Public health

Question 1

Disease prevention - primary

Answer 1

Prevent disease occurrence

Question 2

Disease prevention - secondary

Answer 2

Screening early for disease

Question 3

Disease prevention - tertiary

Answer 3

Treatment to reduce disability from disease

Question 4

Disease prevention - quaternary

Answer 4

Identifying patients at risk of unnecessary treatment, protecting from the harm of new intervention

Question 5

Disease prevention - chemotherapy

Answer 5

Tertiary Disease prevention

Question 6

Disease prevention - HPV vaccination

Answer 6

Primary Disease prevention

Question 7

Disease prevention - pap smear

Answer 7

Disease prevention Secondary

Question 8

Medicare and Medicaid

Answer 8

Federal programs that originated from amendments to the Social Security Act

Question 9

Medicaid is joint ….

Answer 9

Federal and state health assistance for people with very low income (indigent)

Question 10

Medicaid - coverage

Answer 10

inpatient and outpatient hospital care 
physician service 
home health care 
Prescription drugs
Long term nursing home care 
dental care, eyeglasses, hearing aids
laboratory test and dialysis 
No co-payment or deductible

Question 11

Medicare is divided to

Answer 11

part A, B, C, D

Question 12

Medicare is available to

Answer 12

patients: 1. >= 65 years old 2. patients with certain disabilities 3. End stage renal disease

Question 13

Medicare part A coverage

Answer 13

inpatient hospital costs
home health care
hospice care

Question 14

Medicare part B coverage

Answer 14

physician fees, dialysis, physical therpay, lab tests, ambulance services, medical equipment

Question 15

Medicare part C coverage

Answer 15

part A and B delivered by approved private companies

Question 16

Medicare part d coverage

Answer 16

Prescription drugs

Question 17

usa - common cause of death in order - under 1

Answer 17

1. congenital malformations
2. preterm birth
3. SIDS

Question 18

usa - common cause of death in order - 1-14

Answer 18

1. Unintentional injury
2. cancer
3. congenital malformation

Question 19

usa - common cause of death in order - 15-34

Answer 19

1. Unintentional injury
2. suicide
3. homicide

Question 20

usa - common cause of death in order - 35-44

Answer 20

1. Unintentional injury
2. cancer
3. Heart disease

Question 21

usa - common cause of death in order - 45-64

Answer 21

1. cancer
2. heart disease
3. Unintentional injury

Question 22

usa - common cause of death in order - 64+

Answer 22

1. Heart disease
2. cancer
3. chronic respiratory disease

Question 23

Hospitalized conditions with frequent readmissions - medicate

Answer 23

1. Congestive HF
2. Septicemia
3. Pneumonia

Question 24

Hospitalized conditions with frequent readmissions - medicaid

Answer 24

1. Mood disorder
2. Schizophrenia/psychotic disorder
3. DM with complications

Question 25

Hospitalized conditions with frequent readmissions - private insurance

Answer 25

1. maintenance of chemotherapy or radiation 2. mood disorder 3. complications of surgical procedures or medical care

Question 26

Hospitalized conditions with frequent readmissions - uninsured

Answer 26

1. Mood disorders 2. Alcohol related disorders 3. Diabetes mellitus with complications

Question 27

Readmission means

Answer 27

readmission for any reason within 30 days of original admission

Question 28

Safety culture - definition/purpose

Answer 28

organizational environment in which everyone can freely bring up safety concerns without fear of censure. --> Facilitates errors identifications event reporting systems collect data on errors for internal and external monitoring

Question 29

PDSA cycle?

Answer 29

Process improvement model to test changes in real clinical setting. Impact on patients: Plan - define problem and solution DO - test new process Study - measure and analyze data Act - integrate new process into regular workflow

Question 30

Swiss cheese model - definition

Answer 30

In complex organizations, flaws in multiple process and systems may align to cause patient harm. Focuses on systems and conditions rather than an individuals error

Question 31

Swiss cheese model - sequence

Answer 31

Organizational factors --> unsafe supervision --> preconditions --> unsafe acts --> HARM

Question 32

Types of medical errors may involve

Answer 32

1. patient identification 2. diagnosis 3. monitoring 4. nosocomial infections 5. medications 6. procedures 7. devises 8. documentation 9. handoffs

Question 33

medical errors are divided to

Answer 33

1. active error | 2. latent error

Question 34

active medical error

Answer 34

occurs at level of frontline operator (eg. wrong IV pump dose programmed) --> immediate impact

Question 35

latent medical error

Answer 35

occurs in process indirect from operator but impacts patient care (eg. different type of IV pumps used within same hospital) --> accident waiting to happen

Question 36

Medical error analysis are divided to

Answer 36

1. Root cause analysis | 2. failure mode and effect analysis

Question 37

Medical error analysis - Root cause analysis - definition

Answer 37

Uses records and participant interviews to identify all the underlying problems that led to an error --> categories of causes include process, people (providers or patients), environment, equipment, materials, management

Question 38

Medical error analysis - Root cause analysis - characteristics

Answer 38

- Retrospective approach applied after failure event to prevent recurrence - plotted on fishbone (Ishikawa, cause-and-effect) diagram. Fix causes with corrective action plan

Question 39

Medical error analysis - failure mode and effect analysis - definition

Answer 39

Uses inductive reasoning to identify all the ways a process might fail and prioritize these by their probability of occurrence and impact on patients

Question 40

Medical error analysis - failure mode and effect analysis - characteristics

Answer 40

Forward-looking approach applied before implementation to prevent failure occurrence

Question 41

Quality measurements - appearance

Answer 41

Plotted on run and controls charts

Question 42

Quality measurements - outcome - measures and example

Answer 42

impact on patients (eg. average HbA1c of patients with diabetes)

Question 43

Quality measurements - Process - measure and example

Answer 43

performance of system as planned (eg. ratio of patients whose HbA1c was measured the past 6 months)

Question 44

Quality measurements - Balancing - measure and example

Answer 44

impact on other systems/outcomes (eg. Incidence of hypoglycemia among those patients

Question 45

if poor and over 65 - medicare vs medicaid

Answer 45

madicare is first use, then medicaid

Question 46

deductible

Answer 46

the amount the patient must pay out of pocket before the insurance company begins cover expenses

Question 47

co-payment

Answer 47

typically 20% of the total bill that the patient must pay

Question 48

medicaid not cover

Answer 48

routine physicals, eye, ears examinations for glasses and hearing aids, immunizations, rootine foot care, most self administrated drugs

Question 49

medicare vs medicaid according to deductible

Answer 49

medicare --> applicable | medicaid --> not

Question 50

medicare vs medicaid according to co-payment

Answer 50

medicare --> applicable | medicaid --> not

Question 51

LONG TERM CARE - Nursing homes and related facilities are classified and priced according to the level of care that they offer -divisions and definitions

Answer 51

1. assisted living --> limited care, for example meals and houskeeping and typically (36000/year) 2. skilled nursing home --> proferssional nursing care (at least 75000/year)

Question 52

medicare vs medicaid according to federal and states

Answer 52

both federal | medicaid --> federal AND STATES

Question 53

health care expenditures in usa have increased because of the

Answer 53

increasing age of the population ,advance in medical technology and availability of health care to the poor and elderly through Medicaid and Medicare, respectively