HCM exam S1

Question 1

define health

Answer 1

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

Question 2

what was the leading cause of death in the US in 2007

Answer 2

diseases of the heart

Question 3

what is the central focus of health care

Answer 3

restore health or prevent exacerbation of health problems

Question 4

what is the goal of primary health care

Answer 4

prevention (eliminate risk factors for a disease)

Question 5

what is the goal of secondary prevention

Answer 5

early detection of disease so treatment is more effective

Question 6

what is the focus of tertiary prevention

Answer 6

focuses on treatment of identified disease to reduce the incidence of later complications

Question 7

what are the management elements of healthcare

Answer 7

administration, planning, regulation and evaluation

Question 8

what criteria can health care systems be judged on

Answer 8

quality of health care provided, equity achieved in the provision of health care, efficiency

Question 9

what does primary care include

Answer 9

personal treatment and preventive measures

Question 10

what type of care do most people need most of the time

Answer 10

primary care

Question 11

what does secondary care include

Answer 11

most surgical procedures, diagnostic and treatment interventions of specialists

Question 12

what are the 2 main types of health care facilities

Answer 12

inpatient and outpatient

Question 13

what are the 4 ways to categorize hospitals

Answer 13

by control, size, function and average length of patient stay

Question 14

what are the 4 functional categories of inpatient care

Answer 14

general, special, rehabilitation and chronic disease, psychiatric

Question 15

what type of hospitals are all non-federal, short-term general and special hospitals whose facilities and serves are available to the public

Answer 15

community hospitals

Question 16

what is the average number of people served on an inpatient basis on a single day

Answer 16

average daily census

Question 17

what accounts for the largest portion of US health care spending

Answer 17

hospitals (31%)

Question 18

what is the primary agency that counts and classifies hospitals in the US

Answer 18

AHA

Question 19

what percentage of nonfederal hospitals are community hospitals

Answer 19

86%

Question 20

what is the role of the executive committee

Answer 20

provides overall coordination and sets general policy

Question 21

what is the role of the joint conference committee

Answer 21

serves as liaison between the medical staff and the hospital’s governing board

Question 22

what is the role of the credentials committee

Answer 22

reviews applications to join the medical staff and controls the periodic reappointment process

Question 23

what percentage of nursing homes are for-profit

Answer 23

66%

Question 24

what percentage of nursing homes are not-for-profit

Answer 24

26%

Question 25

where does the majority of nursing home financial support come from

Answer 25

public funds

Question 26

what type of care is given to a person who is not a bed patient in a health care institution

Answer 26

ambulatory care

Question 27

what setting do most physician-patient contacts occur

Answer 27

ambulatory care settings

Question 28

what speciality is visited the most in ambulatory care settings

Answer 28

general and family practice

Question 29

what is the major source of payment for ambulatory visits

Answer 29

private insurance

Question 30

what are the 3 categories presenting to EDs

Answer 30

non urgent, urgent, emergent

Question 31

describe non urgent presentation to ED

Answer 31

condition does not require the resources of an ED (condition is not acute or is minor)

Question 32

what was the rate of ED visits for the uninsured in 2007

Answer 32

41.6 visits per 100 persons

Question 33

what was the rate of ED visits for persons with private insurance in 2007

Answer 33

19.9 visits per 100 persons

Question 34

what was the physician/population ratio in 2008

Answer 34

27.7 per 10,000

Question 35

what type of physicians have a gatekeeper function

Answer 35

primary care physicians

Question 36

under the US constitution, where does the federal government's authority concerning health and health services come from

Answer 36

the powers to tax and spend to provide for the general welfare and the ability to regulate interstate and foreign commerce

Question 37

what branch of the federal government writes regulations for administering legislation

Answer 37

executive branch

Question 38

what branch of the government determine if legislation is constitutional and if regulations exceed the original statutes

Answer 38

judicial branch

Question 39

what branch decides things if contract disputes occur

Answer 39

judiciary

Question 40

what is the most important federal agency involved in the delivery of healthcare

Answer 40

DHHS

Question 41

what is the focus of the FDA

Answer 41

efficacy and safety

Question 42

how long must someone serve for the armed services to be considered a veteran for VA services

Answer 42

90 days

Question 43

what is the name of the military health insurance program

Answer 43

TRICARE

Question 44

what does "therapeutics" include

Answer 44

equipment and pharmaceuticals

Question 45

what does national health expenditures (NHE) include

Answer 45

health consumption expenditures, investment in healthcare structures and equipment, noncommercial health care research to procure future health care expenditures

Question 46

what is most of the natural health expenditure from

Answer 46

person health care (84%)

Question 47

what is a deductible

Answer 47

fat amount that an individual or family must pay out-of-pocket before the insurance company will begin paying during some set time period

Question 48

what does MCO (managed care organization)determine

Answer 48

determines what care the patient is entitled to and under what circumstances

Question 49

when was medicare established and by what

Answer 49

by congress in 1965, authorized by title XVIII of the social security act

Question 50

describe part A of medicare

Answer 50

hospital insurance (covers limited skilled nursing care also)

Question 51

describe part B of medicare

Answer 51

supplementary medical insurance which covers physician and some other health professional services, hospital outpatient care, and some other services

Question 52

describe part C of medicare

Answer 52

permits medicare beneficiaries to enroll in managed care organizations

Question 53

describe part D of medicare

Answer 53

medicare prescription drug coverage which was designed to lower the cost of prescriptions for medicare beneficiaries

Question 54

what is part A of medicare funded primarily from

Answer 54

social security taxes

Question 55

what is part D of medicare funded from

Answer 55

through premiums

Question 56

what is the majority (2/3) of part B off medicare funded from

Answer 56

general revenues with the balance form enrollee premium payments

Question 57

what is medicare operated by

Answer 57

centers for medicare and medicaid services (CMS)

Question 58

how are payments for services determined in the RBRVS system

Answer 58

by the resource costs needed to provide them

Question 59

what components are the cost of providing services for medicare payments divided into

Answer 59

physician work, practice expense, professional liability insurance

Question 60

why were DRGs implemented

Answer 60

to control medicare expenditures

Question 61

describe medicaid

Answer 61

needs-based program that provides coverage for some health services for some of the poor on a "means tested basis"

Question 62

how is medicaid supported and administered

Answer 62

supported by federal and state tax funds and is administered by the states

Question 63

what 3 criteria are health care systems generally evaluated on

Answer 63

quality, equity, and efficiency of health care

Question 64

what was the average life expectancy for all US residents in 2011

Answer 64

78.7

Question 65

when was the children's health insurance program (CHIP) created

Answer 65

1997

Question 66

when was the sustainable growth rate (SGR) created

Answer 66

1997

Question 67

when was the medicare prescription drugs benefit (medicare part D) created

Answer 67

2003