HMGT Exam #1 Questions With Complete Solutions
10 basic characteristics of the US HC delivery system -
#2 Partial Access Correct Answers the ability to obtain health
care when needed
americans can access health care services through several outlets
and health insurance helps ensure access
10 basic characteristics of the US HC delivery system -
#3 Imperfect market Correct Answers quasi-market where HC
is partially managed by free markets and in a free market
multiple pt's and providers act independently
unrestrained competition
pt's must have info about the availability of different services -
internet is a source
pt's must bear cost of services
10 basic characteristics of the US HC delivery system -
#1 No central agency governs the system Correct Answers U.S.
has mostly private financing/delivery
financing via employees 52% and government 48%
,U.S. determine public-sector expenses and reimbursement rates
for Medicare/Medicaid/CHIP and the government sets standards
for participation and providers must comply to be certified to
provide care to these patients
most developed countries have a national healthcare system that
controls proliferation of health services to control costs and use
global budget to determine total health care expenses
10 basic characteristics of the US HC delivery system -
#4 3rd party payers and insurers Correct Answers pt is the 1st
party
provider is the 2nd party
insurance intermediary is the 3rd party
a wall of separation between financing and delivery
quality and price is not a primary concern
10 basic characteristics of the US HC delivery system - #10
Quest for Quality Correct Answers definition/measurement are
not clear cut - increased pressure to develop quality standards
and demonstrate compliance
higher expectations
continuous quality improvement
,10 basic characteristics of the US HC delivery system - #5
Multiple payers Correct Answers companies can choose
different plans
10 basic characteristics of the US HC delivery system - #6
Power Balancing Correct Answers multiple players
key players : docs, admins, insurance companies, large
employers, govt
-- all with own economic interest to protect and self-interests are
often at odds
10 basic characteristics of the US HC delivery system - #7
Litigation Risks Correct Answers litigious society
private HC providers are increasingly susceptible
risk of malpractice suits
10 basic characteristics of the US HC delivery system - #8 High
Technology Correct Answers hotbed of research/innovation in
new technology
creates demand for new services despite high costs
with capital investments must have utilization
legal risks for providers denying new technology
, 10 basic characteristics of the US HC delivery system - #9
Continuum of Services Correct Answers 3 categories of
medical care services
(1) curative
(2) restorative
(3) preventative
HC is not defined to the hospital there are additional settings
3 Pros of the U.S. HCS Correct Answers (1) medical research
and technology
(2) medical training
(3) sophisticated institutions, products, services and care
processes
4 Cons of the U.S. HCS Correct Answers (1) duplication and
overlap
(2) complexity and waste
(3) inefficiency and fragmentation
(4) wasted resources
A System = Correct Answers a set of interrelated and
interdependent, logically coordinated components designed to
achieve common goals
10 basic characteristics of the US HC delivery system -
#2 Partial Access Correct Answers the ability to obtain health
care when needed
americans can access health care services through several outlets
and health insurance helps ensure access
10 basic characteristics of the US HC delivery system -
#3 Imperfect market Correct Answers quasi-market where HC
is partially managed by free markets and in a free market
multiple pt's and providers act independently
unrestrained competition
pt's must have info about the availability of different services -
internet is a source
pt's must bear cost of services
10 basic characteristics of the US HC delivery system -
#1 No central agency governs the system Correct Answers U.S.
has mostly private financing/delivery
financing via employees 52% and government 48%
,U.S. determine public-sector expenses and reimbursement rates
for Medicare/Medicaid/CHIP and the government sets standards
for participation and providers must comply to be certified to
provide care to these patients
most developed countries have a national healthcare system that
controls proliferation of health services to control costs and use
global budget to determine total health care expenses
10 basic characteristics of the US HC delivery system -
#4 3rd party payers and insurers Correct Answers pt is the 1st
party
provider is the 2nd party
insurance intermediary is the 3rd party
a wall of separation between financing and delivery
quality and price is not a primary concern
10 basic characteristics of the US HC delivery system - #10
Quest for Quality Correct Answers definition/measurement are
not clear cut - increased pressure to develop quality standards
and demonstrate compliance
higher expectations
continuous quality improvement
,10 basic characteristics of the US HC delivery system - #5
Multiple payers Correct Answers companies can choose
different plans
10 basic characteristics of the US HC delivery system - #6
Power Balancing Correct Answers multiple players
key players : docs, admins, insurance companies, large
employers, govt
-- all with own economic interest to protect and self-interests are
often at odds
10 basic characteristics of the US HC delivery system - #7
Litigation Risks Correct Answers litigious society
private HC providers are increasingly susceptible
risk of malpractice suits
10 basic characteristics of the US HC delivery system - #8 High
Technology Correct Answers hotbed of research/innovation in
new technology
creates demand for new services despite high costs
with capital investments must have utilization
legal risks for providers denying new technology
, 10 basic characteristics of the US HC delivery system - #9
Continuum of Services Correct Answers 3 categories of
medical care services
(1) curative
(2) restorative
(3) preventative
HC is not defined to the hospital there are additional settings
3 Pros of the U.S. HCS Correct Answers (1) medical research
and technology
(2) medical training
(3) sophisticated institutions, products, services and care
processes
4 Cons of the U.S. HCS Correct Answers (1) duplication and
overlap
(2) complexity and waste
(3) inefficiency and fragmentation
(4) wasted resources
A System = Correct Answers a set of interrelated and
interdependent, logically coordinated components designed to
achieve common goals
