Deck 1: Health Care Delivery Systems

Question 1

The development of medical specialization occurred prior to WWI.

Answer 1

False

Question 2

Belonging to one's professional association is an important way of finding current information and learning about changes in one's chosen field.

Answer 2

True

Question 3

An IPA is a prepaid, organized system for providing comprehensive health care services within a geographic area to all persons under contract.

Answer 3

False

Question 4

The fee-for-service basis is the primary method used by managed care.

Question 5

Capitation is a fixed amount per person paid to the physician for health care services.

Question 6

The mentally ill were at one time housed in poorhouses or prisons.

Question 7

Voluntary health agencies are governmental organizations created to perform public work in health care through private means.

Question 8

Bylaws are the framework used to identify the roles and responsibilities of the board and its members.

Question 9

Center for Medicare and Medicaid Services administers the Medicare and Medicaid programs.

Question 10

Managed Care allows an individual who is buying a high deductible insurance coverage to save money for out-of-pocket costs tax-free accounts.

Question 11

Mental illness can result from the inability to cope effectively with the recurrent stresses of living in today's world.

Question 12

A D.O. must be supervised by an M.D.

Question 13

Sigmund Freud, Alfred Adler, and Carl Jung contributed to the reform of how mentally ill patients were treated.

Question 14

Fringe benefits are part of every employee's hiring package.

Question 15

The CFO (Chief Financial Officer) reports directly to the governing board for the success of the facility.

Question 16

Tracer methodology is used by JCAHO.

Question 17

Outsourcing refers to the delegation of health care operations from internal production of a business to an external entity that specializes in an operation.

Question 18

In primitive times, most of the health care was handled by medicine men or shamans.

Question 19

Accreditation is directly tied to the ability of the facility to attract patients and receive reimbursement.

Question 20

A nurse is an allied health professional.

Question 21

Which of the following statements most accurately describes the health care delivery system?

A) It has changed little over the last decade.
B) It is both varied and complex.
C) It will need a major overhaul to be effective.

Question 22

Which of the following has proven to be the most relevant to the development of treatments to improve or cure disease?

A) connection between cause and effect
B) connection between nature and disease
C) connection between supernatural and disease
D) connection between diseases and punishing forces

Question 23

Which of the following would be the primary administrator of a hospital?

A) CEO
B) CFO
C) CIO
D) COO

Question 24

Which of the following best describes a health savings account (HSA)?

A) It refers to a means of tracing the delivery of the patient's care through the health record and interviews.
B) It allows individuals to save money for health care costs in tax-free accounts.
C) With an HSA, there is a delegation of non-care operations from internal production to an external entity.

Question 25

A coworker states he is licensed to practice in his field. What does this mean?

A) He has the right, which was conferred by a governmental entity, to practice an occupation or provide a service.
B) He has purchased a certificate stating he is licensed to practice through a private agency.
C) He has completed the educational requirements and a practicum in his field of study.
D) None of these statements adequately defines licensing.

Question 26

A patient goes in for minor surgery and is discharged within 24 hours. What type of care is best described by this scenario?

A) rehabilitation care
B) ambulatory health care
C) tertiary care

Question 27

At age 65, a U.S. citizen qualifies for

A) MediCal
B) Medicaid
C) Medicare

Question 28

A patient is referred to a cardiologist for further evaluation. This is what type of care?

A) primary
B) secondary
C) tertiary
D) quaternary

Question 29

A program designed to provide coverage of health care to people of low-income, pregnant, and disabled people.

A) Medicaid
B) Medicare
C) Fee For Service
D) HMO

Question 30

Licensing controls the number of individuals who are permitted to practice an occupation or provide a service.

Question 31

The continuum of care refers to

A) the coordination of all aspects of the patient's health care
B) the care provided by the health care professional at the initial point of contact
C) matching an individuals's ongoing needs with the appropriate level and type of care
D) ensuring that the same professionals care for the patient to maintain continuity of care

Question 32

Tertiary care is care provided by a specialist, often at the request of the primary care physician.

Question 33

Both the JC and the AOA accredit health care entities beyond the hospital setting such as behavioral health and home health.

Question 34

In what year did congress pass the Hospital Survey and Construction Act?

A) 1945
B) 1946
C) 1950
D) 1955

Question 35

Public health focuses on the social and behavioral aspects of life that affect a person's health.

Question 36

A patient is transferred to a long-term care facility. What does this tell you about the patient?

A) The patient is no longer in need of acute care but does need continued nursing service in a facility.
B) The patient needs to restore functional abilities.
C) The patient needs end-of-life care as they can no longer care for themselves at home.

Question 37

As Egyptian civilization declined, other civilizations adopted and expanded the Egyptians' knowledge of medicine, Arabians refined the concept of

A) Public hygiene.
B) Punishments for malpractice.
C) Pharmacology.
D) Physician practice.

Question 38

You discover that in evaluating which college to attend that some are and some are not accredited. What does accreditation mean?

A) The college has received a license to offer the specified coursework.
B) The college has met certain size and population requirements.
C) An external entity has reviewed the program of study to determine if the program meets certain predetermined standards.

Question 39

Medical Record Committees review records for all of the following EXCEPT:

A) Accuracy
B) Authentication
C) Completeness
D) Timeliness

Question 40

Full privileges, rights, and responsibilities are granted to active members of the medical staff. What is granted to a junior physician or to those who wish to become active medical staff members upon existence of a vacancy?

A) courtesy staff privileges
B) consulting staff privileges
C) associate staff privileges
D) temporary or provisional privileges

Question 41

_______________ enrolled population will receive health care services through either a prepayment or discounted fee-for-services arrangement.

Question 42

What are the three main types of managed care arrangements?

A) HMO, PPO, IPA
B) HMO, PPO, POS
C) PPO, IRA, POS
D) PPO, POS, HMO

Question 43

_______________ refers to the delegation of non-care operations from internal production of a business to an external entity that specializes in an operation.

Question 44

Two organizations that play a role in health care accreditations are ______________________ and ________________________.

Question 45

Who has the ultimate authority and responsibility for operation of the hospital?

A) Physicians
B) CEO
C) Board of Directors

Question 46

____________________ allows an individual who is buying a high-deductible insurance coverage to save money for out-of-pocket costs in tax-free accounts.

Question 47

____________________ care is the most complex level of medical and surgical care available.

Question 48

Health care is generally delivered in two ways: _________________ and _______________.

Question 49

A PPO consists of a

A) participating physician on a capitated basis, and others on a fee-for-service basis.
B) primary physician who serves as the "gatekeeper" and authorizes patient access to specialists and other services as necessary.
C) network of participating hospitals, physicians, medical groups, and other providers who contract with a sponsor.

Question 50

Three main types of managed care arrangements have proliferated in the United States. They are ____________________ ____________________ ____________________, ____________________ ____________________ ____________________, and ____________________ ____________________ ____________________.

Question 51

Since some men were considered unable to fight due to mental deficiencies, the military became interested in mental health during which war?

A) War of 1812
B) World War I
C) World War II
D) None of these

Question 52

________________ revolutionized the financing of health care services by introducing the concept of a prospective payment system that sets limitations on reimbursement based on the use of diagnosis-related groups.

Question 53

What is the term for care given to patients who are not confined to an institutional bed as inpatients at the time care is rendered?

A) Home Health
B) Ambulatory
C) Palliative
D) Both a and b, not c

Question 54

Individuals who buy high-deductible insurance coverage to save money for out-of-pocket costs in tax-free accounts are called

A) HMO.
B) PPO.
C) FFS.
D) HAS.

Question 55

Refers to a right conferred by a governmental entity to practice an occupation or provide a service

A) Licensure
B) Accreditation
C) Bylaws
D) Rules

Question 56

The health care discipline that would deal with achieving better sanitation, the growing of food, and the conditions of work is ____________________ health.

Question 57

Who wrote the first psychiatric textbook in the United States, Diseases of the Mind?

A) Dorothea Dix
B) Alfred Adler
C) Benjamin Rush
D) Sigmund Freud

Question 58

____________________ is a fixed amount per person paid to the physician for health care services.

Question 59

____________________ is a community-based group of independent practitioners who contract to provide care for prepaid individuals.

Question 60

_______________ is the process by which an external entity reviews an organization or program study to determine if the organization or program meets certain predetermined standards.

Question 61

____________________________ administers the Medicare and Medicaid programs.

Question 62

Match the term with the best descriptor.
process of obtaining written proof of qualifications

A)registration
B)bylaws
C)rules
D)regulations
E)clinical privileges
F)credentialing process
G)medical staff coordinator

Question 63

Match the term with its descriptor.
treats the body's structural and neurological systems

A)long-term care facility
B)generalists
C)rehabilitation care facility
D)specialists
E)physician assistant
F)chiropractor
G)podiatrist
H)dentist
I)nurse
J)optometrist

Question 64

Match the term with the best descriptor.
framework used to identify the roles and responsibilities of the board and its members

A)registration
B)bylaws
C)rules
D)regulations
E)clinical privileges
F)credentialing process
G)medical staff coordinator

Question 65

Match the term with its descriptor.
institution offering health care services to patients who need to restore their functional abilities

A)long-term care facility
B)generalists
C)rehabilitation care facility
D)specialists
E)physician assistant
F)chiropractor
G)podiatrist
H)dentist
I)nurse
J)optometrist

Question 66

Match the term with its descriptor.
physicians who conduct a wide or unlimited practice

A)long-term care facility
B)generalists
C)rehabilitation care facility
D)specialists
E)physician assistant
F)chiropractor
G)podiatrist
H)dentist
I)nurse
J)optometrist

Question 67

Match the term with its descriptor.
institution offering health care to patients who are not in an acute episode of illness & need continuous nursing service in an inpatient setting

A)long-term care facility
B)generalists
C)rehabilitation care facility
D)specialists
E)physician assistant
F)chiropractor
G)podiatrist
H)dentist
I)nurse
J)optometrist

Question 68

Match the term with the best descriptor.
the actions of a nongovernmental entity to recognize those individuals who meet specified standards such as education and experience

A)registration
B)bylaws
C)rules
D)regulations
E)clinical privileges
F)credentialing process
G)medical staff coordinator

Question 69

Match the term with its descriptor.
provides patient services under the direction and supervision of a physician or surgeon

A)long-term care facility
B)generalists
C)rehabilitation care facility
D)specialists
E)physician assistant
F)chiropractor
G)podiatrist
H)dentist
I)nurse
J)optometrist

Question 70

___________________ administer programs for the prevention and control of communicable and vector-borne diseases and other preventable conditions.

Question 71

Match the term with the best descriptor.
limits set by the governing boards

A)registration
B)bylaws
C)rules
D)regulations
E)clinical privileges
F)credentialing process
G)medical staff coordinator

Question 72

Match the term with the best descriptor.
principles established by authorities, prescribing or directing certain action or forbearance from action

A)registration
B)bylaws
C)rules
D)regulations
E)clinical privileges
F)credentialing process
G)medical staff coordinator

Question 73

Match the term with the best descriptor.
prescribed courses of action which arise from law, principle, or custom

A)registration
B)bylaws
C)rules
D)regulations
E)clinical privileges
F)credentialing process
G)medical staff coordinator

Question 74

Match the term with the best descriptor.
coordinates all efforts related to procuring written documentation of a physician's qualifications to provide clinical services

A)registration
B)bylaws
C)rules
D)regulations
E)clinical privileges
F)credentialing process
G)medical staff coordinator

Question 75

________________ is a health care discipline dealing with the community at large, focused on protecting and improving community health by organized community effort and preventive delivery of medical, social, and sanitary services.

Question 76

Match the term with its descriptor.
concerned with diagnosing, treating, and preventing abnormal foot conditions

A)long-term care facility
B)generalists
C)rehabilitation care facility
D)specialists
E)physician assistant
F)chiropractor
G)podiatrist
H)dentist
I)nurse
J)optometrist

Question 77

Match the term with its descriptor.
works with the teeth, oral cavity, and associated structures of the mouth

A)long-term care facility
B)generalists
C)rehabilitation care facility
D)specialists
E)physician assistant
F)chiropractor
G)podiatrist
H)dentist
I)nurse
J)optometrist

Question 78

Match the term with its descriptor.
physicians who limit their practice to a particular branch of medicine or surgery

A)long-term care facility
B)generalists
C)rehabilitation care facility
D)specialists
E)physician assistant
F)chiropractor
G)podiatrist
H)dentist
I)nurse
J)optometrist

Question 79

Match the term with its descriptor.
provides services essential to the promotion, maintenance, and restoration of health and well-being and prevention of illness

A)long-term care facility
B)generalists
C)rehabilitation care facility
D)specialists
E)physician assistant
F)chiropractor
G)podiatrist
H)dentist
I)nurse
J)optometrist

Question 80

Match the term with its descriptor.
diagnoses and provides selective eye treatment

A)long-term care facility
B)generalists
C)rehabilitation care facility
D)specialists
E)physician assistant
F)chiropractor
G)podiatrist
H)dentist
I)nurse
J)optometrist