NR 442 COMMUNITY HEALTH EXAM
WITH QUESTIONS AND
ANSWERS/RATED A+
Hill-Burton Act 1946 - ANSWER>>>>>-Federal assistance in construction of
hospitals with stipulations about service for uninsured
-Hospitals went bankrupt, couldn't support themselves
Federal Legislation for Health care - ANSWER>>>>>-Prevent illness by
influlencing environment
-Funding to support programs to improve health= inc. regulations
-increased role of state and local gov.
-promoted similarities of services in all states
-standardized public health policy in U.S.
Social security act - ANSWER>>>>>-welfare for high risk mothers, children,
elderly and disabled
Welfare reform act - ANSWER>>>>>-restricted eligibility for AFDC (family and
child), medicaid and welface
-number w/welfare dropped many recipients causing problems
-people took low paying jobs, no insurance
Medicare A - ANSWER>>>>>-inpatient, care in hospoitals/skilled nursing
facilities, hospice care, some home health care
-pay deductible
-does NOT pay for ALL health care costs of enrollees
-"gaps" in coverage
Medicare B - ANSWER>>>>>-type of "medigap" (privately purchased
individual or group health insurance plan designed to supplement Medicare
coverage.) supplements type A Medicare
-purchased for monthly fee, have to pay deductible and coinsurance
-not mandatory
-helps pay for md services
-hospital out-patient, durable medical equipment & some home care
,Medicare modernization act - ANSWER>>>>>-very IMPORTANT, provides
seniors and disabled w/some RX drug benefit coverage
-more choices, better benefits
Voluntary agency categories: - ANSWER>>>>>1. Specific diseases: American
Diabetes Association, American Cancer Society and National Multiple
Sclerosis Society
2. Organ or body structures: National Kidney Foundation or the American
Heart Association
3. Health & welfare of special groups: National Council on Aging or March of
Dimes
4. Particular phases of health, such as the Planned parenthood
Federal Government- public health administration responsibilities -
ANSWER>>>>>-focus on POPULATION
-prevention of disease and illness.
-mandated by US Constitution, promote general welfare on federal, state and
local levels
-Public health and community health nurses are in a unique position to
provide leadership and facilitate change in the health care system
Federal level subsystem - ANSWER>>>>>-U.S. Department of Health and
Human Services
-ex: Surgeon General
-Targets: general population, special populations and international health
State level subsystem - ANSWER>>>>>-State Health Departments
-responsibility: health of their citizens
-Central authorities in public HC system
-establishes own STATE laws (state's rights)
Health care for military and veterans - ANSWER>>>>>-the Department of
Defense TRICARE and TRICARE for Life programs, the Veterans
Administration program
-federal government is the largest purchaser of care and has a major impact
on many people. It provides direct care to military personnel and their
families and veterans
MCO (Medical Care Organization) - ANSWER>>>>>...
, MCOs ethical problems - ANSWER>>>>>-remove gag rules (control what their
providers discuss with clients about all treatment options)
-financial control incentives to control costs
-consumer rights:emergency services without prior approval; longer lengths
of stay (obstetric & mastectomy); detailed disclosure of benefits and plan
procedures; provider choice
Local Health Departments - ANSWER>>>>>-responsible for DIRECT DELIVERY
of public health services/protection
-not all communities have LHDs
-Responsible for: Community, Enviornmental, Personal and mental health
services
deductible - ANSWER>>>>>Cost sharing- individual pays a specified amount
before the health plan pays for covered services.
co-payment - ANSWER>>>>>Cost sharing required by the health plan
whereby the individual must pay a FIXED dollar amount for EACH service.
Indemnity HC plan - ANSWER>>>>>-no incentives/gatekeeper (person in an
MCO who decides whether a patient will be referred for specialty care.
Doctors, nurses, nurse practitioners, and physician assistants) -pays covered
services on a fee-for-fee basis (more expensive)
Health Maintenance Organization (HMOs) - ANSWER>>>>>-managed care
plan that acts as an insurer and sometimes a provider for a fixed pre-paid
(LOWER) premium
-NO deductible/co-payment
-comphrehensive care
-usually employ physicians, restricted to plan provider
-may have lower quality care to max costs
Preferred provider organization (PPO) - ANSWER>>>>>-greater provider
selection than HMO
-contracts w/providers to furnish services to enrollees of plan
-gatekeeper
-ADDITIONAL cost for providers out of plan
-also chance of lower quality care
WITH QUESTIONS AND
ANSWERS/RATED A+
Hill-Burton Act 1946 - ANSWER>>>>>-Federal assistance in construction of
hospitals with stipulations about service for uninsured
-Hospitals went bankrupt, couldn't support themselves
Federal Legislation for Health care - ANSWER>>>>>-Prevent illness by
influlencing environment
-Funding to support programs to improve health= inc. regulations
-increased role of state and local gov.
-promoted similarities of services in all states
-standardized public health policy in U.S.
Social security act - ANSWER>>>>>-welfare for high risk mothers, children,
elderly and disabled
Welfare reform act - ANSWER>>>>>-restricted eligibility for AFDC (family and
child), medicaid and welface
-number w/welfare dropped many recipients causing problems
-people took low paying jobs, no insurance
Medicare A - ANSWER>>>>>-inpatient, care in hospoitals/skilled nursing
facilities, hospice care, some home health care
-pay deductible
-does NOT pay for ALL health care costs of enrollees
-"gaps" in coverage
Medicare B - ANSWER>>>>>-type of "medigap" (privately purchased
individual or group health insurance plan designed to supplement Medicare
coverage.) supplements type A Medicare
-purchased for monthly fee, have to pay deductible and coinsurance
-not mandatory
-helps pay for md services
-hospital out-patient, durable medical equipment & some home care
,Medicare modernization act - ANSWER>>>>>-very IMPORTANT, provides
seniors and disabled w/some RX drug benefit coverage
-more choices, better benefits
Voluntary agency categories: - ANSWER>>>>>1. Specific diseases: American
Diabetes Association, American Cancer Society and National Multiple
Sclerosis Society
2. Organ or body structures: National Kidney Foundation or the American
Heart Association
3. Health & welfare of special groups: National Council on Aging or March of
Dimes
4. Particular phases of health, such as the Planned parenthood
Federal Government- public health administration responsibilities -
ANSWER>>>>>-focus on POPULATION
-prevention of disease and illness.
-mandated by US Constitution, promote general welfare on federal, state and
local levels
-Public health and community health nurses are in a unique position to
provide leadership and facilitate change in the health care system
Federal level subsystem - ANSWER>>>>>-U.S. Department of Health and
Human Services
-ex: Surgeon General
-Targets: general population, special populations and international health
State level subsystem - ANSWER>>>>>-State Health Departments
-responsibility: health of their citizens
-Central authorities in public HC system
-establishes own STATE laws (state's rights)
Health care for military and veterans - ANSWER>>>>>-the Department of
Defense TRICARE and TRICARE for Life programs, the Veterans
Administration program
-federal government is the largest purchaser of care and has a major impact
on many people. It provides direct care to military personnel and their
families and veterans
MCO (Medical Care Organization) - ANSWER>>>>>...
, MCOs ethical problems - ANSWER>>>>>-remove gag rules (control what their
providers discuss with clients about all treatment options)
-financial control incentives to control costs
-consumer rights:emergency services without prior approval; longer lengths
of stay (obstetric & mastectomy); detailed disclosure of benefits and plan
procedures; provider choice
Local Health Departments - ANSWER>>>>>-responsible for DIRECT DELIVERY
of public health services/protection
-not all communities have LHDs
-Responsible for: Community, Enviornmental, Personal and mental health
services
deductible - ANSWER>>>>>Cost sharing- individual pays a specified amount
before the health plan pays for covered services.
co-payment - ANSWER>>>>>Cost sharing required by the health plan
whereby the individual must pay a FIXED dollar amount for EACH service.
Indemnity HC plan - ANSWER>>>>>-no incentives/gatekeeper (person in an
MCO who decides whether a patient will be referred for specialty care.
Doctors, nurses, nurse practitioners, and physician assistants) -pays covered
services on a fee-for-fee basis (more expensive)
Health Maintenance Organization (HMOs) - ANSWER>>>>>-managed care
plan that acts as an insurer and sometimes a provider for a fixed pre-paid
(LOWER) premium
-NO deductible/co-payment
-comphrehensive care
-usually employ physicians, restricted to plan provider
-may have lower quality care to max costs
Preferred provider organization (PPO) - ANSWER>>>>>-greater provider
selection than HMO
-contracts w/providers to furnish services to enrollees of plan
-gatekeeper
-ADDITIONAL cost for providers out of plan
-also chance of lower quality care
