Lecture 19+20+DLA

Question 1

rate of an event in the treatment group (EER)

Answer 1

a / (a+b)

Question 2

rate of an event in the control group (CER)

Answer 2

c / (c+d)

Question 3

ARR

Answer 3

CER - EER

Question 4

hazard ratio

Answer 4

hazard in the intervention group / hazard in the control group

0.5 = half as many patients in the treatment group
are experiencing an event compared to the control group

1 = event rates are the same in both groups

2 = twice as many patients in the treatment group
are experiencing an event compared to the control group

Question 5

6 components of a healthcare system

Answer 5

1. financing mechanism
2. trained and adequately paid workforce
3. reliable info to base decisions and policies
4. well-maintained facilities
5. logistics to deliver quality care
6. leadership

Question 6

healthcare challenges in the US

Answer 6

1. malpractice and defensive medicine
2. ineffective or inappropriate care
3. higher medical prices
4. administrative waste
5. pressures of profit

Question 7

affordable care act

Answer 7

1. make affordable health insurance for more people
2. expand Medicaid (income below 133%)
3. Support innovative medical care delivery methods

no denial of coverage based on preexisting conditions
no cancellation of coverage based illness

Question 8

mode of payment for healthcare

Answer 8

1. out of pocket payment
2. individual private insurance
3. employment based private insurance
4. government financing

Question 9

problems with direct payments

Answer 9

may not be able to afford the direct cost
do not know what the bill will be

harder for the healthcare workers to be paid
fluctuation in demand

Question 10

individual private insurance

Answer 10

person pays a premium to a health insurance plan

When the individual needs care, the insurer reimburses the provider of care

Question 11

problems of individual insurance

Answer 11

large administrative overhead
cost gets higher for those who are sick

before 2010… you could have been turned down

Question 12

employment based insurance

Answer 12

Employers pay part of the premium to purchase health insurance for employees

Subsidized by the federal government through tax exemptions for employers

Question 13

pros and cons of employer based insurance

Answer 13

pros:
cost less than individual insurance
admin is high cost.. but not as high as individual
given as part of insurance

cons:
cost can rise year to year
employer has no obligation to give you insurance
employer may have you pay a higher % of the premium

Question 14

medicare

Answer 14

pays roughly 80% of doctor and hospital bills
Subject to large deductibles, copayments, & coverage gaps

elderly

Question 15

Medicare part A… who can have it?

Answer 15

those 65 and older
must have paid into social security for at least 10 years
covers spouse, as well

waiting period is 24 months ( minus ERSD and ALS )
covers those with disability

financed by social security tax

Question 16

what is covered by Medicare A

Answer 16

1. Hospitalization
2. Skilled nursing facility
3. Home health care
4. Hospice care
   • Medicare does not cover → Unskilled (custodial) nursing home care

Question 17

medicare part B.. who can get it

Answer 17

people who can have part A+ elect to pay the part B premium

higher income beneficiaries

financed by general federal revenues and payment

Question 18

what is covered by medicare part B

Answer 18

medical expenses
doctor services
Physical, occupational, & speech therapy
Medical equipment and Diagnostic tests

preventative care

DOES NOT cover:
eye refractions
hearing aids
dental

Question 19

medicare part C

Answer 19

“all in one” (Part A, B, and D)

offered by private companies

Beneficiaries sacrifice some freedom of choice of healthcare providers for lower out-of-pocket payments

Question 20

medicare part D

Answer 20

Medicare drug coverage helps pay for prescription drugs and is optional

Financing: through monthly premiums + yearly deductible

drug coverage: Medicare D and part C

Question 21

Medicaid

Answer 21

Joint FEDERAL & STATE program & is the single largest source of health coverage in the US

low-income families, qualified pregnant women &
children, & those with disabilities

Question 22

what is covered by medicaid

Answer 22

MANDATORY benefits include:
o Inpatient & outpatient hospital services
o Physician services
o Laboratory and x-ray services
o Home health services, among others

OPTIONAL benefits includes: prescription
drugs & physical therapy

Question 23

CHILDREN’S HEALTH PROGRAM (CHIP)

Answer 23

CHIP covered children in families with incomes ≤200% of the federal poverty level but above Medicaid income eligibility level

now 300% below

Question 24

what does chip cover??

Answer 24

Routine check-ups 
▪ Immunizations
▪ Doctor Visits ▪ Prescriptions
▪ Dental and vision
▪ In & Out patient hospital care
▪ Laboratory and XRay services
▪ Emergency services

It is free.. but may have co payments
some states have a monthly premium

Question 25

case control study

Answer 25

observational and individual based study

Data about exposure to a risk factor or several risk factors are collected retrospectively, typically by interview, abstraction from records, or survey.

Question 26

odds ratio

Answer 26

An odds ratio (OR) is a measure of association
between an exposure and an outcome

represents the odds that an outcome will occur given a particular exposure, compared to the odds of the outcome occurring in the absence of that exposure

1 = not associated with the disease

more than 1 = may be a risk factor

less than one = may be protective

Question 27

cross- sectional surveys

Answer 27

observational and individual
descriptive (prevalence of disease) or analytical (associations)

characterized by the collection of relevant information (data) at a given point in time

there is no time dimension involved in cross‐sectional studies, as all data are collected and mostly refer to the time at or around the time of the data collection

Question 28

ecological studies

Answer 28

observational and population based (compare populations)

an observational study defined by the level at which data are analyzed, namely at the population or group
level, rather than individual level

often used to measure prevalence and incidence of disease, particularly when disease is rare

Question 29

ecological fallacy

Answer 29

a type of confounding specific to ecological studies

It occurs when relationships which exist for
groups are assumed to also be true for individuals