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Foundations of Health Services > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Define concept

A

An abstract idea formed by generalizing observations.

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2
Q

Define theory

A

A system of relationships between concepts.

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3
Q

List four (4) examples of concepts

A
  1. Quality
  2. Productivity
  3. Effectiveness
  4. Social Network
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4
Q

Define construct

A

Another word for “concept” when talking about a particular theory.

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5
Q

Define variable

A

Measurable concepts.

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6
Q

Define operationalization

A

The process of relating a concept to a variable to further the explanatory power of a theory.

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7
Q

What are the four (4) functions of scientific theories

A
  1. Understanding
  2. Explanation
  3. Prediction
  4. Fruitfulness
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8
Q

What are three theory-evaluation criteria?

A
  1. Formalization
  2. Falsifiability
  3. Accuracy
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9
Q

Define self efficacy

A

People will only try to do what they think they can do.

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10
Q

What are four (4) theoretical constructs for building self-efficacy

A
  1. Mastery experience (e.g. patient training)
  2. Vicarious experiences (e.g. observing others doing the behavior)
  3. Verbal persuasion (e.g. pharmacist counseling)
  4. Reduction of stress (e.g. reduce fear)
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11
Q

What fundamental concepts does the Health Belief model relate?

A
  1. Health-related behavior

2. Behavioral interventions

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12
Q

What are the six (6) constructs of HBM?

A
  1. Perceived susceptibility
  2. Perceived severity
  3. Perceived barrier
  4. Perceived benefits
  5. Self-efficacy
  6. Cues to action
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13
Q

What are the four (4) constructs of the Anderson model?

A
  1. Predisposing characteristics
  2. Enabling factors
  3. Perceived need
  4. Use of health services
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14
Q

What fundamental concepts does the Anderson Model relate?

A
  1. Patient characteristics

2. Use of health services

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15
Q

Health management involves what two types of behaviors?

A
  1. Health Behavior

2. Illness behavior

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16
Q

What is the difference between health behavior and illness behavior? Use the example of hypertension.

A

Healthy behavior is checking blood pressure BEFORE diagnosis (prophylactic), while illness behavior is checking blood pressure AFTER diagnosis.

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17
Q

Using these health behavior models, what is the ROLE of the PHARMACIST in TREATMENT?

A

Align BELIEF ABOUT BEHAVIOR (e.g. extent of adherence) with ACTUAL BEHAVIOR.

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18
Q

What are two models for describing self-regulation of illness behavior?

A
  1. Common Sense model (leventhal)

2. Explanatory Model (Kleinman)

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19
Q

What are the six (6) constructs of illness for the Common Sense model?

A
  1. Identity
  2. Consequences
  3. Time-line
  4. Temporal Course
  5. Cause
  6. Cure
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20
Q

What are the six (6) constructs of illness for the explanatory model?

A
  1. Severity
  2. Timing and mode of onset
  3. Pathophysiology
  4. Natural History
  5. Etiology
  6. Treatments
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21
Q

What are three (3) ways OTC medications help save U.S. healthcare system resources?

A
  1. Cost savings of the drug
  2. Cost savings of avoiding healthcare providers.
  3. $102B annual saved by self-care and OTC.
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22
Q

Contrast the regulation of dietary supplements with OTC medications

A
  1. Supplements are regulated similar to food approval

2. OTC are regulated similar to prescription drugs (abbreviated steps).

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23
Q

What are four (4) qualifications of an OTC drug

A
  1. Does not require healthprovider access for SAFETY and EFFICACY
  2. Low ABUSE potential
  3. Patient can SELF-DIAGNOSE condition
  4. Adequately LABELED
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24
Q

When did the FDA begin requiring Drug Facts labels for OTCs?

A

2002

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25
Q

What are three (3) models used by pharmacists for [self-care assessment] and [consultation]

A
  1. QuEST
  2. SCHOLAR
  3. MACS
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26
Q

What are the four (4) constructs of QuEST model?

A
  1. Qu: Quickly and accurately assess patient [using SCHOLAR]
  2. E: Establish the patient is appropriate self-care candidate
  3. S: Suggest appropriate strategies.
  4. T: Talk (direction, counseling)
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27
Q

What are seven (7) constructs of SCHOLAR model?

A
  1. Symptoms
  2. Characteristics
  3. History
  4. Onset
  5. Location
  6. Aggravating factors
  7. Remitting factors
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28
Q

What are four (4) constructs of MACS?

A
  1. Medications
  2. Allergies
  3. Coexisting
  4. Social History
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29
Q

What are four (4) SAFETY concerns with self-care?

A
  1. IMPROPER treatment
  2. DUPLICATION of therapy
  3. INTERACTIONS (Drug-Drug/Drug-Disease)
  4. MISINFORMATION from brand extension.
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30
Q

What are three CORRECT ways to coach?

A
  1. Listen
  2. Ask
  3. Reflect
31
Q

What are three INCORRECT ways to coach?

A
  1. Talk
  2. Tell
  3. Comment
32
Q

What are five (5) types of coaches?

A
  1. Health
  2. Wellness
  3. Life
  4. Fitness
  5. Business
33
Q

What is the difference between a health coach and a wellness coach? (2 components)

A
  1. Wellness coaches are not necessarily HEALTH professionals.
  2. Health coaches focus on managing MEDICAL conditions.
34
Q

List three (3) models used in health coaching

A
  1. Transtheoretical model of behavior change
  2. Motivational Interviewing
  3. SMART goals
35
Q

What is the difference between self-management and self-care? (2 components)

A
  1. Self-management is focused on health AND illness behavior.
  2. Self-care is focused on illness behavior.
36
Q

What are the five (5) constructs of the Five A’s Model of Self-Management?

A
  1. Assess
  2. Advise
  3. Agree
  4. Assist
  5. Arrange
37
Q

What are five strategies for behavior-change intervention?

A
  1. Ask open-ended questions
  2. Use reflective listening
  3. Assess readiness (listen for cues)
  4. Ask permission
  5. Voice confidence
38
Q

What are five (5) pitfalls of health coaching?

A
  1. Patients may want a FIX
  2. Patient NOT READY
  3. Discouraged by FAILURE
  4. LOFTY goals
  5. Tendency to give ADVICE
39
Q

What six (6) fundamental economic principles are useful for a pharmacist?

A
  1. Trade-offs
  2. Cost
  3. Marginality
  4. Incentives
  5. Externality
  6. Utility
40
Q

What is a trade-off?

A

For a quality to be gained, a different quality is often sacrificed.

41
Q

Draw a tree for the types of costs in healthcare.

A 
1. Total cost
A. Tangible
a. Direct
i. Direct Medical
ii. Direct Nonmedical
b. Indirect
B. Intangible
42
Q

How does marginality relate to rationality?

A

A rational decision is when marginal benefit is greater than marginal cost.

43
Q

What is an incentive?

A

An incentive is a motivation to act.

44
Q

What is an externality?

A

A cost or benefit received by an individual that did not make the decision.

45
Q

What are three (3) ways externalities are managed?

A
  1. Regulations
  2. Pigouvian tax
  3. Market solution (Coase theorem: (1) property rights (2) negotiation possible)
46
Q

What is the relationship between utility and decision-making?

A

Rational individuals make a decision with the greatest utility.

47
Q

What are three (3) components of the utility function: U(x1,x2)= 3x1 - 6x2 = 6

A
  1. Components (e.g. U(x1,x2)
  2. Factor loading (e.g. 3x1 - 6x2)
  3. Total utility (e.g. 6)
48
Q

Define the health productions function mathematically

A

A = f(B;C)

A: Output (measurement of health; e.g. # of healthy days)
B: modifiable input (e.g. treatment)
C: nonmodifiable input (e.g. citizenship, age)

49
Q

Define the marginal product of health (2 components)

A
  1. MP = Change in # of Health Days / Change in Amount of Healthcare
  2. Represents EFFICIENCY of producing health.
50
Q

Describe the relationship between rational decisions, healthcare utilization and marginal product of health.

A
  1. A rational health decision is one in which the marginal product of health is greater than the marginal cost of health.
  2. The marginal product of health is determined by the health production function.
  3. An input in the health production function is healthcare utilization.
51
Q

Health is both a ______ commodity and a ______ commodity.

A
  1. Consumption (intrinsic value)

2. Investment (instrumental value – it gives us returns).

52
Q

Health is a _____ stock

A

Capital – asset used to produce goods.

53
Q

What does the Grossman model propose in regard to the utility function?

A
  1. Health, NOT healthcare, belongs in the utility function.

2. We do not demand healthcare.

54
Q

The U.S healthcare system is a “quilt with holes” – what are the holes and what is done with them?

A

Uninsured people/peopl who cannot afford. The holes are filled with third party payers.

55
Q

What are five (5) examples of third party payers

A
  1. Medicare
  2. Medicaid
  3. Private employer
  4. Private individual
  5. Other (Indian Health Service, Worker’s compensation, Veteran)
56
Q

All third party payers have what two (2) goals?

A
  1. Minimize costs

2. Maximize quality of care

57
Q

Private third party payer have what additional goal?

A

Maximize profit

58
Q

Who does Medicare finance?

A

Old (>65) and/or Disabled

59
Q

Who does Medicaid finance?

A

Poor and/or Disabled

60
Q

Third party payers can have a short-term or a long-term outlook. Describe what this looks like using the example of a vaccine.

A
  1. Short-term outlook would choose a yearly vaccine (cheaper in the short term).
  2. Long-term outlook would choose a lifetime vaccine (more expensive in the short term).
61
Q

What is a Pharmacy Benefit Manager (PBM)?

A

The organization/party from whom the pharmacy usually received payment.

62
Q

What tasks is a Pharmacy Benefit Manager responsible for?

A
  1. Create pharmacy networks
  2. Process insurance claims
  3. Design formularies
  4. Leverage bargaining power to lower drug cost.
63
Q

What three (3) sources fund Medicare?

A
  1. General fund (e.g. from Gov’t budget)
  2. Payroll tax
  3. Premiums
64
Q

What three (3) sources fund Medicaid?

A
  1. State funds
  2. Federal funds
  3. Premiums
65
Q

What two (2) sources fund Employee private insurance?

A
  1. Employer premiums

2. Employee premiums

66
Q

What source funds individual private insurance?

A

Individual premium

67
Q

List three (3) examples of imperfect information in healthcare

A
  1. Treatment outcomes uncertain
  2. Treatment prices uncertain
  3. Lack of consumer reports
68
Q

What results in a demand for insurance?

A

Threshold risk of catastrophic loss.

69
Q

What are four ways loss in health are different from loss in other things?

A
  1. Difficult to quantity loss (e.g. how to define?)
  2. Uncertain whether loss will require continuous or discrete healthcare investment.
  3. Depending on how it is defined, frequency of loss can be very frequent or very infrequent.
70
Q

Define expected loss

A

The amount of loss * The probability of loss.

71
Q

Name five (5) phenomena that arise from the existence of health insurance

A
  1. Change probability of illness (e.g. probability of loss)
  2. Change amount of healthcare investment in event of loss.
  3. Provider-induced demand
  4. Increase in amount of technology that only serves marginal patients.
  5. Decrease incentive to “price shop.”
72
Q

What are two components of health insurance?

A
  1. Risk removal

2. Prepayment (e.g. when probably is approx. 1)

73
Q

What are benefits of using health insurance for RISK REMOVAL

A

This is related to avoiding catastrophic loss.

74
Q

What are benefits of using health insurance for PREPAYMENT?

A
  1. Employer may shield total premium.
  2. Tax subsidy
  3. Bargaining power

Foundations of Health Services (3 decks)

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