answer
True
question
T or F: A license to operate a long term care facility is issued by the Department of Health and Human Serviecs
answer
False
question
What is the term for the reciprocal effects of many factors that people have little to no control over?
answer
Vulnerability
question
What is the term for the rapid and cumulative physical and emotional changes that characterize childhood?
answer
Developmental vulnerability
question
What are some challenges that rural health faces?
answer
Poverty, lack of health care providers, minority population
question
What are some major health concerns for women?
answer
Greater morbidity, poorer health outcomes, higher chance of developing more acute and chronic illnesses.
question
Mental disorders are common psychiatric illnesses affecting which group?
answer
Adults
question
What caused the Acquired Immunodeficiency Syndrome?
answer
HIV
question
T or F: Women experience more mental illness than men
answer
False
question
T or False: Significant differences exist across the various racial/ethnic groups on health
answer
True
question
Why does third party payment system increase healthcare costs?
answer
Patients are shielded from the true cost
question
The rate of growth in health spending in the U.S. slowed to its lowest level during what time period?
answer
1993-2000
question
What is it called when a physician orders more tests and services that are not medically justified because of the threat of malpractice lawsuits?
answer
Defensive Medicine
question
Central health planning is a characteristic of what type of national health care system?
answer
Socialized health (social justice)
question
How were diagnostic related groups (DRG's) originally supposed to decrease costs?
answer
Creating certain procedures/service codes that hospitals would be reimbursed accordingly
question
What is healthcare access best predicted by?
answer
Race, income, and occupation
question
According to Donabedian, in order to help define and measure quality in healthcare organizations, you must examine three domains. What are the domains?
answer
Structure, Process, Outcomes
question
T or F: Defensive medicine is a cost reducing strategy
answer
False
question
T or F: The U.S. healthcare system is centrally planned by the government
answer
False
question
What is the Hill- Burton act?
answer
Hill-Burton Free and Reduced-Cost Health Care. In 1946, Congress passed a law that gave hospitals, nursing homes and other health facilities grants and loans for construction and modernization.
question
HMO vs PPO
answer
An HMO gives you access to certain doctors and hospitals within its network. A network is made up of providers that have agreed to lower their rates for plan members and also meet quality standards. But unlike PPO plans, care under an HMO plan is covered only if you see a provider within that HMO's network.
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