health and aandP Flashcards

1
Q

focuses on primary care first

A

HMO

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2
Q

Can see specialist without referral

A

PPO

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3
Q

how are MCOs financed

A

thru capitation and discounted fees

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4
Q

financed by the military and covers families, dependents, or retired military.

A

Tricare

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5
Q

VA=

A

veterans administration

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6
Q

VISN=

A

Veterans Integrated Service Networks

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7
Q

does Medicare or Medicaid NOT cover Long-Term Care?

A

Medicare

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8
Q

what % of health care is financed thru employers?

A

57%

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9
Q

what % of health care is financed thru the government?

A

43%

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10
Q

SJ focuses on

A

the community

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11
Q

MJ focuses on

A

the individual

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12
Q

complete state of knowledge

A

diagnosis

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13
Q

something that is measurable (ex: BP, temp)

A

sign

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14
Q

subjective (“my head hurts”)

A

symptom

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15
Q

According to WHO what is the definition of health

A

the complete state of mental, physical, and social well being, not merely the absence of disease.

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16
Q

what is the primary purpose of a health care system (according the WHO)

A

promote, restore, or maintain health

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17
Q

identified by a person’s perception of how they feel

A

Illness

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18
Q

based on professional evaluation

A

disease

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19
Q

example of a subacute disease

A

trauma in a wreck

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20
Q

HCAHCPS

A

Hospital consumer survey. first standardized survey

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21
Q

a person’s genetic makeup determine what % of health outcomes?

A

20%

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22
Q

Medical practice determines what percentage of health outcomes

A

10%

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23
Q

Individual behaviors determine what percentage of health outcomes

A

50%

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24
Q

social/environmental factors determine what percentage of health outcomes

A

20%

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25
Q

first asylum was built in what year?

A

1790

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26
Q

growth and medicare and Medicaid happened in what era

A

postindustrial

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27
Q

discovery of anesthesia

A

Horace Wells

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28
Q

aseptic technique

A

Ignaz Semmelweis

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29
Q

germ theory of disease

A

Louis Pasteur

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30
Q

father of antiseptic surgery

A

Joseph Lister

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31
Q

discovery of x ray

A

William Roentgen

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32
Q

discovered the antibacterial properties of penicillin

A

Alexander Fleming

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33
Q

interest of the AMA is what

A

to protect physicians

34
Q

what report showed how well med schools were doing

A

Flexner report

35
Q

first hospital plan

A

Blue Cross

36
Q

first physician plan

A

Blue Shield

37
Q

when did Blue Cross and Blue Shield merge?

A

1974

38
Q

Why did a national insurance plan fail? (4 reasons)

A

ideological differences, tax aversion, political stability, and institutional instability.

39
Q

title 18

A

Medicare

40
Q

title 19

A

medicaid

41
Q

Medicare part A

A

finances hospital care

42
Q

Medicare part B

A

covers physician services (premium)

43
Q

Kerr Mills Act

A

income based insurance for elderly people over the age of 65.

44
Q

Medicare part C

A

have to already be enrolled in A or B but you get the choice of preferred provider. but is more expensive.

45
Q

Medicare part D

A

helps elderly pay for prescription drugs

46
Q

who oversees medicare/medicaid

A

CMS

47
Q

When was the Kerr Mills act entacted

A

1960

48
Q

what is the primary vehicle for insurance and delivery

A

managed care

49
Q

in 1995, the GATS was signed. what does it do?

A

allows you to get elsewhere for treatment if you cannot get it in the U.S.

50
Q

type of doctor that focuses on whole self

A

Doctor of Osteopathic medicine (DO)

51
Q

Type of doctor that focuses on neutralizing disease

A

MD

52
Q

% of physicians that are DOs

A

7%

53
Q

6 main specialties

A

internal medicine, OBGYN, neurologists, psychiatry, surgery, and radiologists

54
Q

% of generalists

A

38%

55
Q

% of specialists

A

62%

56
Q

specialize in drug therapy and work closely with physicians

A

pharmacotherapists

57
Q

determine and prepare drugs needed for nutritional therapy

A

nutrition-support pharmacists

58
Q

produce radioactive drugs used for patient diagnosis and therapy

A

Radiopharmacists or nuclear pharmacists

59
Q

pharmacists that do compounding and mixing

A

clinical pharmacists

60
Q

top 3 ways a nurse can lose her license

A

diverting, breach of privacy, and negligence

61
Q

area in which materials are manipulated at the atomic and molecular levels for better diagnosis and treatment of disease such as cancer

A

Nanotechnology

62
Q

EMR’s are an example of what

A

Clinical information systems

63
Q

everyone having access

A

Interauthroability

64
Q

this act provided incentives to providers for adopting meaningful use of EHR technology

A

HITECH Act of 2009

65
Q

development and dissemination of technology

A

Technology diffusion

66
Q

what is driving innovation

A

Research and development

67
Q

the desire to have state of the art technology available to use it despite its cost

A

the technological imperative

68
Q

authorized to take action only after drugs sold to consumers cause harm

A

Food and Drugs Act

69
Q

Evidence of safety is required before new drugs or devices can be marketed

A

Federal food, Drug, and cosmetic Act

70
Q

FDA takes charge of reviewing efficacy and safety of new drugs, which can be marketed only once approval is granted

A

Drug Amendments

71
Q

Drug manufacturers are given incentives to produce new drugs for rare diseases

A

orphan drug act

72
Q

health care facilities must report device-related injuries or illness of patients or employees to the manufacturer of the device, and if death is involved, the incident must also be reported to the FDA

A

Safe Medical Devices Act

73
Q

FDA receives the authority to collect application fees from drug companies to provide additional resources to shorten the drug approval process

A

Prescription Drug User Fee Act

74
Q

x ray machines, pregnancy tests, and powered wheel chairs are what class of device

A

2

75
Q

which two organizations provide financial support to private and public institutions for biomedical research

A

AHRQ and NIH

76
Q

the evaluation of medical technology to determine efficacy, safety, and cost effectiveness

A

Heath Technology Assessment (HTA)

77
Q

if a product or service actually produces some health benefits

A

Efficacy

78
Q

benefits must outweigh any negative consequences

A

Primary benchmark

79
Q

do the benefits or initial medical treatment usually exceed costs

A

Yes

80
Q

how is value of technology enhanced?

A

By improving quality and/or reducing cost