Deck 5: Economics of Health Care Delivery
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Deck 5: Economics of Health Care Delivery
1
A nurse is examining the characteristics that affect one's health. Which factor is of greatest concern to the nurse?
A) Obesity
B) Marital status
C) Health insurance
D) Age
A) Obesity
B) Marital status
C) Health insurance
D) Age
Obesity
2
A nurse is working with members of the community to assist them with acquiring health insurance. Which individual is most likely to be uninsured?
A) An 82-year-old with chronic medical problems
B) A 2-year-old whose mother is on welfare
C) A 50-year-old business executive who works for a large corporation
D) A 32-year-old who works part-time at a small business
A) An 82-year-old with chronic medical problems
B) A 2-year-old whose mother is on welfare
C) A 50-year-old business executive who works for a large corporation
D) A 32-year-old who works part-time at a small business
A 32-year-old who works part-time at a small business
3
A nurse discusses services with a federal Congressional representative. Which service would the nurse most likely be discussing?
A) Family planning
B) Counseling
C) Policy making
D) Prevention of communicable diseases
A) Family planning
B) Counseling
C) Policy making
D) Prevention of communicable diseases
Policy making
4
Which statement regarding poverty and health insurance is true?
A) Millions of people in the United States are without health insurance.
B) The poor in the United States are as healthy as persons with higher incomes.
C) Persons with money or health insurance are less likely to seek health care.
D) The poor are more likely to receive health care through private agencies.
A) Millions of people in the United States are without health insurance.
B) The poor in the United States are as healthy as persons with higher incomes.
C) Persons with money or health insurance are less likely to seek health care.
D) The poor are more likely to receive health care through private agencies.
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5
Public health economics focuses on what?
A) Use of resources.
B) Availability and usage of goods and services related to public health.
C) Scarcity of resources in the health care industry.
D) Management and use of monies to improve the health of populations.
A) Use of resources.
B) Availability and usage of goods and services related to public health.
C) Scarcity of resources in the health care industry.
D) Management and use of monies to improve the health of populations.
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6
A nurse conducts a class at a public health clinic on breast self-examination for a group of 50 women. Which term best describes the nurse's action?
A) Supply and demand
B) Macroeconomics theory
C) Efficiency
D) Effectiveness
A) Supply and demand
B) Macroeconomics theory
C) Efficiency
D) Effectiveness
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7
A nurse enrolls in a microeconomics course at a local college. Which statement best describes the rationale for taking this course?
A) Nurses are often the ones to allocate resources to solve a problem.
B) Nurses are often involved in federal policy making.
C) Health care policy can be influenced using these principles.
D) Health care supplies can be very costly and nurses must use them wisely.
A) Nurses are often the ones to allocate resources to solve a problem.
B) Nurses are often involved in federal policy making.
C) Health care policy can be influenced using these principles.
D) Health care supplies can be very costly and nurses must use them wisely.
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8
A community health nurse is assisting clients to access health care. Which individual would most likely experience a barrier when accessing health care?
A) A 40-year-old who speaks English
B) A 25-year-old with health insurance
C) A 50-year-old with hypertension
D) A 30-year-old who is unemployed
A) A 40-year-old who speaks English
B) A 25-year-old with health insurance
C) A 50-year-old with hypertension
D) A 30-year-old who is unemployed
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9
A nurse is faced with a macroeconomics issue. Which situation describes what is happening?
A) The evaluation of client access to services
B) A health policy that makes the development of a new program possible
C) Informing clients and others of the cost of service
D) The referral of clients to available services
A) The evaluation of client access to services
B) A health policy that makes the development of a new program possible
C) Informing clients and others of the cost of service
D) The referral of clients to available services
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10
A nurse evaluates a smoking cessation program, the gained or increased financial income, the improvements in the community attributable to the program, and the costs that would result if the program was not offered. Which term best describes the action of the nurse?
A) Cost-effectiveness analysis
B) Cost-benefit analysis
C) Supply and demand
D) Microeconomic theory
A) Cost-effectiveness analysis
B) Cost-benefit analysis
C) Supply and demand
D) Microeconomic theory
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11
The allocation of scarce resources within the health care sector and the focus on resource allocation issues related to producing and distributing health care is referred to by what term?
A) Economics
B) Health economics
C) Public health economics
D) Microeconomic theory
A) Economics
B) Health economics
C) Public health economics
D) Microeconomic theory
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12
A nurse implements a teen pregnancy prevention program in a high school that has been shown to decrease the rate of teen pregnancy. Which term best describes the nurse's action?
A) Effectiveness
B) Efficiency
C) Microeconomics
D) Production
A) Effectiveness
B) Efficiency
C) Microeconomics
D) Production
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13
A nurse is promoting efficiency within the public health department. Which activity describes the action the nurse would be taking?
A) Evaluating how well a program of service achieves what was intended
B) Trying new products provided by sales representatives
C) Using time wisely by delegating non-nursing tasks to unlicensed care providers
D) Setting up a clinic to look aesthetically pleasing to clients
A) Evaluating how well a program of service achieves what was intended
B) Trying new products provided by sales representatives
C) Using time wisely by delegating non-nursing tasks to unlicensed care providers
D) Setting up a clinic to look aesthetically pleasing to clients
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14
The first stage of development of the health care system was characterized by what event?
A) The rise in technology
B) Epidemics of infectious disease, such as typhoid, influenza, and malaria
C) Physicians and nurses who attained their skills in scientifically based programs
D) An expansion of hospital clinics and long-term care facilities
A) The rise in technology
B) Epidemics of infectious disease, such as typhoid, influenza, and malaria
C) Physicians and nurses who attained their skills in scientifically based programs
D) An expansion of hospital clinics and long-term care facilities
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15
A nurse plans to implement a primary prevention strategy in the community. The development of which program would the nurse most likely complete?
A) Smoking prevention
B) Support group for widows
C) Hypertension screening
D) A hospice care
A) Smoking prevention
B) Support group for widows
C) Hypertension screening
D) A hospice care
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16
What is a characteristic of the fourth developmental stage of the health services delivery framework?
A) Nurses in the United States being predominantly women
B) The expansion of the number and type of health care facilities
C) Dependence on technology for patient care
D) The discovery and development of pharmacological advances
A) Nurses in the United States being predominantly women
B) The expansion of the number and type of health care facilities
C) Dependence on technology for patient care
D) The discovery and development of pharmacological advances
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17
A public health nurse applies the principles of the macroeconomics theory when working with a community. Which statement best describes why this theory would be used?
A) The nurse is concerned with factors that determine prices and affect resource allocation.
B) The nurse is concerned with the positive effect of competitiveness on health care costs.
C) The nurse is concerned with the supply, demand, and costs of services available to their clients.
D) The nurse is concerned with the policies to support programs to improve the health of the community.
A) The nurse is concerned with factors that determine prices and affect resource allocation.
B) The nurse is concerned with the positive effect of competitiveness on health care costs.
C) The nurse is concerned with the supply, demand, and costs of services available to their clients.
D) The nurse is concerned with the policies to support programs to improve the health of the community.
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18
A business offers wellness incentives to its employees and then notices a decrease in the frequency of physician visits among employees. Which term best describes what has happened?
A) Macroeconomic theory
B) Efficiency
C) Supply and demand
D) Microeconomic theory
A) Macroeconomic theory
B) Efficiency
C) Supply and demand
D) Microeconomic theory
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19
Which legislation was considered the first national health insurance plan in the United States?
A) Health Maintenance Organization (HMO) Act
B) Marine Hospital Service
C) Medicare
D) Medicaid
A) Health Maintenance Organization (HMO) Act
B) Marine Hospital Service
C) Medicare
D) Medicaid
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20
A nurse is using the principles of supply and demand in daily practice. Which situation describes this phenomenon?
A) The demand for nurses in public health is low, but the supply is high.
B) When few goods or services are available, the price tends to rise.
C) When supplies are low, nurses must find alternate resources.
D) Lesser-developed countries receive supplies from other countries.
A) The demand for nurses in public health is low, but the supply is high.
B) When few goods or services are available, the price tends to rise.
C) When supplies are low, nurses must find alternate resources.
D) Lesser-developed countries receive supplies from other countries.
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21
Medicare and Medicaid are accurately described by which statement?
A) Both are available to any citizen who wishes to enroll.
B) They are two federal programs that provide insurance to special groups.
C) Both are private insurance providers.
D) They are funded by the state government.
A) Both are available to any citizen who wishes to enroll.
B) They are two federal programs that provide insurance to special groups.
C) Both are private insurance providers.
D) They are funded by the state government.
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22
Which statement about the Medicare program is accurate?
A) Part A provides coverage for hospitalization.
B) Part A requires payment of a monthly premium for coverage.
C) Part B provides payment for home health services and extended care facilities.
D) Part B is available without cost to all elderly people who have paid social security taxes.
A) Part A provides coverage for hospitalization.
B) Part A requires payment of a monthly premium for coverage.
C) Part B provides payment for home health services and extended care facilities.
D) Part B is available without cost to all elderly people who have paid social security taxes.
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23
What term is used to describe when a health care organization's fees for delivery of services are not decided until after they are provided?
A) Retrospective reimbursement
B) Prospective reimbursement
C) Fee-for-service
D) Capitation
A) Retrospective reimbursement
B) Prospective reimbursement
C) Fee-for-service
D) Capitation
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24
A physician receives a set amount of money to provide care to a given group of clients for a set period of time. Which term is being described?
A) Retrospective reimbursement
B) Prospective reimbursement
C) Fee-for-service
D) Capitation
A) Retrospective reimbursement
B) Prospective reimbursement
C) Fee-for-service
D) Capitation
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25
An employee can receive health insurance from a former employer after changing jobs. The enactment of which legislation makes this possible?
A) Health Insurance Portability and Accountability Act (HIPAA)
B) Omnibus Budget Reconciliation Act
C) Balanced Budget Act of 1997
D) Social Security Act of 1935
A) Health Insurance Portability and Accountability Act (HIPAA)
B) Omnibus Budget Reconciliation Act
C) Balanced Budget Act of 1997
D) Social Security Act of 1935
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26
A nurse is caring for a client who has end-stage kidney failure and is on dialysis. The nurse recognizes that this client is eligible for which form of insurance?
A) Medicaid
B) Blue Cross
C) Medicare
D) Health Maintenance Organization (HMO)
A) Medicaid
B) Blue Cross
C) Medicare
D) Health Maintenance Organization (HMO)
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27
A nurse is working with a client who receives health insurance through a managed care organization. Which term best describes this form of insurance?
A) Medicare
B) Medicaid
C) Medical savings accounts (MSAs).
D) Health maintenance organizations
A) Medicare
B) Medicaid
C) Medical savings accounts (MSAs).
D) Health maintenance organizations
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28
Factors that influence health care costs include which of the following? (Select all that apply.)
A) Technology and intensity
B) Demographics-the aging population
C) Chronic illness
D) Use of the health care system
E) Type of health care insurance
A) Technology and intensity
B) Demographics-the aging population
C) Chronic illness
D) Use of the health care system
E) Type of health care insurance
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29
Which client is most likely to have enrolled in Medicaid?
A) An 85-year-old female who has hypertension.
B) A 25-year-old female who is pregnant.
C) A 50-year-old male who is blind.
D) A 70-year-old male who is hearing impaired.
A) An 85-year-old female who has hypertension.
B) A 25-year-old female who is pregnant.
C) A 50-year-old male who is blind.
D) A 70-year-old male who is hearing impaired.
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30
A Medicare recipient has elected to pay a monthly premium for Medicare that will cover expenses, such as laboratory services and equipment. Which part of Medicare is being described?
A) Part A
B) Part B
C) Part C
D) Part D
A) Part A
B) Part B
C) Part C
D) Part D
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31
Which statement about the reimbursement of health services for nurses is accurate?
A) Reimbursement for health care services can be directed only to physicians.
B) Nurse practitioners and clinical nurse specialists are reimbursed for Medicare Part B services.
C) Nursing care is a separate budget item in determining hospital service costs.
D) Nursing care is reimbursed separately from medical care in outpatient settings.
A) Reimbursement for health care services can be directed only to physicians.
B) Nurse practitioners and clinical nurse specialists are reimbursed for Medicare Part B services.
C) Nursing care is a separate budget item in determining hospital service costs.
D) Nursing care is reimbursed separately from medical care in outpatient settings.
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32
What term is used to describe when a third-party payer establishes the amount of money that will be paid for the delivery of a service before offering the service to the client?
A) Retrospective reimbursement
B) Prospective reimbursement
C) Fee-for-service
D) Capitation
A) Retrospective reimbursement
B) Prospective reimbursement
C) Fee-for-service
D) Capitation
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33
A nurse is discussing the services that are covered under Medicare Part A with a client who has recently become eligible for Medicare. Which service is the nurse most likely to mention?
A) Blood drawing to assess prothrombin time (PT)/International Normalized Ratio (INR)
B) Physical therapy rehabilitation
C) Skilled nursing facility care
D) Ambulance transportation
A) Blood drawing to assess prothrombin time (PT)/International Normalized Ratio (INR)
B) Physical therapy rehabilitation
C) Skilled nursing facility care
D) Ambulance transportation
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