Medical societies were first established for the primary purpose of:
improving the quality of medical education and practice
In 1905, the American Medical Association, with support from the Carnegie Foundation, commissioned a study of U.S. medical schools in response to decades of concern about the quality of medical education and training. The resulting Flexner Report is considered a benchmark in the history of medical education because it;
stimulated licensing legislation and established new requirements pertaining to training lengths and quality standards in laboratories and other training facilities;
resulted in contributions of large sums of charitable dollars from foundations and wealthy individuals
In 1965, the federal government recognized the contributions of medical-school/teaching-hospital research and training activities in advancing the sophistication and effectiveness of medical care with the passage of:
Regional Medical Program legislation
Academic Health Centers may be best described as:
complexes of medical schools and other health professional schools--such as nursing, pharmacy, dentistry, and allied health--affiliated with each other and with teaching hospitals and other research and clinical facilities
Specialization in medical training, while resulting in high-quality care, also caused significant problems for the medical care delivery system. Such problems include:
higher costs and fragmentation of patient care continuity;
the tendency of specialists to concentrate practices in urban centers, leaving large geographic areas underserved;
an undersupply of generalist physicians
Health care reforms have begun changing the emphasis in medical practice from treating illness in individual patients to maintaining wellness in community populations. This shift poses major challenges to the medical education process because:
medical eduation and training has historically focused on curing illness, not preventing it;
the health care delivery system is largely operated as an "illness intervention" system;
community health and preventative medicine has historically been assigned low priority in medical school curricula
States try to protect the public from receiving incompetent care by licensing certain health professions. Certification differs from licensing, in that certification:
only recognizes special education or training
For more than a century, nurse midwives have provided valuablwe obstetrical services in the United States. Today, the need for midwives is:
growing along with the interest in "birthing centers"
Major influences on the evolution of the US health care financing system include:
a combination of employer, consumer, purchaser and provider influences
The health care system does not respond to the traditional market forces of supply and demand because:
the suppliers (doctors and other providers) influence the demand
Government's share of total heatlh care expenditures has remained stable recently, while costs have risen. The major reason for this stability is:
the offsetting effect of major increases in employer-sponsored heatlh insurance premiums
Historically, factors contributing to growth in health care spending have included:
additions of advanced technology;
specialization medicine;
reimbursement incentives
The increasing numbers of uninsured or underinsured Americans contribute to the high cost of health care because they:
tend to use hospital emergency services as their primary source of care
The fee-for-service system of reimbursement fueled high costs because it:
encouraged physcians and hospitals to use the maximum number of services;
placed few, if any, restrictions on patients' choice of services;
placed a strong emphasis on the quality of care
The prospective hospital reimbursement system introduced in 1983 was an effort to:
achieve cost savings by reducing excessive hospital lengths of stay;
align Medicare payments with the acutal costs of care;
provide incentives to hospitals for achieving economy in patient care costs, based upon diagnoses
In retrospect, implenmentation of the DRG system demonstrated that:
hospitals could profit from instituting more efficient patient care procedures
The Balanced Budget Act of 1997 may be charaterized as:
enacting sweeping reductions in Medicare and Medicaid spending while addressing access barriers to children's health services
Almost three-fourths of the 47 million individuals who lack health insurance in the US are:
in housholds or families where at least one person is working full time
The health care concept called "capitation" refers to:
for a prepaid premium, providers agree to provid all medical care an individual requires for a specified time period
An aim of managed care is to transfer some measure of financial risk to providers and to a lesser extent, to patients. Transferring financial risk to providers is accomplished by:
using fee withholds
A managed care pre-payment method that pays providers on a per-member basis whether or not services are used is called:
capitation
A feature of manage care is teh role of primary care provider as "gatekeepers." By requiring passage through the primary "gate" managed care organizations seek to:
avoid unnecessary use of high-cost services
The arrangment in which some managed care organizations pay on a fee-for-service basis but penalize providers if they exceed preset service targets is called:
a withhold plan
By focusing on insured "populations" rather than individuals, managed care organizations can project health service use by:
demographic factors such as age, gender, and area of residence
A goal of managed care is to control costs by controlling service utilization. It is accomplished primarily by:
reversing the financial incentives of fee-for-service reimbursement
The phenomenon of managed care "backlash" is best characterized by which of the following:
more than 1000 bills introduced to Congress to address a wide range of consumer issues about their health plans
Recent cost-control initiatives undertaken by managed care organizations to improve communications with chronic-disease patients in the hope of avoiding unnecessary, costly care are known by the term:
disease management
The United States history of institutional long-term care began with:
communal care settings operated by charitable community members
Which of the following best describes the informal long-term care system?
care and assistance provided in the home by family members and friends
What societal factors increases the need for formal long-term care services?
women working outside the home,
high divorce rates,
smaller family sizes
Long-term care and nursing-home reform legislation of the 1970s occurred as a response to which of the following:
widespread media reports and ensuing Congressional hearings on nursing home and residential care facility abuses and negligence AND national recognition of inadequate quality assurance and monitoring systems in the long-term care industry
The major distinction between skilled-nursing and residential care facilities is that skilled nursing facilities:
provide care primarily for people requiring intensive nursing, rehabilitation, or related services
Respite care refers to:
services that temporarily relieve informal caregivers through assistance in the home or through institutional placement on a temporary basis
The hospice movement is concerned with care for the terminally ill patient. Which of the following is/are major goal(s) of hospice care?
providing an alternative to the curative/intervention approach of hospitals in the care of the terminally ill AND providing state-of-the-art pain relief interventions while supporting the patient and his/her family through the life-death transition
Medicare reforms in oversight and payment for home health care services resulted from:
service audits documenting significant fraud and abuse of Medicare billing
A major reason why only a small percentage of those in need of mental health services actually receives them is:
mental health treatment is known to rarely be effective
One factor that does not affect the accurate diagnosis and treatment of mental illness in older adults is that:
physicians often fail to recognize and properly identify mental disorders
Respite care's duration is:
short-term, intermittent
The first professional nursing training program was at
Philadelphia Women's Hospital
The reasons for decline in nurses' dissatisfaction with employment conditions are:
Patient ratio, acuity, overtime
treat diseases, injuries of lower leg and foot
Podiatrist
Who are considered "complementary practitioners"?
chiropractors
State licensure is required for the following disciplines
chiropractic, nursing, physical therapist, occupational therapist
The following are therapeutic science practitioners
physical therapist, physician assistants, occupational therapists, speech pathologists
The modern model of Hospice was developed by
Cicely Saunders, 1960's
One of the main purposes of Hospice is
Palliative Care
Respite Services are approved by Medicare
PAY small co-pay
