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849 > Midterm > Flashcards

Midterm Flashcards

1
Q

The health outcomes of a group of individuals, including the distribution of such outcomes within the group

A

Population Health

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2
Q

The capacity of people to adapt to, respond to, or control life’s challenges and changes

A

health

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3
Q

Health promotion, wellness is what risk on the care continuum?

A

No or low risk

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4
Q

Health risk management is what risk on the care continuum?

A

Low to moderate risk

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5
Q

Care coordination/advocacy is what risk on the care continuum?

A

Moderate to high risk

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6
Q

Disease/Case Management is what risk on the care continuum?

A

High risk

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7
Q

Which foundation of population health covers burden, course, and distribution of disease/injury?
A. Descriptive Epidemiology
B. Etiology, Benefits and Harms- health research evaluation
C. Evidence-Based practice
D. Implementation of health promotion and disease prevention interventions
E. Determinants of health

A

A. Descriptive Epidemiology

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8
Q

Which foundation of population utilizes comparative effectiveness research (CER)?
A. Descriptive Epidemiology
B. Etiology, Benefits and Harms- health research evaluation
C. Evidence-Based practice
D. Implementation of health promotion and disease prevention interventions
E. Determinants of health

A

B. Etiology, Benefits and Harms- health research evaluation

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9
Q

Aims to produce the type of evidence that will assist
all parties to make informed decisions to improve
health care at both the individual and population levels.

A

Comparative effectiveness research (CER)

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10
Q

Which foundation of population assess evidence using nationally recognized guidelines?
A. Descriptive Epidemiology
B. Etiology, Benefits and Harms- health research evaluation
C. Evidence-Based practice
D. Implementation of health promotion and disease prevention interventions
E. Determinants of health

A

C. Evidence-Based practice

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11
Q

Which foundation of population has a target audience for direct interventions?
A. Descriptive Epidemiology
B. Etiology, Benefits and Harms- health research evaluation
C. Evidence-Based practice
D. Implementation of health promotion and disease prevention interventions
E. Determinants of health

A

D. Implementation of health promotion and disease prevention interventions

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12
Q

Which foundation of population impacts social factors on individual behaviors (income, education, employment)?
A. Descriptive Epidemiology
B. Etiology, Benefits and Harms- health research evaluation
C. Evidence-Based practice
D. Implementation of health promotion and disease prevention interventions
E. Determinants of health

A

E. Determinants of health

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13
Q

Which foundation of population is a collection of population health data to assess population health, guide the provision of healthcare services and analyze health outcomes?
A. Evidence-Based practice
B. Population health informatics
C. Implementation of health promotion and disease prevention interventions
D. Determinants of health
E. Evaluation

A

B. Population health informatics

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14
Q

Which foundation of population uses process, quality and outcome assessments along with decision analysis and quality improvement outcomes?
A. Evidence-Based practice
B. Population health informatics
C. Implementation of health promotion and disease prevention interventions
D. Determinants of health
E. Evaluation

A

E. Evaluation

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15
Q

Which type of healthcare data is easy to obtain; standardized; diagnosis codes?
A. Claims data
B. Electronic health record data
C. Socioeconomic data
D. Patient-generated health data
E. Prescription and medication adherence data

A

A. Claims data

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16
Q

Which type of healthcare data provides clinical clues; ease of grouping patients?
A. Claims data
B. Electronic health record data
C. Socioeconomic data
D. Patient-generated health data
E. Prescription and medication adherence data

A

B. Electronic health record data

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17
Q

Which type of healthcare data is not frequently linked with EHR data?
A. Claims data
B. Electronic health record data
C. Socioeconomic data
D. Patient-generated health data
E. Prescription and medication adherence data

A

C. Socioeconomic data
D. Patient Generated health data

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18
Q

Which type of healthcare data utilizes satisfaction surveys; patient-reported outcomes?
A. Claims data
B. Electronic health record data
C. Socioeconomic data
D. Patient-generated health data
E. Prescription and medication adherence data

A

D. Patient-generated health data

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19
Q

Which type of healthcare data utilizes EHR and claims data?
A. Claims data
B. Electronic health record data
C. Socioeconomic data
D. Patient-generated health data
E. Prescription and medication adherence data

A

E. Prescription and medication adherence data

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20
Q

What is USAs rank among the world in life expectancy?

A

45

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21
Q

The goal of population health’s conceptual framework is to maintain or improve the physical and psychosocial well-being of individual through __________ tailored health solutions

A

cost-effective

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22
Q

T/F: Major population health determinants like health care, education, and income remain outside public health authority
and responsibility

A

True

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23
Q

Which of the following is NOT one of the four types of costs?
Direct medical costs
Direct non-medical costs
Indirect costs
Tangible costs
Intangible costs

A

Tangible costs

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24
Q

Which of the following are medical costs for providing treatment such as cost of medications, physician visits and hospitalizations?
A. Direct medical costs
B. Direct non-medical costs
C. Indirect costs
D. Intangible costs

A

A. Direct medical costs

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25
Q

Which of the following are costs to patients/family directly associated with treatment, but not medical in nature such as cost of transportation to clinic, babysitter, food/lodging?
A. Direct medical costs
B. Direct non-medical costs
C. Indirect costs
D. Intangible costs

A

B. Direct non-medical costs

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26
Q

Which of the following are costs that result from loss of productivity because of illness or death such as missed work or school days and decreased productivity?
A. Direct medical costs
B. Direct non-medical costs
C. Indirect costs
D. Intangible costs

A

C. Indirect costs

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27
Q

T/F: Indirect costs can involve a transfer of money

A

False: Do not involve a transfer of money

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28
Q

Which of the following are costs of pain, suffering, anxiety, or fatigue due to an illness or treatment of an illness difficult to measure and assign value?
A. Direct medical costs
B. Direct non-medical costs
C. Indirect costs
D. Intangible costs

A

D. Intangible costs

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29
Q

Which of the following is used to compare costs of interventions with equivalent clinical outcomes?
A. Cost-minimization analysis (CMA)
B. Cost-benefit analysis (CBA)
C. Cost-effectiveness analysis (CEA)
D. Cost-utility analysis (CUA)

A

A. Cost-minimization analysis (CMA)

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30
Q

Compares generic vs brand name drug, Drug A vs Drug B (assuming equal efficacy, safety and medication class)
A. Cost-minimization analysis (CMA)
B. Cost-benefit analysis (CBA)
C. Cost-effectiveness analysis (CEA)
D. Cost-utility analysis (CUA)

A

A. Cost-minimization analysis (CMA)

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31
Q

Which of the followings outcome measurement unit is not measured since they are assumed to be equivalent?
A. Cost-minimization analysis (CMA)
B. Cost-benefit analysis (CBA)
C. Cost-effectiveness analysis (CEA)
D. Cost-utility analysis (CUA)

A

A. Cost-minimization analysis (CMA)

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32
Q

Which of the following measures costs of interventions and outcomes in monetary units? This determines which intervention provides and the best monetary benefit.
A. Cost-minimization analysis (CMA)
B. Cost-benefit analysis (CBA)
C. Cost-effectiveness analysis (CEA)
D. Cost-utility analysis (CUA)

A

B. Cost-benefit analysis (CBA)

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33
Q

Which of the following can be used to compare different drugs or services for different outcomes but must assign a monetary outcome to clinical endpoint
A. Cost-minimization analysis (CMA)
B. Cost-benefit analysis (CBA)
C. Cost-effectiveness analysis (CEA)
D. Cost-utility analysis (CUA)

A

B. Cost-benefit analysis (CBA)

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34
Q

Which is typically used to compare different interventions using the same measured outcome?
A. Cost-minimization analysis (CMA)
B. Cost-benefit analysis (CBA)
C. Cost-effectiveness analysis (CEA)
D. Cost-utility analysis (CUA)

A

C. Cost-effectiveness analysis (CEA)

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35
Q

Which of the following measures outcomes in natural health units and determines which intervention achieves a given objective at the lowest cost?
A. Cost-minimization analysis (CMA)
B. Cost-benefit analysis (CBA)
C. Cost-effectiveness analysis (CEA)
D. Cost-utility analysis (CUA)

A

C. Cost-effectiveness analysis (CEA)

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36
Q

What ratio calculates the total cost of drugs compared to their outcome?

A

Incremental Cost-Effectiveness Ratio (ICER)

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37
Q

Calculate the ICER

A

Drug A:
1,000/pt * 100pts = $100,000
4% mortality of 100 = 96 pts saved
Drug B:
500/pt * 100pts = $50,000
5% mortality of 100 = 95 pts saved
ICER = (100k-50k)/(96-95)
$50,000 per death prevented

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38
Q

Which of the following measures outcomes in terms of the quality of the outcome produced through examining the cost of an intervention and the value of the outcome?
A. Cost-minimization analysis (CMA)
B. Cost-benefit analysis (CBA)
C. Cost-effectiveness analysis (CEA)
D. Cost-utility analysis (CUA)

A

D. Cost-utility analysis (CUA)

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39
Q

Which of the following is referred to as “utility units” with the most common outcome being in quality-adjusted life years?
A. Cost-minimization analysis (CMA)
B. Cost-benefit analysis (CBA)
C. Cost-effectiveness analysis (CEA)
D. Cost-utility analysis (CUA)

A

D. Cost-utility analysis (CUA)

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40
Q

Incremental Cost-Effectiveness Ratio (ICER) is used in which of the following?
A. Cost-minimization analysis (CMA)
B. Cost-benefit analysis (CBA)
C. Cost-effectiveness analysis (CEA)
D. Cost-utility analysis (CUA)

A

C. Cost-effectiveness analysis (CEA)

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41
Q

Measure the QALY:

A

of yrs x health state
Drug A: 3 QALYs
Drug B: 2 QALYs

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42
Q

Match the utility score with the health state
Health State:
Perfect Health, Severe angina, Death
Utility Score:
0.00, 0.53, 1.00

A

Perfect health: 1.00
Severe angina: 0.53
Death: 0.00

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43
Q

Calculate QALY gained

A

(100k-50k)/3.6-3.1 = $100k/QALY gained

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44
Q

Advantages: Simplicity, no assessment of outcome
Disadvantage: ONLY useful when outcomes are equal
A. Cost-minimization analysis (CMA)
B. Cost-benefit analysis (CBA)
C. Cost-effectiveness analysis (CEA)
D. Cost-utility analysis (CUA)

A

A. Cost-minimization analysis (CMA)

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45
Q

Advantages: Allows comparison of interventions with different outcomes
Disadvantage: Requires assigning monetary value to pain, suffering, life
A. Cost-minimization analysis (CMA)
B. Cost-benefit analysis (CBA)
C. Cost-effectiveness analysis (CEA)
D. Cost-utility analysis (CUA)

A

B. Cost-benefit analysis (CBA)

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46
Q

Advantages: Outcomes measured in units that are understandable to many clinicians; no need to convert outcomes into a dollar amount
Disadvantage: Outcomes must be measured in same units; length of life (survival) is not the same as quality of life
A. Cost-minimization analysis (CMA)
B. Cost-benefit analysis (CBA)
C. Cost-effectiveness analysis (CEA)
D. Cost-utility analysis (CUA)

A

C. Cost-effectiveness analysis (CEA)

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47
Q

Advantages: Accounts for both quantity and quality of the outcome
Disadvantage: Not a precise measure; viewpoint may bias outcome measures
A. Cost-minimization analysis (CMA)
B. Cost-benefit analysis (CBA)
C. Cost-effectiveness analysis (CEA)
D. Cost-utility analysis (CUA)

A

D. Cost-utility analysis (CUA)

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48
Q

The study of the distribution and the determinants of health
related events in a population, and the application of this
information to the control of health problems

A

Epidemiology

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49
Q

Which disease uses a baseline level typically found in a community for a disease that is habitually present in that community with an expected level of disease over time
A. Endemic
B. Hyperendemic
C. Sporadic
D. Epidemic
E. Pandemic

A

A. Endemic

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50
Q

Which of the following has persistent, high levels of disease
A. Endemic
B. Hyperendemic
C. Sporadic
D. Epidemic
E. Pandemic

A

B. Hyperendemic

51
Q

Which of the following is a disease that occurs infrequently and irregularly
A. Endemic
B. Hyperendemic
C. Sporadic
D. Epidemic
E. Pandemic

A

C. Sporadic

52
Q

Which of the following is an increase (potentially sudden) in number of cases of disease above what is expected in that population
A. Endemic
B. Hyperendemic
C. Sporadic
D. Epidemic
E. Pandemic

A

D. Epidemic

53
Q

Which of the following is a global epidemic spread over several countries or continents
A. Endemic
B. Hyperendemic
C. Sporadic
D. Epidemic
E. Pandemic

A

E. Pandemic

54
Q

Which of the following outbreak patterns has exposure originating from the same source (point source, continuous common source and intermittent common source)?
A. Common source outbreak
B. Propagated outbreak
C. Mixed epidemic

A

A. Common source outbreak

55
Q

Which of the following outbreak patterns results from transmission from one person to another typical of community wide outbreaks?
A. Common source outbreak
B. Propagated outbreak
C. Mixed epidemic

A

B. Propagated outbreak

56
Q

The amount of time between initial contact with the agent and the onset of disease. May create multiple peaks.
A. Incubation period
B. Generation period
C. Propagated period

A

A. Incubation period

57
Q

The amount of time between peaks in a spread
A. Incubation period
B. Generation period
C. Propagated period

A

B. Generation period

58
Q

Common-source outbreak followed by person-to-person spread
A. Common source outbreak
B. Propagated outbreak
C. Mixed epidemic

A

C. Mixed epidemic

59
Q

What was the incubation period of COVID-19?

A

4-5 days

60
Q

What is the serial interval of COVID-19

A

mean 7.5 days

61
Q

(Serial Interval/Incubation Period) can indicate that disease may be transmitted prior to onset of symptoms

A

Incubation Period

62
Q

Incidence rate equation

A

Incidence = (# of new cases over a time period/total pop at risk during the same time period)

63
Q

Number of new cases of a disease that occur in a group over a defined time period
A. Incidence
B. Prevalence
C. Attack Rate
D. Secondary attack rate

A

A. Incidence

64
Q

Proportion of people who have a disease at a specified time, or over a specified period of time. This is the number of existing (total) cases in a population at some designated time.
A. Incidence
B. Prevalence
C. Attack Rate
D. Secondary attack rate

A

B. Prevalence

65
Q

If duration is short, then prevalence is (greater than, less than, similar to) incidence

A

similar to

66
Q

Alternate form of incidence rate in outbreak settings used for diseases observed in a population for short times. This is often due to specific exposure and not a true rate because time dimension may be uncertain.
A. Incidence
B. Prevalence
C. Attack Rate
D. Secondary attack rate

A

C. Attack Rate

67
Q

How is attack rate measured?

A

Overall AR = number of new cases/total population

68
Q

Rate of disease in a group among those exposed to an initial case. Can use to document transmission in community vs community in a defined/closed population.
A. Incidence
B. Prevalence
C. Attack Rate
D. Secondary attack rate

A

D. Secondary attack rate

69
Q

What equation is used for SAR?

A

SAR= # of new cases/# of exposed susceptible individuals

70
Q

Average number of secondary cases produced by one infected individual introduced into a population of susceptible individuals

A

Basic Reproductive Number: R(knot)

71
Q

Which values of basic reproductive number may indicate disease dying out? likelihood of spread?

A

<1: may indicated disease dying out
>1: may indicate likelihood of spread

72
Q

Frequency of death in a defined population during a specified period with a varying denominator (eg vital stats, size of pop)
A. Mortality (morbidity) rate
B. Case fatality rate
C. Death to case ratio
D. Proportional mortality

A

A. Mortality (morbidity) rate

73
Q

Proportion of people with a given condition who die from that condition (not a true rate)
A. Mortality (morbidity) rate
B. Case fatality rate
C. Death to case ratio
D. Proportional mortality

A

B. Case fatality rate

74
Q

Number of deaths attributed to a disease during a specified time period/number of new cases identified in that time period
A. Mortality (morbidity) rate
B. Case fatality rate
C. Death to case ratio
D. Proportional mortality

A

C. Death to case ratio

75
Q

Proportion of deaths in a specified population over a period of time attributable to different causes. Can calculate a PMR to compare in a given population to the broader population
A. Mortality (morbidity) rate
B. Case fatality rate
C. Death to case ratio
D. Proportional mortality

A

D. Proportional mortality

76
Q

Measures of association in cohort study; risk of an outcome among one group with the risk (or exposure), among another group
A. Risk ratio (Relative risk)
B. Rate Ratio
C. Odds Ratio

A

A. Risk ratio (Relative risk)

77
Q

Compares incidence rates between 2 groups in cohort studies and may include person-time
A. Risk ratio (Relative risk)
B. Rate Ratio
C. Odds Ratio

A

B. Rate Ratio

78
Q

How to calculate risk ratio

A

RR= risk in exposed/risk in unexposed

79
Q

A RR > 1 indicates (increase/decrease) risk in exposed group while a RR < 1 indicates (increase/decrease) risk in exposed group

A

RR > 1 increase, RR < 1 decrease

80
Q

Used for case control studies by estimating relative risk. Does NOT use RR in case control since we don’t know the true denominator.
A. Risk ratio (Relative risk)
B. Rate Ratio
C. Odds Ratio

A

C. Odds Ratio

81
Q

Study of the use, risks, and benefits of drugs in populations (large numbers of people)
A. Pharmacoepidemiology
B. Pharmacovigilance
C. Comparative effectiveness research (CER)
D. Pragmatic research

A

A. Pharmacoepidemiology

82
Q

Continual monitoring for unwanted effects and other safety-related aspects of marketed drugs
A. Pharmacoepidemiology
B. Pharmacovigilance
C. Comparative effectiveness research (CER)
D. Pragmatic research

A

B. Pharmacovigilance

83
Q

Determining what therapeutic intervention (not just drug products) works best for a given disorder in patients likely to be
seen in clinical practice
A. Pharmacoepidemiology
B. Pharmacovigilance
C. Comparative effectiveness research (CER)
D. Pragmatic research

A

C. Comparative effectiveness research (CER)

84
Q

Studies (often using randomization) that often test small practical changes that could have an impact on health outcomes
A. Pharmacoepidemiology
B. Pharmacovigilance
C. Comparative effectiveness research (CER)
D. Pragmatic research

A

D. Pragmatic research

85
Q

Experimental/Non-Experimental:
RCTs (active treatment, usual care, pragmatic, others)

A

Experimental

86
Q

Experimental/Non-Experimental:
Observational (case control, cohort)

A

Nonexperimental

87
Q

Which of the following uses supplement information from premarketing studies and new information not available from premarketing studies to better quantify ADRs and beneficial effects
A. Pharmacoepidemiology
B. Pharmacovigilance
C. Comparative effectiveness research (CER)
D. Pragmatic research

A

A. Pharmacoepidemiology

88
Q

The Indiana Network for Patient Care (INPC) is a data source under the category of _________
A. Pharmacoepidemiology
B. Pharmacovigilance
C. Comparative effectiveness research (CER)
D. Pragmatic research

A

A. Pharmacoepidemiology

89
Q

Systematic deviation from the truth that distorts the results of research

A

Bias

90
Q

Relationship between treatment and response; independently related to both the exposure and the outcome

A

confounding

91
Q

Bias related to information regarding exposure or outcome; includes measurement and/or classification error
A. Information bias
B. Detection bias
C. Selection Bias
D. Referral bias
E. Protopathic bias
F. Prevalence bias

A

A. Information bias

92
Q

Specific outcome is diagnosed preferentially in subjects exposed to the agent (may be more likely to look for an AE in someone who is exposed to a drug)
A. Information bias
B. Detection bias
C. Selection Bias
D. Referral bias
E. Protopathic bias
F. Prevalence bias

A

B. Detection bias

93
Q

Confounding by indication occurs when the risk of an event is related to the (indication/reason) for medication use but not the use of the medication itself.
Confounding by indication also appears when the (indication/reason) of prescription is associated with the outcome of interest

A

indication, reason

94
Q

Bias related to procedures used to select subjects/influence study participation; due to systematic differences in characteristics between those who are selected for the study and those who are not
A. Information bias
B. Detection bias
C. Selection Bias
D. Referral bias
E. Protopathic bias
F. Prevalence bias

A

C. Selection Bias

95
Q

Reason for encounter is related to drug treatment (eg when the use of the drug contributes to the the diagnostic process)
A. Information bias
B. Detection bias
C. Selection Bias
D. Referral bias
E. Protopathic bias
F. Prevalence bias

A

D. Referral bias

96
Q

Exposure of interest is used unknowingly to treat an adverse event related to outcome/agent is
used for early manifestation of a disease that has not yet been diagnosed (e.g., an antipsychotic may be started to treat delirium, but the drug may have anticholinergic effects that contribute to delirium)
A. Information bias
B. Detection bias
C. Selection Bias
D. Referral bias
E. Protopathic bias
F. Prevalence bias

A

E. Protopathic bias

97
Q

Prevalent cases rather than new (incident) cases are selected
A. Information bias
B. Detection bias
C. Selection Bias
D. Referral bias
E. Protopathic bias
F. Prevalence bias

A

F. Prevalence bias

98
Q

Occurs if a particular treatment was started, stopped or otherwise changed because of the baseline manifestation caused by a disease or other outcome event

A

Protopathic bias “reverse causality”

99
Q

In pharmacoepidemiology, protopathic bias occurs when the drug is initiated __________ which is, at this point, undiagnosed.

A

in response to the first symptoms of the disease

100
Q

Period of follow-up when, due to the exposure definition, the outcome being studied could never occur

A

immortal time bias

101
Q

Efficacy/Effectiveness:
Whether a drug (or other treatment) has the ability
to bring about a given intended effect in controlled settings

A

Efficacy

102
Q

Efficacy/Effectiveness: Whether, in real-world patients and settings, a treatment, in fact achieves it’s desired effect

A

Effectiveness

103
Q

When did employer-sponsored plans as a benefit dramatically expand as a direct result of wage controls
A. Social Security Act
B. WWII
C. Hill Burton Act
D. Revenue Act

A

B. WWII

104
Q

The entire health insurance system was built on the __________ model

A

employer-sponsored

105
Q

Data indicates that _____ % of 30 day readmissions are preventable

A

75%

106
Q

When was medicare and medicaid signed into law?

A

July 30, 1965

107
Q

When did medicare begin? What age did you have to be? What was it lacking in benefits?

A

Began Jul 1, 1966 for elderly (>65yo) with NO dental, eye or drug benefits for outpatients

108
Q

Which part of Medicare covers hospital costs, some home health care and hospice care with no premium costs and SNF care (max of 100 days).

A

Part A

109
Q

Which part of medicare is also called ____ with premium costs deducted from SS. Covers physician costs, medical supplies and drugs admin in MD offices

A

Part B - Medigap

110
Q

Which part of medicare is also called ____ with combined parts A, B and D with managed care (private insurance companies)

A

Part C - Medicare Advantage

111
Q

Which part of medicare includes drug benefits and premium costs deducted from SS

A

Part D

112
Q

When can you enroll in medicare part A?

A

3 months before 65th bday with a 7-mon initial enrollment period where you can sign up for Part C and Part D

113
Q

T/F: Medicare Part B covers dental care, eye examinations for prescribing glasses, hearing aids and exams, and long-term care

A

False

114
Q

What rating system is used and by whom to measure how well Medicare Advantage and Part D plans perform

A

Medicare STAR Rating System by CMS

115
Q

T/F: Medigap is administered through CMS

A

False

116
Q

Who runs medicare part D?

A

Run by private insurance companies

117
Q

When did Medicaid begin?

A

Jan 1, 1966

118
Q

What population benefits from medicaid?

A

Poor and medically indigent of all ages
( <138% of FPL in IN)
1/3 of children pop

119
Q

Who manages medicaid?

A

State govt

120
Q

Pregnant mothers are covered by Medicaid for __________ after the pregnancy ends

A

12 months

121
Q

Groups of hospitals, providers and community partners who came together, along with a health plan, to improve patient outcomes and reduce health care costs by delivering highly coordinated care

A

Accountable Care Organizations (ACOs)

122
Q

Approach to the delivery
of healthcare services in a way that puts limited resources to best use in optimizing patient care

A

Managed care

123
Q

Groups of doctors, hospitals, and other health care providers, who voluntary work together to provide
coordinated high-quality care to their Medicare patients and accept financial risk/reward tied to clinical outcomes

A

Accountable Care Organizations (ACOs)

124
Q

A managed care delivery model consisting of preferred networks of providers with some out-of-network coverage. Offer patients more choice and flexibility than health maintenance organizations (HMOs) with correspondingly higher premiums.

A

Preferred Provider Organization (PPO)

849 (3 decks)

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