KATES' FINAL EXAM STUDY GUIDE
HSA3111 QUESTIONS &
ANSWERS(RATED A+)
The effects or final results obtained from utilizing the structure and process of health
care delivery
-Patient satisfaction
-Health status
-Recovery
-Improvement
-Nasocomial infections
-Iatrogenic illness (injuries)
-Mortality
-Incidence and prevalence of disease - ANSWEROutcome (Donabedian Model)
-Final Results
The specific way in which care is provided
-Correct diagnostic tests
-Correct prescriptions
-Accurate drug administration
-Pharmaceutical care
-Waiting time to see a physician - ANSWERProcess (Donabedian Model)
-Actual Delivery of Health Care
The relatively stable characteristics of the providers of care, of the tools and
resources they have at their disposal, and of the physical and organizational settings
in which they work
-Facilities: licensing and accreditation
-Equipment: staffing levels and qualifications
-Training
-Delivery system: distribution of hospital beds and physicians - ANSWERStructure
(Donabedian Model)
-Resource Inputs
The following are _______ aspects of care in the Donabeidan Model.
-Diagnosis, treatment procedures, correct prescriptions, accurate drug admin,
pharmaceutical care, waiting time, cost - ANSWERTechnical Aspects of Care (DM
Process)
The following are _______ aspects of care in the Donabedian Model.
-Communication, dignity and respect, compassion and concern -
ANSWERInterpersonal Aspects of Care (DM Process)
______ integration links services that are at different stages in the production
process of health care.
, Purpose is to increase comprehensiveness and continuity of care. -
ANSWERVertical
______ integration is a growth strategy in which a health care organization extends
its core product or service.
Purpose is to achieve geographic expansion. - ANSWERHorizontal
The following describes which managed care plan?
-Use of only in-network providers
-Providers on staff and/or contracted providers
-Gatekeeping
-Focus on prevention and primary care
-Speciality services are obtained upon referral
-Providers are paid mostly under capitation
-Some fee-for-service
-Risk sharing with providers under capitation - ANSWERHMOs (Health Maintenance
Organizations)
The following describes which managed care plan?
-Use of both in-network and out-of-network providers is allowed
-Contracted providers only
-No gatekeeping
-Unrestricted use of specialty services
-Providers are paid according to discounted fee schedules (fee-for-service)
-No risk sharing - ANSWERPPOs (Preferred Provider Organizations)
The following describes which managed care plan?
-Use of both in-network and out-of-network providers
-Contracted providers only
-Unrestricted use of speciality services
-Combination of capitation and fee for service
-Some risk sharing - ANSWERPOS (Point of Service)
______ Model HMO
-Employs its own salaried physicians
-Physicians paid fixed salaries and at end of year get bonus
-Provide services to that specific HMOs enrollees
-Employ physician for all specialities and subspecialties
-Able to control practice patterns of their physicians
-People have little choice of providers
-Model declining - ANSWERStaff
-Preventative services also covered: pap smears, mammography, screening for
colorectal and prostate cancer, glaucoma screening, flu shots and vaccinations
against pneumonia
-Also an annual physical exam made available with no deductibles or co payments
needing to be applied
-Must pay a monthly premium (income based)
-Annual deductible of an 80:20 coinsurance to most services - ANSWERMedicare
Part B (Physicians; Supplementary Medical Insurance)
HSA3111 QUESTIONS &
ANSWERS(RATED A+)
The effects or final results obtained from utilizing the structure and process of health
care delivery
-Patient satisfaction
-Health status
-Recovery
-Improvement
-Nasocomial infections
-Iatrogenic illness (injuries)
-Mortality
-Incidence and prevalence of disease - ANSWEROutcome (Donabedian Model)
-Final Results
The specific way in which care is provided
-Correct diagnostic tests
-Correct prescriptions
-Accurate drug administration
-Pharmaceutical care
-Waiting time to see a physician - ANSWERProcess (Donabedian Model)
-Actual Delivery of Health Care
The relatively stable characteristics of the providers of care, of the tools and
resources they have at their disposal, and of the physical and organizational settings
in which they work
-Facilities: licensing and accreditation
-Equipment: staffing levels and qualifications
-Training
-Delivery system: distribution of hospital beds and physicians - ANSWERStructure
(Donabedian Model)
-Resource Inputs
The following are _______ aspects of care in the Donabeidan Model.
-Diagnosis, treatment procedures, correct prescriptions, accurate drug admin,
pharmaceutical care, waiting time, cost - ANSWERTechnical Aspects of Care (DM
Process)
The following are _______ aspects of care in the Donabedian Model.
-Communication, dignity and respect, compassion and concern -
ANSWERInterpersonal Aspects of Care (DM Process)
______ integration links services that are at different stages in the production
process of health care.
, Purpose is to increase comprehensiveness and continuity of care. -
ANSWERVertical
______ integration is a growth strategy in which a health care organization extends
its core product or service.
Purpose is to achieve geographic expansion. - ANSWERHorizontal
The following describes which managed care plan?
-Use of only in-network providers
-Providers on staff and/or contracted providers
-Gatekeeping
-Focus on prevention and primary care
-Speciality services are obtained upon referral
-Providers are paid mostly under capitation
-Some fee-for-service
-Risk sharing with providers under capitation - ANSWERHMOs (Health Maintenance
Organizations)
The following describes which managed care plan?
-Use of both in-network and out-of-network providers is allowed
-Contracted providers only
-No gatekeeping
-Unrestricted use of specialty services
-Providers are paid according to discounted fee schedules (fee-for-service)
-No risk sharing - ANSWERPPOs (Preferred Provider Organizations)
The following describes which managed care plan?
-Use of both in-network and out-of-network providers
-Contracted providers only
-Unrestricted use of speciality services
-Combination of capitation and fee for service
-Some risk sharing - ANSWERPOS (Point of Service)
______ Model HMO
-Employs its own salaried physicians
-Physicians paid fixed salaries and at end of year get bonus
-Provide services to that specific HMOs enrollees
-Employ physician for all specialities and subspecialties
-Able to control practice patterns of their physicians
-People have little choice of providers
-Model declining - ANSWERStaff
-Preventative services also covered: pap smears, mammography, screening for
colorectal and prostate cancer, glaucoma screening, flu shots and vaccinations
against pneumonia
-Also an annual physical exam made available with no deductibles or co payments
needing to be applied
-Must pay a monthly premium (income based)
-Annual deductible of an 80:20 coinsurance to most services - ANSWERMedicare
Part B (Physicians; Supplementary Medical Insurance)
