Delivering Health Care in America Exam Questions Answered Correctly Already Passed (A+)

Delivering Health Care in America Exam Questions Answered Correctly Already Passed (A+) What are the two main objectives of a health delivery system? - Answers The primary objectives of any health delivery system are to enable all citizens to receive health careservices whenever needed, and to deliver health services that are cost-effective and meet pre-established standards of quality. What is the primary reason for employers to purchase insurance plans to provide health benefits to their employees? - Answers The United States does not have a universal health care system covering all citizens. Health insurance is primarily employer-based. What is managed care? - Answers Managed care is a system of health care delivery that seeks to achieve efficiencies by integrating the basic functions of health care delivery, and employs mechanisms to control utilization of medicalservices and the price at which the services are purchased. Discuss the intermediary role of insurance in the delivery of health care. - Answers the insurance function introduces a third party into the transaction between the patient and the provider. Health insurance insulates the consumer from the cost of health care. Providers are sometimes restricted from delivering services that are non covered. Who are the major players in the US health services system? What are the positive and negative effects of these players? - Answers The key players in the system are the physicians, administrators of health service institutions, insurance executives, large employers, and the government. One positive effect of these opposing forces is that they prevent any single entity from dominating the system. On the other hand, they also make it difficult to achieve system wide reforms. What main roles does the government play in the US health services system? - Answers The government is a major financier of health care delivery through the Medicare and Medicaid programs. The government determines eligibility criteria as to who can receive services under these programs; it also determines the reimbursement rates that providers will receive for rendering services to Medicaid and Medicare patients. In order to render services to Medicare and Medicaid, these organizations must comply with the standards of participation formulated by the government. What is socialized health insurance (SHI)? - Answers In a socialized health insurance system, health care is financed through government-mandated contributions by employers and employees. What are the two major goals of chapter 2? - Answers The first goal is to propose a holistic approach to health care delivery that focuses on curative medicine, health promotion, and disease prevention. The second goal is to further explore the issue of equity in the distribution of health services using the contrasting theories of market justice and social justice in U.S. Health Care Delivery. Distinguish between illness and disease. How are these concepts related to the medical model of health care delivery? - Answers Illness reflects what a person feels. Disease may or may not be present. On the other hand, disease reflects the physician's diagnosis. It requires therapeutic intervention. A person who is ill seeks health care with the objective of finding relief of symptoms and discomfort. A medical professional attempts to diagnose the illness and prescribes treatment if disease is present. What are the 3 classifications of disease? Define them. - Answers Acute condition: relatively severe, episodic and often treatable, Sub acute condition, and Chronic condition: less severe What are the 4 major determinants of health? Explain each determinant. - Answers Environment, Behavior and Lifestyle, Heredity, Medical Care What are the main objectives of public health? - Answers Public health is concerned with ensuring conditions that promote optimum health for society as a whole. Its main objectives are to prevent disease, prolong life, and promote health through organized community effort. What are the two overarching goals of Healthy People Initiatives? - Answers The first goal is to help individual of all ages increase life expectancy and improve their quality of life. The second goal is to eliminate health disparities among different segments of the population. Describe how health care is rationed in the market justice and social justice systems. - Answers In the market justice system, health care services are rationed through prices and the ability to pay. The uninsured and those who lack sufficient income to pay privately cannot obtain the quantity and type of health care services when they want them. This is referred to as demand-side rationing, or price-rationing. What is the role of health risk appraisal in health promotion and disease prevention? - Answers Health risk appraisal is the process of evaluating risk factors and their health consequences in individuals. Only when the risk factors and their health consequences are known can avenues be developed for motivating individuals to alter their behaviors to more healthful patterns. Which type of health insurance is based on the market justice? - Answers Private, employer-based health insurance, mainly for middle-income Americans, falls under the heading of market justice. Health promotion and disease prevention may require both behavioral modification and therapeutic intervention. Discuss. - Answers Behavior can be modified through educational programs and incentives directed at specific high risk populations. For example cigarette smoking Discuss the significance of an individual's quality of life from the health delivery perspective - Answers During institutionalization, life domains such as comfort, ability to make decisions, respect and dignity, and attention to personal preferences are important indicators of quality of life. Self-perceptions of health, ability to function, and role limitations stemming from physical or emotional problems are important life domains after the patient has returned to the community. What are the 2 major objectives of chapter 4? - Answers The first objective is to provide an overview of the large array of health professionals employed in the vast assortment of health delivery settings. The second objective is to describe the differences and imbalances between primary and specialty care services characterized in the U.S. health care system. Explain why the health care sector of the U.S. economy continues to grow? - Answers The first reason is that there is a growth in population that now utilizes a greater amount of health services. This growth is mainly due to immigration. Another reason is the aging of the population. This particularly describes the baby boom generation that starts to hit retirement age in the year 2011 and beyond. What factors are associated with the development of health services professionals in the U.S.? - Answers The development of health services professionals in the U.S. is closely related to population trends, advances in research and technology, disease and illness trends, and the changing environment of health care financing and delivery. What are the major distinctions between primary care and specialty care? - Answers Primary care may be distinguished from specialty care by the time, focus, and scope of the services provided to the patients. Primary care is first-contact care or the portal to the health care system, whereas specialty care, if needed, generally follows primary care. Primary care focuses on the person as a whole, whereas specialty care centers on diseases or organ systems. Primary care is comprehensive in scope and includes health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis, and treatment of acute and chronic illnesses. Specialists are more narrowly focused. Why is there a geographic mal distribution of the physician labor force in the U.S.? - Answers Physicians are more likely to concentrate in metropolitan and suburban areas than in rural and inner-city areas because they're normally offered higher income, professional interaction, access to modern facilities and technology, continuing education and growth, high standards of living, and social amenities. The basic physician labor force problem in the United States is that while the supply of physicians is largely determined by population need, medical services are delivered in a market that links services to ability to pay, whether through insurance or out of pocket. Why is there an imbalance between primary care and specialty care in the U.S.? - Answers The principal determinant of need for primary care physicians is the demographics of the general population. The major driving force behind specialists is the development of medical technology. The rapid advance of medical technology expands the demand for specialty services. Specialists not only earn higher incomes, but they also have more predictable work hours and have higher prestige.