3- Stanhope Ch. 3_ US and Global Health Care Flashcards _ Quizlet
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Stanhope Ch. 3: US and Global Health Care
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A public health agency is planning to implement the
electronic health record. (Which is a benefit of this
choice)?
a. Facilitation of interprofessional care
b. Improved client compliance with medical regimens
c. Cost savings to the agency
d. Compliance with JCAHO standards
ANS: A
The electronic medical record facilitates interprofessional care in chronic disease
management and coordination of referrals; 24-hour availability of records with downloaded
laboratory results and up-to-date assessments; incorporation of protocol reminders for
prevention, screening, and management of chronic disease; improvement of quality
measurement and monitoring; increased client safety; and decline in medication errors.
There is no evidence that an electronic health record improves client compliance with
medical regimens. Electronic health records can increase costs to an agency. JCAHO does
not accredit public health agencies.
Which statement best describes the cost of health care in
the United States?
a. Health care costs are kept low, and the indicators of
health are among the best worldwide.
b. Health care costs are low which has resulted in poor
health outcomes.
c. Health care costs are the highest in the world, but the
indicators of health are not the best worldwide.
d. Health care costs and indicators of health are the
highest in the world.
ANS: C
Health care costs in the United States are the highest in the world and comprise the greatest
percentage of the gross domestic product, the indicators of what constitutes good health
do not document that Americans are really getting their money's worth. Health care costs
are not low in comparison to the rest of the world. The health outcomes in the United States
are poor in comparison to other countries who spend less money on health care.
A nurse is explaining the health care system in the United
States to a group of health care providers visiting from
South America. How would the nurse best describe the
current health care system?
a. "It is a logical, rational approach to meeting expressed
needs while still trying to control costs."
b. "It is a centralized system that provides care in
hospitals."
c. "It is divided primarily into two components: private
health care and public health care."
d. "It is the best in the world with outstanding research
and high-technology care available to all."
ANS: C
Health care in the United States consists of a private or personal care system and a public
health system, with overlap between the two. The United States health care system is one of
the most expensive systems in the world that does not do a good job at controlling costs.
Care is provided through an enormous range of facilities and providers, including hospitals,
physicians' and dentists' offices, nursing homes, mental health facilities, ambulatory care
centers, and freestanding clinics. Although there is great research and high-technology care
in the United States, the health care outcomes of the country do not reflect this. Health care
disparities exist among multiple populations making this system not available to all.
Which statement best describes ideal primary health
care?
a. Based on a multidisciplinary group of health care
providers that work as a team
b. Essential care available to all community members,
which encourages self-management
c. Focused on health promotion and disease prevention
for everyone enrolled in the health center
d. Local efforts to meet the Declaration of Alma Ata
principles
ANS: B
Primary health care is generally defined as essential care made universally accessible to
individuals, families, and the community. Health care is made available to them with their full
participation and is provided at a cost that the community and country can afford. Public
health is described as organized and multidisciplinary efforts aimed at preventing disease
and promoting health, not primary care. Primary care provides for the integration of health
promotion, disease prevention, with curative and rehabilitative services. The Declaration of
Alma Ata was aimed at a world-wide, not local goal, to attain a level of health that permitted
all citizens of the world to live socially and economically productive lives.
How does managed care (MC) attempt to control costs of
care?
a. By encouraging families to use the point of service list
of individual practice associates
b. By requiring families to choose a care provider from the
MC network and not allowing access to other services
without their provider's permission
c. By moving Medicaid-eligible families onto state
Medicare enrollment
d. By refusing permission for families to use urgent care or
emergency department services
ANS: B
Managed care is a system in which care is delivered by a specific network of providers. Each
provider serves as a gatekeeper who controls access to other providers and services. Cost
is reduced because members cannot use specialists or seek hospital or other care without
permission from their primary-care providers. Thus, those enrolled in Medicaid managed
care have restrictions that help keep costs down for government (and for taxpayers).
Managed care provides care through a specific network of providers who agree to comply
with the care approaches established through a case management approach, not through a
point of service list of individual practice associates. Medicaid and Medicare programs are
not interchangeable, these programs serve different populations. Managed care does not
refuse permission for certain services such as urgent care or emergency department, rather
a case management approach is used to control costs
An 80-year-old woman comes to the community health
care facility with a large bag of medications. She tells the
nurse she can no longer afford these medications
because her only income is Social Security. Which
statement is the best response by the nurse?
a. "Let's go through these medications and see which ones
we can delete."
b. "You can get these medicines at this clinic for free."
c. "Let's see if we can get some help from Medicare to
help you pay for these medications."
d. "These medications are important. Do your best to pay
for them."
ANS: C
This elderly patient probably is eligible for benefits through Medicare Part D. Medicare Part
D has been added to Medicare to help cover the cost of prescriptions. The role of the nurse
would not be to delete medications for the patient or to tell the patient to figure it out on
her own. Because of the age of the patient, the nurse should see if options exist under the
Medicare system before looking into receiving the medications for free as there may be
other barriers which limit the abilities to get these medications at a discounted cost
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A nurse is determining which health care services must be
offered at a local public health clinic. Which factor is most
important for the nurse to consider?
a. Data available from the most recent community
assessment
b. Suggestions from community members about what is
needed
c. Recommendations from Healthy People 2020
d. Services mandated by the state government
ANS: D
At the local level, health departments provide care that is mandated by state and federal
regulations. Data available from the most recent community assessment, suggestions from
community members about need, and recommendations from Healthy People 2020 could
all be used. However, funding for these types of programs may not be available. The
services that are mandated by the state government will be funded and allow the clinic to
be able to provide these services.
A public health nurse is working with a low-income
population in Massachusetts. Which of the following
assumptions can the nurse make about this population?
a. They have difficulty accessing health care due to a
shortage of primary-care providers.
b. They most likely receive health insurance through
Medicare.
c. They are unable to access health care due to the
implementation of the Affordable Care Act.
d. They have access to affordable health care insurance
ANS: D
Massachusetts began an experiment in health reform in 2006. Two years after health reform
legislation became effective, only 2.6% were uninsured, the lowest percentage ever
recorded in any state. The shortage of primary care providers is not significantly different in
Massachusetts than in other areas of the country. Low-income populations are eligible for
Medicaid services, not Medicare. The program in Massachusetts became a model for the
Affordable Care Act.
A public health nurse is working with a client who does
not have health insurance. Where will the nurse most likely
direct the client to in order to receive care?
a. Managed care
b. Community health center
c. Emergency department
d. Physician office
ANS: B
There is a safety net for the uninsured or underinsured. These are the federally funded
community health centers which provide a broad range of health and social services, using
nurse practitioners and RNs, physician assistants, physicians, social workers, and dentists.
Community health centers serve primarily in medically underserved areas which can be rural
or urban as well as people of all ages, races, and ethnicities, with or without health
insurance. Managed care is a system in which care is delivered by a specific network of
providers who agree to comply with the care approach, not a place to refer a client without
health insurance. Emergency departments and physician offices are not the best place for
an individual without health insurance to receive care. Both are expensive and do not
provide the necessary resources for the individual to possibly receive health insurance
Which of the following best describes why local, state,
and federal governmental agencies have started to
cooperate and collaborate more closely in the last few
years?
a. Increased administrative pressures to demonstrate
outcomes
b. Increased focus on emergency preparedness and
response
c. Increased taxpayers' complaints and general
unhappiness
d. Increased pressure to decrease overlap in services
ANS: B
Since the tragedy of September 11, 2001, health departments have increasingly focused on
emergency preparedness and response. In case of an emergency event, state and local
health departments in the affected area will be expected to collect data and accurately
report the situation, to respond appropriately to any type of emergency, and to ensure the
safety of the residents of the immediate area, while protecting those just outside the danger
zone. This goal
—
to enable public health agencies to anticipate, prepare for, recognize, and
respond to terrorist threats or natural disasters
—
has required an unprecedented level of
interstate and federal-local planning and cooperation among these agencies.
Demonstrating outcomes and decreasing overlap of services are both important factors to
consider; however, this is not the reason why increased collaboration has occurred. There
has not been an increase in taxpayer complaints or unhappiness that has caused these
changes to occur.
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Minority nurses represented about 30.1 percent of the RN
population. What is this an example of?
a. Projection
b. Disparity
c. Racism
d. A sentinel event
ANS: B
Disparities are racial or ethnic differences in the quality of health care or representation of a
faction of the population, not based on access or clinical needs, preferences, or
appropriateness of an intervention. Projection is an estimate or forecast of a future situation
based on current trends. Racism is a prejudice that exists against someone of a different
race based on the belief that one's own race is superior. A sentinel event is an unanticipated
event in health care that results in death or serious injury to the patient.
A public health agency is in the process of obtaining
accreditation. Which of the following best describes why
the agency would want to achieve accreditation? (Select
all that apply.)
a. To improve health programming and services
b. To improve community relationships
c. To improve performance and quality
d. To improve management
e. To decrease cost of health care
ANS: B, C, D
The purpose of accreditation for public health departments is to assist and identify quality
health department performance and quality, and it develops leadership, improve
management, and improve community relationships. Neither the improvement of health care
programming and services nor minimizing health care costs is a reason why a public health
agency would want to achieve accreditation
What do demographic figures suggest about the ways in
which the population of the United States is changing?
(Select all that apply.)
a. Foreign-born immigrant population is increasing.
b. Hispanics are the largest minority group population.
c. Leading causes of death are from infectious diseases.
d. Mortality for both genders in all age groups declined.
e. Unintentional injuries are among the top 10 causes of
death.
ANS: A, B, D, E
The nation's foreign-born population is growing, and it is projected that from now until 2050
the largest population growth will be due to immigrants and their children. Although African
Americans used to be the largest minority group, Hispanics now have that distinction. The
population of the United States continues to increase, and mortality for both genders from
all age groups has declined. The leading causes of death have changed from infectious
diseases to chronic and degenerative diseases with unintentional injuries being among the
top 10.
Which of the following statements is accurate descriptions
of current social and economic trends in the United
States? (Select all that apply.)
a. Citizens are appreciating the quality of life enjoyed in
the United States.
b. Enjoying life is not as important as the need to take
care of oneself.
c. People often spend a considerable amount of their own
money on complementary therapies.
d. The gap between the richest and poorest is widening.
e. The composition of families and living patterns are
changing
ANS: A, C, D, E
Several social trends that influence health care include changing lifestyles, a growing
appreciation of the quality of life, the changing composition of families and living patterns,
changing household incomes, and a revised definition of quality health care. People often
spend a considerable amount of their own money for these types of therapies because few
are covered by insurance. It is obvious that the gap between the richest and poorest is
widening because of the percent wage increase in the higher income levels. Americans
spend considerable money on health care, nutrition, and fitness, because health is seen as
an irreplaceable commodity. To be healthy, people must take care of themselves
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Which of the following provides evidence that the US
health care system is in crisis? (Select all that apply.)
a. Health insurance is an expensive benefit for employers
to provide.
b. Incompetent or negligent nurses are an ongoing
source of medical errors.
c. Long work hours and provider fatigue are a major
factor in medical errors.
d. More punitive measures must be taken to decrease
provider errors.
e. Consumers want lower costs and high-quality health
care without limits.
ANS: A, C, E
Consumers want lower costs and high-quality health care without limits and with an
improved ability to choose providers and services of their choice while employers are
typically the purchasers of health care; they want to be able to obtain basic health care
plans at reasonable costs for their employees. Many employers have seen their profits
diminish as they put more money into providing adequate health care coverage for
employees. Nurses working long hours pose a serious threat to patient safety because
fatigue slows reaction time, saps energy, and diminishes attention to detail. The Institute of
Medicine's (IOM) report To Err Is Human recommends that we stop blaming and punishing
individuals for errors and instead begin identifying and correcting system failures by
designing safety into the process of care. The report makes it clear that the majority of
medical errors today were not produced by provider negligence, lack of education, or lack
of training.
A nurse is working at a state health department. Which of
the following duties would most likely be completed in
this setting? (Select all that apply.)
a. Administering the Medicaid program
b. Assessing the health needs of the state's citizens
c. Employing and supervising school health nurses
d. Establishing and maintaining child immunization clinics
e. Providing education regarding established health
codes
ANS: A, B, E
State health departments try to prevent and respond to infectious disease outbreaks. They
also are responsible for health care financing and administering Medicaid, providing mental
health and professional education, establishing health codes, licensing facilities and
personnel, and regulating the insurance industry. State health departments also give direct
assistance to local health departments in areas such as ongoing assessment of health needs.
Employing and supervising school health nurses occur at the local level, and many times
within a specific school. Provision of child immunization clinics occurs at the local level.
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