Test Bank For Well Managed Healthcare Organization 9th
Edition By John R. Griffith; Kenneth R. White 9781640550582
Chapter 1-15 Complete Guide .
Provide a broad description of the U.S. healthcare system. - ANSWER: •Multiplicity of
financial arrangements
•Numerous insurers/managed care organizations that employ various mechanisms
for insuring against risk
•Multiple payers that make their own determinations about the costs for each
service
•Little standardization and missing dimensions
•No planning, direction, or coordination from a central agency
•Inefficiencies- duplication, inconsistency, and waste
•Leads the world in medical technology, training, and research with sophisticated
institutions, products, and processes
What are the four components of the quad-function model and how do the different
functions interact in the delivery of health services? - ANSWER: •The four parts are
financing, insurance, delivery, and payment.
o Financing pays for the purchase of health insurance.
o Insurance protects the buyers of health coverage against risks.
o Delivery of health care enables people to receive services covered under their
health insurance plans.
o Payment mechanisms allow providers to receive payments for services delivered
to the insured.
What is managed care? - ANSWER: 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.
Know the ten basic characteristics of the U.S. healthcare system which differentiate
it from most other countries: - ANSWER: •No central agency
•Access to health services is selectively based on insurance coverage
•Healthcare is delivered under imperfect market conditions
•Third party insurers and payers
, •Multiple payers makes the system cumbersome
•Balance of power among stakeholders prevents any single entity from dominating
system
•Legal risks influence practice behavior of physicians
•Development of new technology creates demand for its use
•New service settings have evolved along a continuum
•Quality is increasing in importance
Medical model - ANSWER: Defines health as the absence of illness or disease
Health - ANSWER: "A state of complete physical, mental and social well-being and
not merely the absence of disease or infirmity" -WHO
Holistic health - ANSWER: The well-being of every aspect of what makes a person
whole and complete
Holistic medicine - ANSWER: A philosophy of health care that emphasizes the well-
being of every aspect of a person, including the physical, mental, social, and spiritual
aspects of health
What is quality of life? - ANSWER: Overall satisfaction with life during and following a
person's encounter with the health care delivery system
How do risk factors lead to disease? - ANSWER: •Risk factors increase the likelihood
of developing disease
o Under/overweight, unsafe sex, high blood pressure, tobacco and alcohol
consumption, and unsafe water, sanitation and hygiene.
Explain the epidemiology triangle. - ANSWER: •Host is human that becomes sick
•Agent must be present
•The external environment can enhance or reduce susceptibility to disease
o Because the three entities of host, agent, and environment often interact to
produce disease, disease prevention efforts should focus on a broad approach to
mitigate or eliminate risk factors associated with all three entities.
What are the three classifications of disease? - ANSWER: Acute
Subacute
Edition By John R. Griffith; Kenneth R. White 9781640550582
Chapter 1-15 Complete Guide .
Provide a broad description of the U.S. healthcare system. - ANSWER: •Multiplicity of
financial arrangements
•Numerous insurers/managed care organizations that employ various mechanisms
for insuring against risk
•Multiple payers that make their own determinations about the costs for each
service
•Little standardization and missing dimensions
•No planning, direction, or coordination from a central agency
•Inefficiencies- duplication, inconsistency, and waste
•Leads the world in medical technology, training, and research with sophisticated
institutions, products, and processes
What are the four components of the quad-function model and how do the different
functions interact in the delivery of health services? - ANSWER: •The four parts are
financing, insurance, delivery, and payment.
o Financing pays for the purchase of health insurance.
o Insurance protects the buyers of health coverage against risks.
o Delivery of health care enables people to receive services covered under their
health insurance plans.
o Payment mechanisms allow providers to receive payments for services delivered
to the insured.
What is managed care? - ANSWER: 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.
Know the ten basic characteristics of the U.S. healthcare system which differentiate
it from most other countries: - ANSWER: •No central agency
•Access to health services is selectively based on insurance coverage
•Healthcare is delivered under imperfect market conditions
•Third party insurers and payers
, •Multiple payers makes the system cumbersome
•Balance of power among stakeholders prevents any single entity from dominating
system
•Legal risks influence practice behavior of physicians
•Development of new technology creates demand for its use
•New service settings have evolved along a continuum
•Quality is increasing in importance
Medical model - ANSWER: Defines health as the absence of illness or disease
Health - ANSWER: "A state of complete physical, mental and social well-being and
not merely the absence of disease or infirmity" -WHO
Holistic health - ANSWER: The well-being of every aspect of what makes a person
whole and complete
Holistic medicine - ANSWER: A philosophy of health care that emphasizes the well-
being of every aspect of a person, including the physical, mental, social, and spiritual
aspects of health
What is quality of life? - ANSWER: Overall satisfaction with life during and following a
person's encounter with the health care delivery system
How do risk factors lead to disease? - ANSWER: •Risk factors increase the likelihood
of developing disease
o Under/overweight, unsafe sex, high blood pressure, tobacco and alcohol
consumption, and unsafe water, sanitation and hygiene.
Explain the epidemiology triangle. - ANSWER: •Host is human that becomes sick
•Agent must be present
•The external environment can enhance or reduce susceptibility to disease
o Because the three entities of host, agent, and environment often interact to
produce disease, disease prevention efforts should focus on a broad approach to
mitigate or eliminate risk factors associated with all three entities.
What are the three classifications of disease? - ANSWER: Acute
Subacute
