healthcare delivery systems test

Question 1

What is the percentage of healthcare jobs in America

Answer 1

9%

Question 2

What is the western medical model?

Answer 2

assumes that

Question 3

What is the wellness model?

Answer 3

The prevention of disease and maintenance of your well being This is what we are moving toward.

Question 4

For-Profit

Answer 4

Owner obtains money from the profits of the agency. They are subject to taxation and likely to offer more profitable medical services. Ex- our hospital

Question 5

The joint commission-

Answer 5

To continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.

Question 6

what are specialty hospitals?

Answer 6

Hospitals created for a specific purpose. For example cancer hospitals or children’s hospitals, rehabilitation hospitals.

Question 7

Ambulatory Facilities (Urgent Care)-

Answer 7

Provides diagnostic and treatment services that were previously performed in hospitals. Ex: Urgent care clinics, outpatient clinics, and optical centers.

Question 8

Long Term Care Facilities-

Answer 8

Mainly care for elderly patients or individuals with disabilities or handicap. Example: Nursing home provides basic physical care

Question 9

Extended Care Facilities-

Answer 9

Provides skilled nursing care and rehabilitation. For patients that may be in a coma or need a lot of medical attention.

Question 10

Assisted Living Facilities-

Answer 10

Independent living they provide basic services such as meals and housekeeping and basic medical care.

Question 11

Home-health care

Answer 11

Providing care for patients from their home.

Question 12

Hospice

Answer 12

Provides palliative care to dying patients and their families

Question 13

World Health Organization (WHO)

Answer 13

sponsored by the united nations they investigate serious health problems throughout the WORLD

Question 14

Public Health System-

Answer 14

Provides immunizations, environment health and sanitation, they provide services to state and local communities and are apart of human services.

Question 15

Veteran’s Administration-

Answer 15

Provides insurance and medical for the retired members of the military

Question 16

Non-Profit Agencies

Answer 16

They are voluntary agencies they deal with specific diseases and PROVIDE FUNDING for research, promote, education, influence laws, and create standards. Ex: March of dimes that cares for polio victims and American heart association

Question 17

Purpose of a chain of command

Answer 17

Indicates areas of responsibility, should lead to the most efficient operation of the facility, can be complex in larger facilities or simple in smaller facilities.

Question 18

What is a premium

Answer 18

It is the cost of insurance monthly

Question 19

What is Co-Pay?

Answer 19

specific amount of money that a patient pays every time he/she seeks medical care.

Question 20

What is a deductible?

Answer 20

A specific amount of money that the patient must pay for medical care before the insurance plan pays

Question 21

What is co-insurance?

Answer 21

It is the percentage of covered medical care that will be paid by the insurance plan and amount that will be paid by patient

Question 22

HMO( Health Maintenance Organization)

Answer 22

You pay a monthly premium, co-pay is required every time you seek medical care, there is NO DEDUCTIBLE. FOCUS’ ON PREVENTATIVE CARE. They detect disease early but patient can only use doctors within that network or pays larger amount for out of network.

Question 23

PPO(Preferred provider organization)

Answer 23

Offered to employees of large corporations, employee contracts with certain health care agencies, industry/company can provide health care at lower rates, patients have lower co-pay as long as in approved providers.

Question 24

Medicare-

Answer 24

Insurance provider covering hospital care for people over the age of 65 or with disability of any age who have SS benefits and end stage kidney failure. Follows a 80%-20% coverage. Has 4 part.

Question 25

What is part A of Medicare-

Answer 25

What is part A of Medicare-

Question 26

What is part B of Medicare-

Answer 26

Covers doctor’s visits, outpatient services, and therapy

Question 27

what is part C of Medicare-

Answer 27

This plan is optional it helps pay for costs of medical services covered by type a and b but you have to pay additional and extra money.

Question 28

What is part D of Medicare-

Answer 28

Provides coverage for medications

Question 29

What is medicaid-

Answer 29

Offered to people with low income, the state determines what care will be paid for and who is eligible, no age restrictions, CHIP is available to children of families who do not qualify for Medicaid.

Question 30

What is worker’s compensation?

Answer 30

Provides medical care for workers injured on the job, employers pay premium to the state, no cost to the employee/patient

Question 31

What is Tricare

Answer 31

Insurance plan for members of the military and their families.

Question 32

This insurance model requires you to select from a list of “approved providers” before you can see a specialist

Answer 32

This insurance model requires you to select from a list of “approved providers” before you can see a specialist

Question 33

___________ is a group of selected health care providers who offer comprehensive services at preset reimbursement levels

Answer 33

PPO- preferred provider orgainizaton

Question 34

Managed care networks are required to provide quality care at the:

Answer 34

Managed care networks are required to provide quality care at the:

Question 35

What is managed care?

Answer 35

insurance designed specifically to control the cost of healthcare.

Question 36

What type of insurance is employer sponsored

Answer 36

What type of insurance is employer sponsored

Question 37

self advocacy is:

Answer 37

Speaking up for one’s self

Question 38

Patient compliance is:

Answer 38

follow the directions of your healthcare provider if he/she says to not eat pork for whatever reason your need to follow instructions for your own health

Question 39

Provider obligations are:

Answer 39

To provide clear, accurate information and allow the patient to tell your their experience don’t jump to conclusions and try to figure it out. Allow patient to participate in treatment decisions.

Question 40

Consumer Obligations are:

Answer 40

Practice health behaviors, participate in healthcare decisions, follow health care plans.