HCR300 Final Review – Midterm questions included in pool of questions – 133 questions in pool, system will randomly draw 100 questions.

1. Health care planners use the concept of natural history of disease to design services that intervene at the weakest link in the chain of progression of specific diseases… false

2. To judge the effects of medical treatment, researchers now measure social functioning… sense of well being satisfaction with care… true

3. Hospitals in the future will – provide a narrower range of services4. Ambulatory care encompasses all care that less than 23-hour stay… true5. Meaningful health care financing reform through government intervention has

been thwarted through periodic shifts in political views of administrations…true6. Managed behavioral health organizations strictly manage service utilization by –

All of the above7. For decades, … sought support - solve support that would ensure payment for

their services – false8. The social model adult day care – provides supervised social activities in a group

setting outside the home9. Nationwide discussion and controversy over the security act significantly…

awareness… health care system reforms – true10. In the 1960’s, congress assigned a health related programs Medicare and

Medicaid to the public health service – false11. There’s growing awareness that… economic benefits… diagnosis and treatment –

true12. Evidence based medicine requires physicians to limit treatments to those

procedures that have been proven effective – false13. When patients adopt the sick role, they – advocate all responsibility for recovery

to medical authorities14. A significant percentage of clinical treatment decisions are not supported by

evidence of effectiveness – true15. States are reluctant to legislate reforms while congress waffles health care bills –

false16. Though physicians believe… could and should judge quality of medical care, they

found such peer review activities a most disagreeable – true17. among other factors, the use of formal home care services continues to increase

because – choices a & b18. current and evolving research demonstrates psychiatric disorders are biologically

based illnesses requiring specific … targeted treatments – true19. quality and medical care may be defined as the greatest benefit at the lowest risk –

true20. while the health care system itself is in turmoil, the sciences within health care are

making progress—true21. throughout the first half of the 20th century, mental illness treatment was largely

based in inpatient institutions – true22. the marketplace is continuing to exert influences upon cost and competition in the

health care industry – true

23. in the future, those in the health care workforce can expect – continued experimentation and variation in staffing

24. health care reforms have dramatically increased the power prestige, and independence… specialists getting referrals from generalist physicians serving as managed care gatekeepers – false

25. prior to the advent of managed care, Americans more cost conscious about health care than they are today – false

26. the US met 85% of the challenging health goals of healthy people 2000 – false27. in November of 1999 the IOM issued a report on the quality of medical care…

preventable medical mistakes… america’s highways – true28. insurance company pre-payment to providers helps to control cost by requiring

providers to share financial risk with insurers – true29. avenues through which nursing home quality of care is regulated include –

stringent criteria… state licensing and federal certification30. health care reforms have produced the greatest change in – hospital inpatient days31. medical care at teaching hospitals is more efficient and less costly because senior

physicians have to consult with.. doctors – false32. one of the major changes resulting from managed care is the requirement of

providers to assume accountability for – individual treatment decisions33. during the last 20 years, the number of women in medical schools, more than

doubled, minority tripled – true34. hospitals striving to find new sources of income since the advent of prospective

payment have adopted – subacute care35. states try to protect the public from receiving incompetent care by licensing

certain professional certification – only recognizes special education or training36. significant historical influence in establishing treatment rather than prevention as

the first priority of us medical care was – insurance companies wouldn’t pay37. health care industry in the us… major employer… false, 10 %38. the new federalism policies of republican congress strive to – transfer public

responsibilities from federal government to the states39. commercial rather than humanistic motives prompted early public health

measures in the us, uk, and other European countries – true40. even though various kinds of health professionals such as… physical therapists

are… educated in separate schools with little or no interdisciplinary contact – true41. The resulting Flexner report as a benchmark because it resulted in the closure of

all medical schools – false42. post-ww2 expansion of research and medical centers that encouraged… health

care professionals… inequitable access… runaway costs – true43. psychiatric diagnosis and treatment in older adults… special challenges… patients

tendency to minimize complaints about mental status – true44. epidemiology or population research is concerned with the… determinants in

human populations – true45. one factor believed to be contributing… nursing home occupancy – vastly

increased availability… community based services for older adults46. “operation restore trust” maybe best characterized as – federal program to

thwart…cost and quality of home health care

47. the advent of private health insurance through BCBS signaled a new role in the health care delivery system because it – all of the above

48. reasons cited for health insurance plans drawing from medicare managed care program include complex administrative procedures and inadequate reimbursement – true

49. hospitals are now reimbursed… patients care on a prospective basis. Based on cost of services provided – false

50. one aspect of health care that has not changed as the result of health care reforms… positions in hospitals. Workplace of physicians who exercise complete authority over services provided – false

51. consistent concerns – iron triangle access quality and cost – true52. since technical advances in health care have spawned.. specially trained

personnel… cross trained personnel who can perform multiple tasks – false53. which of the following was not a major factor fueling the emergence of managed

care in the 80’s – political initiatives… universal coverage54. hospital residency programs were established… service needs of hospitals rather

then provide mix of specialists and generalists – true55. academic health centers may best be described as – complexes consisting of

medical schools and other professional schools… teaching hospitals and medical facilities

56. the present form of health care financing… European financing after wwI – false57. the development of psychotropic medications contributed little… mental health

disorders – false58. the medical model of US health care…recognized… multiple needs of this

nations growing population of older adults – true 59. one health care occupation currently enjoying… growth – nursing60. growth in the numbers of older adults will affect US health care expenditures

because – older adults have high rates of chronic disease…younger counterparts61. a major reason for the expansion of ambulatory care services is technological

advances and treatment that have radically reduced… surgical procedures – true62. since many acute care services will be provided in ambulatory settings… role of

future hospitals will be to – provide intensive patient care and diagnosis and management of the chronically ill

63. today, families and friends are still primary providers of long term care services – true

64. by providing services to enrolled populations for a pre-paid fixed fee, HMO’s were expected to contain costs by – reversing the profit incentive

65. in judging the quality of hospitals, its well known that for complicated procedures such as open heart surgery, which is not related – location

66. managed care has caused the us health care system to – B (continuously monitor the… effectiveness)

67. most schools of medicine & professions & teaching hospitals are heavily subsidized by state funds… no obligation to society – true

68. well over ½ million jobs will be created for personal care and home health aides – all above

69. mental illness results in enormous… cost on… society. Indirect costs… -- reduced and lost productivity due to premature death… providing family care

70. in 1965 the federal government recognized… teaching hospital research and training activities… sophistication and effectiveness… passing of – regional medical program legislation

71. research studies may be observational or experimental. Main differences is in experimental investigations – the investigator applies experimental intervention

72. physicians are discontent under constraints that impeded their ability to use judgment freely… doctors bill of rights – false

73. medical leadership at national & state levels was instrumental in establishing the health care reforms that characterize todays health care – false

74. the HMO act of 1973 – provided loans and grants for planning…implementing… health care organizations

75. the federal government… john windburgs reports among physicians… by establishing policy in research… agency for research and quality, its mission is to – all of the above

76. since 1980 approx. 2000 hospitals closed in the US and hospital inpatient days declined by 1/3 – true

77. personally financed long term care insurance now contributes … long term care services – false

78. governments role in setting health care policy diminished after the 1993 heatlh security act and market driven reforms steered towards managed care – true

79. the service priorities of the us heatlh care system reflect.. high tech medicine. As a result – all of the above

80. like the relationship between client and lawyer… outside scrutiny – true81. definitions of medical quality are left to clinicians to… what is good care – false82. the human services sector of the mental health delivery system is best

characterized as consisting of – social services agency… (longest answer)83. the future role of government in public health is likely to – diminish what the

economic pressures of state and local budgets84. the trend in physicians becoming employees of medical groups…and health care

institutions is best described as – increasing85. insurance company policies play a significant role… from the hospital to the

ambulatory setting – true86. since 1980, efforts to reduce federal support… begun in the 1960’s include – all

of the above87. the correct definition of managed care is – D (A&C)88. in relation to insurance coverage for mental health services, the term parity is best

defined as requiring that – …same level as medical care89. within the last few years many states have passed legislation against the public

access… information, disciplinary… lost privileges – true90. in reference to managed care reimbursement for mental health service, curve

outs… financial risk to external vendors – true91. Ralph nader major role in reforms long term care industry – true

92. the health care reforms that promoted market oriented changes competition in managed care virtually eliminated – the historic charitable orientation of health care institutions and providers

93. the creative federalism programs of the Johnson era, … health care… improving access, the programs – fueled the inflationary spiral of health care costs

94. physicians are the only heatlh care practitioners are the only ones licensed to practice independently in ambulatory settings – false

95. specialization in medical training while resulting in high quality care also caused problems in the health care delivery system, these problems include – all of the above

96. most hospitals that survive the intense economic pressures…integrated system of care – true

97. health care proxy laws enable an individual to appoint an agent to make all medical decisions should that person be unable to make decisions – true

98. many insurers and managed care companies considered the therapies… less expensive and equally effective in feeling well – true

99. growing employment demands in the health care industry are rising principally from – technological advances resulting in new services & need for more personnel to provide them

100. one contributing factor to the crisis… health care industry staffing is – demanding working conditions, constrain employee compenstation

101. voluntary not for profit agencies provide important sources of health care to their communities. Established largely through – advocacy of cause related groups to address needs of populations with special heatlh care needs

102. there are over 200 allied health occupations – true103. in the 1980’s many hospital outpatient clinics were transformed. This

transformation may be characterized as – the recognition of revenue generating opportunities to help offset…

104. home care is essentially limited to individuals needing… following hospitalization – false

105. the evolution and implementation of the DRG medicare prospective payment methodology resulted from research documenting – all of the above

106. epidemiology or the study of health status in population…lacks application in mental health illness and health services planning – false

107. probability of nursing home admission increases in the presence of which of the following factors – A,C, & D

108. for more then a century, nurse midwives… the need for nurse midwives is – growing

109. the us government provided… disease specific programs… health care expenditures – true

110. point of service managed care plans – are growing in favor because they facilitate…out of network providers

111. the HMO act which promoted the first HMOs and led to the… managed care was passed in – 1973

112. lifestyle and social changes of the 60’s played little if any role in physician group practices – false

113. the ultimate responsibility for the quality of care in a hospital rests with – governing board

114. the most significant social legislation passed by any congress in the history of the US was – social security act of 1935

115. managed care gave primary care physicians… gatekeepers in health care. Gatekeeper role is controversial because – their own reimbursement linked to referrals

116. most skilled nursing facilities now operate as charitable not-for-profit organizations – false

117. the principle goal of HEDIS is to provide – C standardized…collect, calculate…to payers and consumers to allow comparisons among different plans

118. almost every technological advance seems to be accompanied by… of care. Properly and not overused, it would actually lower health care cost – true

119. the rights of volunteer participants are protected by – all of the above120. the American public continues to express an affirmative stance…

government control of its health care administration and financing – false121. recommendations of the 1999 surgeon general report on mental health

identify which of the following as a major near future challenge – transferring new evidence based treatments into diverse settings…existing delivery system

122. the early history of outpatient clinics may be best characterized as – stepchildren

123. after several reorganizations, the public health service became the major agency… responsible for the largest health program in the world – true

124. a major obligation of the physician when obtaining informed consent for medical procedures is to shield information…emotional side affects – false

125. the single most important impedus for helath care reform over 44 million uninsured Americans – false

126. individuals who have no or inadequate health insurance – B & D127. in the last few years, theres been an increased interest in outcomes

research, this is – evaluates results of heatlh care in hospitals, clinics and homes128. the future health care system will emphasize vertical integration. That

means tax payers will contract… broad continuum of care… – true129. rapidly increasing health care expenditures are due to a variety of factors.

Most important include – treatment and diagnostic advances, new pharmaceuticals

130. BCBS… modeled after baylors schoolteachers plan – true131. of the total us health care expenditures – hospital care contributes the

highest is the total health care expenditures132. the need for sweeping rather then… reforms was brought to the

forefront… grassroots movement – false133. the for profit health care sector has become a major player in ambulatory

care services - true