Exam 1 Flashcards

1
Q

Managed Care

A

a health care system in which income, resources, and health services are supervised by managing body such as a health maintenance organization or preferred provider organization. Patients pay the organization a set fee each month to receive health insurance.

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2
Q

Diagnosis-Related Group

A

Establishes in advance what the funding agency will pay hospitals for specified proceedures.

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3
Q

Capitated System

A

a set (capitated) amount in the form of premiums (plus minor copays) no matter what care they provide.

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4
Q

Descartes & Cartesian Dualism

A

Every person has a soul and a body but that the two are not the same. The soul lives after the body dies.

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5
Q

Germ Theory

A

Germ theory states that disease is caused by microscopic organisms. Hospital personnel began cleansing their instruments and separating people with contagious diseases from other patients.

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6
Q

Religio-Empirical Approach

A

combining spiritualism and physical study

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7
Q

Festishes

A

Holy relics said to protect those who purchased them from calamities such as shipwreck, fire, lightning, and difficult child birth.

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8
Q

Deductible

A

The amount of out of pocket medical expense an insured individual is required to pay before receive financial assistance from the insurer.

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9
Q

Crisis Communication

A

an approach used by scientists and public health prof. to provide information that allows and individual, stakeholders, or an entire community to make the best possible decisions about their well-being, under nearly impossible time constraints, while accepting the imperfect nature of their choices.

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10
Q

Pay or play

A

employers must either offer their workers health benefits or contribute to the government-sponsored health care fund. (tax incentives are provided for small businesses and nonprofit organizations to offset these costs.)

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11
Q

Gag Rule

A

prohibit physicians from telling patients about costly treatment options

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12
Q

How does the World Health Organization define health?

A

A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

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13
Q

What is the difference between the biomedical model and the biopsychosocial model? Could you distinguish between the two through use of example?

A

the biomedical model is based on the premise that ill health is a physical phenomenon that can be explained, identified and treated through physical means. The biopsychosocial model takes into account peoples physical conditions, their thoughts and beliefs and their social expectations.

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14
Q

What is health communication, and what are the reasons for studying health communication, as outlined in your text and lecture?

A

personal goals, skills, cultural orientation, situational factors, and consideration of other people’s feelings. “The way we seek, process and share health information.” It is crucial to meeting medical goals, enhancing personal well-being , saving time and money, any making the most of health information.

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15
Q

What is more expensive: disease prevention or disease treatment?

A

Disease treatment

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16
Q

What does the job market look like for those interested in health-related fields?

A

Extremely strong and growing

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17
Q

Why was the Flexner Report important? What was its impact?

A

charged lots of medical schools in the country were lax in their coverage of biology and other sciences. Medical school standards became more demanding.

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18
Q

How do principles from the Hippocratic Oath apply to current, modern-day medical issues?

A

Give no deadly medicine, abortion, sexual misconduct, patient confidentiality.

19
Q

During the Middle Ages, was surgery acceptable? Where did most surgeons “hide” their practice?

A

Surgery was banned by the catholic church. Barbers offered surgeries because they had the tools to do so.

20
Q

What are the advantages and disadvantages of managed care?

A

Advantages
employers often offer managed care, it gives health care professionals a mean and an incentive to work together to provide innovative care in a cost-effective way.
strong incentive to streamline processes and eliminate wasteful practices. Makes health care more affordable. Makes the most of every health care dollar. Incentive to keep patients well. Invests in disease prevention and public education.
Disadvantages
Can’t choose your own caregivers, premiums have climbed steadily, caused americans to be completely uninsured, limit care to speed up patient visits, gag rules,

21
Q

What are the primary differences between the types of managed care? (HMO, PPO, High Deductible, etc.) How might physicians and patients view the benefits and disadvantages differently for each of these methods of managed care?

A

High maintenance organization (HPO) - one stop shop for members health needs, payed each month.
Preferred provider organization (PPO) - monthly premium, copay is not a prescribed amount, pay a percentage of the medical bill, usually a catastrophe cap.
High deductible health plan - members pay low premiums, deductibles are higher and catastrophic cap is much higher.

22
Q

If a hospital cuts costs and is able to provide care for less money than the capitated fees it receives, what happens?

A

???

23
Q

What are some reasons why individuals might support universal coverage? Why might others fail to support universal coverage?

A

Some feel it is a moral obligation to provide health care for everyone, financial considerations.

24
Q

How did public health practitioners respond to the 2003 SARS outbreak?

A

Reported cases promptly WHO and other agencies were able to monitor and contain new outbreaks as much as possible. Quarantines worked, officials worked internationally to limit travel. Kept everyone informed and stopped it at the source.

25
Q

What are the elements of the World Health Organization’s Pandemic Flu response plan?

A

?

26
Q

What did the two clips we viewed from the documentary Sicko teach us about managed care and the US health system?

A

?

27
Q

Indemnity Insurance

A

a supplemental form of liability coverage specific to certain professionals or service providers who offer advice, expertise or services.

28
Q

Individual Mandate

A

to obtain private health insurance instead of (or in addition to) a national health insurance plan

29
Q

Public Health

A

the health of the population as a whole, especially as monitored, regulated, and promoted by the state

30
Q

Reimbursement rate/restriction

A

Set for gov-funded health plans have become a baseline of sorts. Reimbursement rates limit the care that health agencies are willing or able to provide.

31
Q

Principle of Verification

A

do not believe if you cannot prove it - look for verifiable signs of illness not just their feelings.

32
Q

Fee for Service

A

the practice of being paid for specific care provided

33
Q

Premium

A

A membership fee paid by subscribers in a conventional insurance or managed care plan. Usually deducted from one’s pay check.

34
Q

Co-Pay

A

The portion of health care bill the patient is required to pay when services are rendered.

35
Q

Orthodox Medicine

A

Scientific knowledge and technology could be used to eradicate disease.

36
Q

Sectarian Medicine

A

practiced folk medicine taught to them by friends and family

37
Q

Rational/empirical Approach

A

disease is best understood by careful observation and logical anaylisis

38
Q

Health Communication

A

the way we seek, process, and share health information

39
Q

Multi-Payer

A

when someone receives medical care, the bill may be paid by a number of sources (gov. sponsored programs, private insurance companies, and individuals)

40
Q

Risk Communication

A

an ongoing process that involves, not just one message, but many diverse messages about risk factors as well as interactive discussions about how people perceive these factors, how they judge the risks and how they feel about the risk messages themselves.

41
Q

Universal Coverage

A

Everyone is covered by tax payers.

42
Q

Single-Payer

A

one source - often the government, although it can be other sources such as a national health insurance company - pays all the bills.

43
Q

communication

A

the process of understanding and sharing meaning - process, personal goals, interdependence, sensitivity and shared meaning.