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HCM S1 > HCM exam S1 > Flashcards

HCM exam S1 Flashcards

1
Q

define health

A

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

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2
Q

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

A

diseases of the heart

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3
Q

what is the central focus of health care

A

restore health or prevent exacerbation of health problems

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4
Q

what is the goal of primary health care

A

prevention (eliminate risk factors for a disease)

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5
Q

what is the goal of secondary prevention

A

early detection of disease so treatment is more effective

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6
Q

what is the focus of tertiary prevention

A

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

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7
Q

what are the management elements of healthcare

A

administration, planning, regulation and evaluation

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8
Q

what criteria can health care systems be judged on

A

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

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9
Q

what does primary care include

A

personal treatment and preventive measures

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10
Q

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

A

primary care

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11
Q

what does secondary care include

A

most surgical procedures, diagnostic and treatment interventions of specialists

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12
Q

what are the 2 main types of health care facilities

A

inpatient and outpatient

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13
Q

what are the 4 ways to categorize hospitals

A

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

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14
Q

what are the 4 functional categories of inpatient care

A

general, special, rehabilitation and chronic disease, psychiatric

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15
Q

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

A

community hospitals

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16
Q

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

A

average daily census

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17
Q

what accounts for the largest portion of US health care spending

A

hospitals (31%)

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18
Q

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

A

AHA

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19
Q

what percentage of nonfederal hospitals are community hospitals

A

86%

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20
Q

what is the role of the executive committee

A

provides overall coordination and sets general policy

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21
Q

what is the role of the joint conference committee

A

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

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22
Q

what is the role of the credentials committee

A

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

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23
Q

what percentage of nursing homes are for-profit

A

66%

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24
Q

what percentage of nursing homes are not-for-profit

A

26%

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25
Q

where does the majority of nursing home financial support come from

A

public funds

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26
Q

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

A

ambulatory care

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27
Q

what setting do most physician-patient contacts occur

A

ambulatory care settings

28
Q

what speciality is visited the most in ambulatory care settings

A

general and family practice

29
Q

what is the major source of payment for ambulatory visits

A

private insurance

30
Q

what are the 3 categories presenting to EDs

A

non urgent, urgent, emergent

31
Q

describe non urgent presentation to ED

A

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

32
Q

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

A

41.6 visits per 100 persons

33
Q

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

A

19.9 visits per 100 persons

34
Q

what was the physician/population ratio in 2008

A

27.7 per 10,000

35
Q

what type of physicians have a gatekeeper function

A

primary care physicians

36
Q

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

A

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

37
Q

what branch of the federal government writes regulations for administering legislation

A

executive branch

38
Q

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

A

judicial branch

39
Q

what branch decides things if contract disputes occur

A

judiciary

40
Q

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

A

DHHS

41
Q

what is the focus of the FDA

A

efficacy and safety

42
Q

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

A

90 days

43
Q

what is the name of the military health insurance program

A

TRICARE

44
Q

what does “therapeutics” include

A

equipment and pharmaceuticals

45
Q

what does national health expenditures (NHE) include

A

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

46
Q

what is most of the natural health expenditure from

A

person health care (84%)

47
Q

what is a deductible

A

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

48
Q

what does MCO (managed care organization)determine

A

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

49
Q

when was medicare established and by what

A

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

50
Q

describe part A of medicare

A

hospital insurance (covers limited skilled nursing care also)

51
Q

describe part B of medicare

A

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

52
Q

describe part C of medicare

A

permits medicare beneficiaries to enroll in managed care organizations

53
Q

describe part D of medicare

A

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

54
Q

what is part A of medicare funded primarily from

A

social security taxes

55
Q

what is part D of medicare funded from

A

through premiums

56
Q

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

A

general revenues with the balance form enrollee premium payments

57
Q

what is medicare operated by

A

centers for medicare and medicaid services (CMS)

58
Q

how are payments for services determined in the RBRVS system

A

by the resource costs needed to provide them

59
Q

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

A

physician work, practice expense, professional liability insurance

60
Q

why were DRGs implemented

A

to control medicare expenditures

61
Q

describe medicaid

A

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

62
Q

how is medicaid supported and administered

A

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

63
Q

what 3 criteria are health care systems generally evaluated on

A

quality, equity, and efficiency of health care

64
Q

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

A

78.7

65
Q

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

A

1997

66
Q

when was the sustainable growth rate (SGR) created

A

1997

67
Q

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

A

2003

HCM S1 (1 decks)

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