HCR300 Final Review Midterm questions included in pool of questions 133 questions in pool, system will randomly draw

aw 100 questions. 1. Health care planners use the concept of natural history of disease to design services that intervene at the weakest link in the chain of progression of specific diseases false 2. To judge the effects of medical treatment, researchers now measure social functioning sense of well being satisfaction with care true 3. Hospitals in the future will provide a narrower range of services 4. Ambulatory care encompasses all care that less than 23-hour stay true 5. Meaningful health care financing reform through government intervention has been thwarted through periodic shifts in political views of administrationstrue 6. Managed behavioral health organizations strictly manage service utilization by All of the above 7. For decades, sought support - solve support that would ensure payment for their services false 8. The social model adult day care provides supervised social activities in a group setting outside the home 9. Nationwide discussion and controversy over the security act significantly awareness health care system reforms true 10. In the 1960s, congress assigned a health related programs Medicare and Medicaid to the public health service false 11. Theres growing awareness that economic benefits diagnosis and treatment true 12. Evidence based medicine requires physicians to limit treatments to those procedures that have been proven effective false 13. When patients adopt the sick role, they advocate all responsibility for recovery to medical authorities 14. A significant percentage of clinical treatment decisions are not supported by evidence of effectiveness true 15. States are reluctant to legislate reforms while congress waffles health care bills false 16. Though physicians believe could and should judge quality of medical care, they found such peer review activities a most disagreeable true 17. among other factors, the use of formal home care services continues to increase because choices a & b 18. current and evolving research demonstrates psychiatric disorders are biologically based illnesses requiring specific targeted treatments true 19. quality and medical care may be defined as the greatest benefit at the lowest risk true 20. while the health care system itself is in turmoil, the sciences within health care are making progresstrue 21. throughout the first half of the 20th century, mental illness treatment was largely based in inpatient institutions true 22. the marketplace is continuing to exert influences upon cost and competition in the health care industry true

23. in the future, those in the health care workforce can expect continued experimentation and variation in staffing 24. health care reforms have dramatically increased the power prestige, and independence specialists getting referrals from generalist physicians serving as managed care gatekeepers false 25. prior to the advent of managed care, Americans more cost conscious about health care than they are today false 26. the US met 85% of the challenging health goals of healthy people 2000 false 27. in November of 1999 the IOM issued a report on the quality of medical care preventable medical mistakes americas highways true 28. insurance company pre-payment to providers helps to control cost by requiring providers to share financial risk with insurers true 29. avenues through which nursing home quality of care is regulated include stringent criteria state licensing and federal certification 30. health care reforms have produced the greatest change in hospital inpatient days 31. medical care at teaching hospitals is more efficient and less costly because senior physicians have to consult with.. doctors false 32. one of the major changes resulting from managed care is the requirement of providers to assume accountability for individual treatment decisions 33. during the last 20 years, the number of women in medical schools, more than doubled, minority tripled true 34. hospitals striving to find new sources of income since the advent of prospective payment have adopted subacute care 35. states try to protect the public from receiving incompetent care by licensing certain professional certification only recognizes special education or training 36. significant historical influence in establishing treatment rather than prevention as the first priority of us medical care was insurance companies wouldnt pay 37. health care industry in the us major employer false, 10 % 38. the new federalism policies of republican congress strive to transfer public responsibilities from federal government to the states 39. commercial rather than humanistic motives prompted early public health measures in the us, uk, and other European countries true 40. even though various kinds of health professionals such as physical therapists are educated in separate schools with little or no interdisciplinary contact true 41. The resulting Flexner report as a benchmark because it resulted in the closure of all medical schools false 42. post-ww2 expansion of research and medical centers that encouraged health care professionals inequitable access runaway costs true 43. psychiatric diagnosis and treatment in older adults special challenges patients tendency to minimize complaints about mental status true 44. epidemiology or population research is concerned with the determinants in human populations true 45. one factor believed to be contributing nursing home occupancy vastly increased availability community based services for older adults 46. operation restore trust maybe best characterized as federal program to thwartcost and quality of home health care

47. the advent of private health insurance through BCBS signaled a new role in the health care delivery system because it all of the above 48. reasons cited for health insurance plans drawing from medicare managed care program include complex administrative procedures and inadequate reimbursement true 49. hospitals are now reimbursed patients care on a prospective basis. Based on cost of services provided false 50. one aspect of health care that has not changed as the result of health care reforms positions in hospitals. Workplace of physicians who exercise complete authority over services provided false 51. consistent concerns iron triangle access quality and cost true 52. since technical advances in health care have spawned.. specially trained personnel cross trained personnel who can perform multiple tasks false 53. which of the following was not a major factor fueling the emergence of managed care in the 80s political initiatives universal coverage 54. hospital residency programs were established service needs of hospitals rather then provide mix of specialists and generalists true 55. academic health centers may best be described as complexes consisting of medical schools and other professional schools teaching hospitals and medical facilities 56. the present form of health care financing European financing after wwI false 57. the development of psychotropic medications contributed little mental health disorders false 58. the medical model of US health carerecognized multiple needs of this nations growing population of older adults true 59. one health care occupation currently enjoying growth nursing 60. growth in the numbers of older adults will affect US health care expenditures because older adults have high rates of chronic diseaseyounger counterparts 61. a major reason for the expansion of ambulatory care services is technological advances and treatment that have radically reduced surgical procedures true 62. since many acute care services will be provided in ambulatory settings role of future hospitals will be to provide intensive patient care and diagnosis and management of the chronically ill 63. today, families and friends are still primary providers of long term care services true 64. by providing services to enrolled populations for a pre-paid fixed fee, HMOs were expected to contain costs by reversing the profit incentive 65. in judging the quality of hospitals, its well known that for complicated procedures such as open heart surgery, which is not related location 66. managed care has caused the us health care system to B (continuously monitor the effectiveness) 67. most schools of medicine & professions & teaching hospitals are heavily subsidized by state funds no obligation to society true 68. well over million jobs will be created for personal care and home health aides all above

69. mental illness results in enormous cost on society. Indirect costs -- reduced and lost productivity due to premature death providing family care 70. in 1965 the federal government recognized teaching hospital research and training activities sophistication and effectiveness passing of regional medical program legislation 71. research studies may be observational or experimental. Main differences is in experimental investigations the investigator applies experimental intervention 72. physicians are discontent under constraints that impeded their ability to use judgment freely doctors bill of rights false 73. medical leadership at national & state levels was instrumental in establishing the health care reforms that characterize todays health care false 74. the HMO act of 1973 provided loans and grants for planningimplementing health care organizations 75. the federal government john windburgs reports among physicians by establishing policy in research agency for research and quality, its mission is to all of the above 76. since 1980 approx. 2000 hospitals closed in the US and hospital inpatient days declined by 1/3 true 77. personally financed long term care insurance now contributes long term care services false 78. governments role in setting health care policy diminished after the 1993 heatlh security act and market driven reforms steered towards managed care true 79. the service priorities of the us heatlh care system reflect.. high tech medicine. As a result all of the above 80. like the relationship between client and lawyer outside scrutiny true 81. definitions of medical quality are left to clinicians to what is good care false 82. the human services sector of the mental health delivery system is best characterized as consisting of social services agency (longest answer) 83. the future role of government in public health is likely to diminish what the economic pressures of state and local budgets 84. the trend in physicians becoming employees of medical groupsand health care institutions is best described as increasing 85. insurance company policies play a significant role from the hospital to the ambulatory setting true 86. since 1980, efforts to reduce federal support begun in the 1960s include all of the above 87. the correct definition of managed care is D (A&C) 88. in relation to insurance coverage for mental health services, the term parity is best defined as requiring that same level as medical care 89. within the last few years many states have passed legislation against the public access information, disciplinary lost privileges true 90. in reference to managed care reimbursement for mental health service, curve outs financial risk to external vendors true 91. Ralph nader major role in reforms long term care industry true

92. the health care reforms that promoted market oriented changes competition in managed care virtually eliminated the historic charitable orientation of health care institutions and providers 93. the creative federalism programs of the Johnson era, health care improving access, the programs fueled the inflationary spiral of health care costs 94. physicians are the only heatlh care practitioners are the only ones licensed to practice independently in ambulatory settings false 95. specialization in medical training while resulting in high quality care also caused problems in the health care delivery system, these problems include all of the above 96. most hospitals that survive the intense economic pressuresintegrated system of care true 97. health care proxy laws enable an individual to appoint an agent to make all medical decisions should that person be unable to make decisions true 98. many insurers and managed care companies considered the therapies less expensive and equally effective in feeling well true 99. growing employment demands in the health care industry are rising principally from technological advances resulting in new services & need for more personnel to provide them 100. one contributing factor to the crisis health care industry staffing is demanding working conditions, constrain employee compenstation 101. voluntary not for profit agencies provide important sources of health care to their communities. Established largely through advocacy of cause related groups to address needs of populations with special heatlh care needs 102. there are over 200 allied health occupations true 103. in the 1980s many hospital outpatient clinics were transformed. This transformation may be characterized as the recognition of revenue generating opportunities to help offset 104. home care is essentially limited to individuals needing following hospitalization false 105. the evolution and implementation of the DRG medicare prospective payment methodology resulted from research documenting all of the above 106. epidemiology or the study of health status in populationlacks application in mental health illness and health services planning false 107. probability of nursing home admission increases in the presence of which of the following factors A,C, & D 108. for more then a century, nurse midwives the need for nurse midwives is growing 109. the us government provided disease specific programs health care expenditures true 110. point of service managed care plans are growing in favor because they facilitateout of network providers 111. the HMO act which promoted the first HMOs and led to the managed care was passed in 1973 112. lifestyle and social changes of the 60s played little if any role in physician group practices false

113. the ultimate responsibility for the quality of care in a hospital rests with governing board 114. the most significant social legislation passed by any congress in the history of the US was social security act of 1935 115. managed care gave primary care physicians gatekeepers in health care. Gatekeeper role is controversial because their own reimbursement linked to referrals 116. most skilled nursing facilities now operate as charitable not-for-profit organizations false 117. the principle goal of HEDIS is to provide C standardizedcollect, calculateto payers and consumers to allow comparisons among different plans 118. almost every technological advance seems to be accompanied by of care. Properly and not overused, it would actually lower health care cost true 119. the rights of volunteer participants are protected by all of the above 120. the American public continues to express an affirmative stance government control of its health care administration and financing false 121. recommendations of the 1999 surgeon general report on mental health identify which of the following as a major near future challenge transferring new evidence based treatments into diverse settingsexisting delivery system 122. the early history of outpatient clinics may be best characterized as stepchildren 123. after several reorganizations, the public health service became the major agency responsible for the largest health program in the world true 124. a major obligation of the physician when obtaining informed consent for medical procedures is to shield informationemotional side affects false 125. the single most important impedus for helath care reform over 44 million uninsured Americans false 126. individuals who have no or inadequate health insurance B & D 127. in the last few years, theres been an increased interest in outcomes research, this is evaluates results of heatlh care in hospitals, clinics and homes 128. the future health care system will emphasize vertical integration. That means tax payers will contract broad continuum of care true 129. rapidly increasing health care expenditures are due to a variety of factors. Most important include treatment and diagnostic advances, new pharmaceuticals 130. BCBS modeled after baylors schoolteachers plan true 131. of the total us health care expenditures hospital care contributes the highest is the total health care expenditures 132. the need for sweeping rather then reforms was brought to the forefront grassroots movement false 133. the for profit health care sector has become a major player in ambulatory care services - true