WGU C425 Final Exam Review Questions and Answers | Latest Update 2023/2024 | 100% Verified

WGU C425 Final Exam Review Questions and Answers | Latest Update 2023/2024 | 100% Verified. Universal Access - ANSWER-Developed countries have national health insurance programs. It provides routine and basic health care. It is ran by the government and financed-through general taxes. All Americans are not "entitled" to routine and basic health care services. - ANSWERAccess also requires an adequate health delivery infrastructure. There is a shortage of primary care physicians mostly in the southern and mountains region. Obesity, chronic disease and aging population will create a much greater demand for medical services and the size of physician workforce will decline. 50 % of PCP accept Medicaid and Participation in Medicare by PCP 36% why PCP are reluctant to accept Medicaid insured patients because of low reimbursement to providers and delays to receive payments after the services. Health Care Reform - ANSWER-Is the extension of health insurance to the uninsured. For system to remain solvent, it must be accompanied by control costs measures. To control costs: · Manage utilization · Limit reimbursement to providers · Employ some sort of rationing for supply of health care services Only the government can control costs in a single payer system because they finance the healthcare system for all citizens. In a single payer system, - ANSWER-Medicare, Medicaid, CHIP and VA are no longer needed. The government will have the right to over the availability of services, utilization and payments to providers. This will be opposed by many Americans and it is not seen as an alternative for the future. ACA proposed interventions to control costs but few provisions on addressing control of health care expenditures. - ANSWER-If the US does not cut expenses in the bloated government, US may be left with no choice except to take drastic "austerity measure" a term used to describe spending cuts, including cuts in social program. To save Medicare from bankruptcy, changes to reduce costs are proposed in the ACA. Medicare benefits and allow a government panel to make decisions about end of life care. Medicaid, the push to enroll beneficiaries to managed care and paying MCO capitated monthly fees to cover all health care expenses for Medicaid beneficiaries. Taxes will increase for Americans to pay for the health care programs to be expanded. If ACA fails: Patient choice act, Health Care Freedom Plan, Empowering Patients First Act were proposed by republican legislatures and the main features for these plans are. - ANSWER-1. Established state-based health care exchanges to facilitate individuals to buy private health insurance and create a market where private health plans compete for enrollees based on price and quality. 2. Create a national market for health insurance to allow individuals to purchase health insurance plans across state lines which are currently prohibited. 3. Allow automatic enrollment in employer plans and create tax incentives for small business for auto enrollment. 4. Give tax credit or vouchers to individuals to purchase health insurance. High risk pools that enable hard to insure people to purchase subsidized covered. • . Replace Medicaid with a program to provide grants to state for: a) Acute Medical Care Assistance to the blind, foster care children, low income women with breast cancer or cervical cancer, TB infected individuals; b) long term care services and support disabled and elderly populations 6). Establish and implement a bidding mechanism to promise competition among Medicare Advantage plans (Part C). 7) Prevent Medicare fraud and abuse. 8) Supplement the costs of Private health insurance for low income families by distributing debit cards which may be used for costs and accessing health care. 9). Repeal CHIP because options for this program may not be necessary. 10) Reform the Tort System by developing mechanism for the resolution of disputes concerning injuries allegedly caused by health care providers. Reduce frivolous lawsuits. 11) Assure consumers have access to price information prior to treatment so that they can make their own decisions about the care. What issues exists in this system which is driven by medical model of health are unresolved? - ANSWER-1) inadequate emphasis on wellness, disease prevention and health promotion 2) a rise of chronic conditions and ensuing disabilities, the current health care system focuses on acute illnesses. 3) Inadequate access to primary care resulting in patients overutilizing the ER 4) increases the costs of health care w/o any improvement in health care 5) The delivery of care is fragmented instead of continuous and coordinated. 3 emerging models of health care delivery - ANSWER-1) Medical Home Model 2) Community Oriented Primary Care Model 3) Accountable Care Organizations. Teamlet Model - ANSWER-1) refers to two-person team consisting of a PCP, nurse practitioners or physician assistant and an allied health professional who will function as a health coach. The main function of health coach: · is to assist patient in gaining the knowledge and skills, confidence to self manage their chronic conditions. · Assist in coordinating appts · Help patients adopt a healthy lifestyle · Help patients understand and adhere to medication regimen Connected Health Care Model - ANSWER-1) uses communication technology 2) patient self management and distant home monitoring Main objective is to keep chronically ill patients connected to necessary clinical expertise in between office visits Future work force challenges - ANSWER-· Shortage of health care professionals · To have a successful model of health care delivery system to be highly effective must have trained professionals. · Nurses should practice to their full extent through education and training. · Licensing requirements rules governing scope of practice should be allowed across states for nurses who have masters or doctoral degrees · Residency programs for nurses need to incorporate training in community health, public health and geriatrics Future workforce challenges - ANSWER-PCP need to be trained to function as a comprehensivist to address the needs of growing number of people with chronic conditions. PCP must be prepared to manage complex pharmacology to address end of life issues and medical ethics and lead health care teams PCP need to be trained to function as a comprehensivist to address the needs of growing number of people with chronic conditions. PCP must be prepared to manage complex pharmacology to address end of life issues and medical ethics and lead health care teams. There is a shortage of health professionals trained in geriatrics which is a challenge because of shortage of faculty in colleges and universities who are trained in geriatrics. The elderly uses most home health care services and nursing homes, accounts for hospital inpatient days and ambulatory care visits. Elderlies suffer from chronic conditions complicated by comorbidities, the use of many prescriptions and increased in mental conditions and dementia. These trends demand will have shortage of MD, nurses, therapist, social workers and pharmacists who are trained in geriatrics. Integration of a racially and culturally diverse workforce will be a challenge as the U.S. Healthcare System itself becomes more complex in taxing both patients and workers. Cultural Competence: - ANSWER-refers to knowledge, skills, attitudes and behavior required of a practitioner to provide optima health care services to persons from a wide range of cultural and ethnic backgrounds. Health care providers need to understand the different belief systems, cultural biases, ethnic origins, family structures and many other culture-based factors that influence people who have illnesses in compliance with medical advice and respond to s to knowledge, skills, attitudes and behavior required of a practitioner to provide optima health care services to persons from a wide range of cultural and ethnic backgrounds. Health care providers need to understand the different belief systems, cultural biases, ethnic origins, family structures and many other culture-based factors that influence people who have illnesses in compliance with medical advice and respond to treatment. GLOBAL THREATS AND INTERNATIONAL COOPERATION - ANSWER-Early identification of infectious threats and rapid response to prevent further spread of disease - a goal that is often difficult to achieve without international cooperation. Efforts to strengthen global health security includes disease surveillance of outbreaks of international importance and urgency, exchange of technical information on new pathogens and control animal disease. IHR (International Health Regulations) - ANSWER-Aim is to help prevent and respond to acute public health risk that can potentially cross borders. ·Apply to other public health emergencies such as chemical spills, leaks and dumping or nuclear melt downs. There are 8 types of medical technology that affect the future of delivery of patient care: - ANSWER-Rational Drug Design: refers to the development of medications based on the study of the structures and functions of target molecules. The role of rational drug design, besides developing effective drugs, is to avoid having to wait for pure luck to design a new drug or to use a shotgun approach in drug design. 2) Imaging technologies: focuses on finding new energy sources and focusing an energy beam to avoid damage to tissues; detects abnormalities; faster accurate analysis using 3 D technology and higher resolutions displays 3) Minimally invasive surgery 4) Genetic mapping: to determine genes complex disease 5) Gene Therapy insertion of functioning gene into target cells to correct an inborn defect 6) Vaccines; for prophylactic basis 7) Research and developing of fluids and artificial bloods 8) Transplantation of organs such as xenotransplantation; animal tissues used to transplant humans Evidence Based Health Care - ANSWER-1) Geographic variations in the practicing of medicine without clinical justification have both quality and cost implications. 2) Has little evidence that high spending providers deliver better outcomes. Tools for the practice of EBM is - ANSWER-Is formed of practice clinical guidelines. Evidence based practice guidelines are intended to represent "best practices" and "proven therapies." Many MD thinks the guidelines and protocols are too simple or too complicated, promote cookbook care, authors lack credibility or evidence are biased, decreases flexibility, reduces autonomy and are not applicable to the practice population. The goal of EBM is to increase the value of medical care. - ANSWER-1) Consumers fear that reducing costs will result in lower quality of care. Quality of care can be improved while cutting costs thereby increasing the value of medical care by reducing misuse and overuse. Recommendations for EBM that can be made for the future. - ANSWER-1) Practitioners, payers and policy makers need to become stakeholders. 2) Computer based models will help incorporate EMB into medical decision making. Models that are easily usable and understandable are essential. 3) Robust research designs, using clinical trials where application can be the backbone of EBM. 4) Guidelines and protocols must be revised and kept current to incorporate with scientific evidence. 5) Future practice guidelines must incorporate economic analysis. Mounting health care expenditures will pressure society to make rational choices about certain types of services because of costs of certain treatments. 6) Financial incentives, including provider payments and patient cost sharing must be restructured. 7) Reimbursement methods should focus on paying for best care instead of paying for services. Future of EBM - ANSWER-Will exceed what MDs do and will incorporate all caregivers. For example, it infuses the practice of nursing, pharmacology or disciplines associated with the practice of medicine. EMB will become the standard that will govern the multidisciplinary process of health care delivery. Foundation of US Health Care Delivery - ANSWER-Curative Medicine decreasing returns on health improvement while health care spending increases. There is increasing recognition of benefits to society that can result from promotion of health and prevention of disease, disability and premature death. Health care money has been focused on curative medicine, slow progress toward health promotion and disease prevention. The slow progress has been d/t the insurance system, cultural values, and medical practice that emphasize disease rather than health. Beliefs and values in US - ANSWER-- Have remained mostly private, • Not a tax-financed national health care program. - Are strong forces against Fundamental changes in the financing and delivery of health care. • Social norms explain - ANSWER-- How we view illness and expectations. What Is Health? - ANSWER--U.S. health care has followed a medical/biomedical model. - It assumes illness or disease thereby emphasizing clinical diagnosis and medical in the treatment of disease or its symptoms. - It emphasizes • Clinical diagnosis and medical interventions to: - Treat disease or its symptoms. - Have a clinical diagnosis and medical interventions. Largely governed by the medical model/biomedical model. Medical Model: - ANSWER-Under the medical model, health is defined as the absence of illness or disease. The problem with this is health exists when a person is free of symptoms and does not require medical treatment. The reason does not provide the definition of health but defines what health is not. Health Care Delivery System - ANSWER-Is Prevention of disease and health promotion are relegated a secondary status . It is a term used often in a population that lacks health.