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14 Jun 2. In its historical context, w

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Study Guide -Delivering Healthcare in America: A Systems Approach
Leiyu Shi & Douglas A. Singh

Chapter 1: A Distinctive System of Health Care Delivery

Multiple Choice Questions

1. The primary objectives of a healthcare system include all of the following except:
a. Enabling all citizens to receive healthcare services
b. Delivering healthcare services that are cost-effective
c. Delivering healthcare services using the most current technology, regardless of cost
d. Delivering healthcare services that meet established standards of quality

2. The U.S. healthcare system can best be described as:
a. Expensive
b. Fragmented
c. Market-oriented
d. All of the above

3. For most privately insured Americans, health insurance is:
a. Employer-based
b. Financed by the government
c. Privately purchased
d. None of the above

4. Medicare is primarily for people who meet the following eligibility requirement:
a. Elderly
b. Low-income
c. Children
d. Disabled

5. Medicaid is primarily for people who meet the following eligibility requirement:
a. Elderly
b. Low-income
c. Children
d. Disabled

6. The role of the government in the U.S. healthcare system is:
a. Regulator
b. Major financer
c. Medicare and Medicaid reimbursement rate-setter
d. All of the above
7. Which of the following is a characteristic of a socialized health insurance system?
a. Health care is financed through government-mandated contributions by employers and employees
b. Health care is delivered by government-employed providers
c. Both a and b
d. Neither a nor b

8. Which of the following is an overarching goal of Healthy People 2010?
a. Decrease health care costs
b. Create a more coordinated health care system
c. Establish a national health insurance program
d. Increase quality and years of healthy life

9. Which of the following is a dimension of social health?
a. Sociability
b. Community involvement
c. Marital satisfaction
d. All of the above

10. Supplier-induced demand is created by:
a. Patients
b. Providers
c. Health insurance companies
d. The government

Chapter 2: Beliefs, Values, and Health

Multiple Choice Questions

1. The elements of the Epidemiology Triangle of disease occurrence include all of the following except:
a. Environment
b. Agent
c. Society
d. Host

2. Which of the following factors is the leading cause of preventable disease and death in the United States?
a. High fat diet
b. Heredity
c. Smoking
d. Unsafe sex

3. Which of the following is not a behavioral risk factor?
a. Irresponsible motor vehicle use
b. Inadequate physical exercise
c. Unsafe neighborhoods
d. Alcohol abuse

4. What is tertiary prevention?
a. Early detection and treatment of disease
b. Rehabilitative therapies and monitoring of health to prevent complications or further illness, injury, or disability
c. Reduction of the probability that a disease will develop in the future
d. None of the above

5. According to the CDC, which factor contributes most to premature death in the U.S. population?
a. Lifestyle and behaviors
b. Lack of medical care
c. Social and environmental factors
d. Genetic makeup

6. Which of the following can be considered an environmental factor contributing to health status?
a. Air quality
b. Access to health care
c. Safety of neighborhoods
d. All of the above

7. Healthcare is considered a social good in:
a. Market justice
b. Social justice
c. Both a and b
d. The total number of cases at a specific point in time divided by the population at risk

8. Demand-side rationing is the same thing as:
a. Nonprice rationing
b. Price rationing
c. Both a and b
d. Neither a nor b

9. Prevalence is:
a. The number of new cases occurring during a specified period divided by the total population
b. The total number of cases at a specific point in time divided by the specified population
c. The number of new cases occurring during a specified period divided by the population at risk
d. The total number of cases at a specific point in time divided by the population at risk

10. Holistic health adds which element to the World Health Organization definition of health?
a. Physical
b. Mental
c. Spiritual
d. Social

Chapter 3: The Evolution of Health Services in the United States

Multiple Choice Questions

1. Which of the following forces remains relatively stable, and major shifts in this area would be necessary to bring about any fundamental change in the US health care delivery system?
a. Economic forces
b. Political change
c. Beliefs and values
d. Social forces

2. In its historical context, which of the following has played a major role in revolutionizing health care delivery?
a. Beliefs and values
b. Science and technology
c. Medical education
d. Economic growth

3. In the preindustrial era, _____ often functioned as surgeons.
a. butchers
b. tailors
c. clergymen
d. barbers

4. Hospitals in the United States evolved from
a. alms houses
b. sick homes
c. pest houses
d. inns

5. What was the function of a pest house in the preindustrial period?
a. To house people who had a contagious disease.
b. To provide refuge to those who were threatened by pests.
c. To eradicate pests.
d. To treat contagious diseases.

6. Which of the following factors was particularly important in promoting the growth of office-based medical practice in the postindustrial period?
a. Urbanization
b. Educational reform
c. Science and technology
d. Dependency
e. licensing

7. Development of the hospital and ______ happened almost hand in hand in a symbiotic relationship between the two.
a. dependency of patients
b. growth of scientific knowledge
c. professionalization of medical practice
d. cohesiveness of the medical profession

8. Why did physicians remain independent of corporate settings even after the medical profession became well recognized?
a. Hospitals were unable to pay high enough salaries to physicians.
b. Physicians disliked salary arrangements.
c. Licensure laws had not yet been passed.
d. Physicians who took up practice in a corporate setting were castigated by the medical profession.

9. Since the early 1900s, the burden of disease in developed countries has shifted
a. to underdeveloped countries
b. from infectious to chronic disease
c. from chronic to infectious disease
d. from the rich to the poor

10. The inception of _____ was used as a trial balloon for the idea of government-sponsored universal health insurance.
a. workers’ compensation
b. trade unions
c. public health
d. health care for the veterans

Chapter 4: Health Services Professionals

Multiple Choice Questions

1. A major factor influencing growth in the health care sector of the U.S. economy is:
a. The aging of the population
b. Increasing fertility rates
c. Declining death rates
d. All of the above

2. Which type of health care facility employs the most people in the U.S.?
a. Physicians’ offices and clinics
b. Hospitals
c. Nursing and personal care facilities
d. None of the above

3. When patients have multiple health problems, this is called:
a. Coaffliction
b. Comortality
c. Codependency
d. Comorbidity

4. The basic source of the physician distribution problem in the U.S. is:
a. Lack of health care coverage for all
b. The need-based model
c. Lack of awareness that there is a problem
d. A shortage of MDs

5. The Nurse Reinvestment Act of 2002 provides:
a. Grants and scholarships for nurses
b. Funding for nurse retention programs
c. Funding for further education for nurses
d. All of the above

6. Allied health professionals include:
a. Osteopaths
b. Dentists
c. Physician assistants
d. None of the above

7. Physician maldistribution occurs by:
a. Specialty
b. Geography
c. Both a and b
d. Neither a nor b
8. Primary care is:
a. Longitudinal
b. The portal to the healthcare system
c. Holistic
d. All of the above

9. The principle source of graduate medical education is:
a. Medicaid
b. Medicare
c. Private funds
d. State grant funds

10. Which of the following is a major criticism of managed care?
a. Quality of care may be sacrificed
b. Managed care is inefficient
c. Utilization may increase
d. Managed care will worsen the physician oversupply

Chapter 5: Medical Technology

Multiple Choice Questions

1. At a fundamental level, medical technology deals with
a. production of new equipment to provide more advanced health care
b. the application of knowledge produced by biomedical research
c. using discoveries made in basic sciences to improve health care
d. new drugs and devices

2. Telemedicine technology that allows a specialist located at a distance to directly interview and examine a patient is referred to as
a. telehealth
b. simultaneous
c. analogous
d. synchronous

3. The asynchronous form of telemedicine uses_____ technology.
a. store-and- forward
b. access-when-needed
c. delayed-access
d. forward-and-retrieve