BUSINESS OF MEDICINE EXAM QUESTIONS AND ANSWERS
Models of healthcare are determined by: - CORRECT ANSWER✅✅-Levels of care (primary, secondary,
tertiary)
-Regionalized vs. Dispursed
Primary: Level of Care (model of healthcare) - CORRECT ANSWER✅✅Common health problems and
preventative measures
- Account for 80-90% of visits to physician or caregiver
Ex) sore throat, HTN, vaccinations
Secondary: Level of Care (model of healthcare) - CORRECT ANSWER✅✅Problems that require more
specialized clinical expertise
Ex) Hospital care for renal failure
Tertiary: Level of Care (model of healthcare) - CORRECT ANSWER✅✅at apex of organizational pyramid.
- Management of RARE and COMPLEX DISORDERS
Ex) pituitary tumor
Regionalized (model of healthcare) - CORRECT ANSWER✅✅· Dawson Model- the organization and
coordination of all health resources and services within a defined area
· Different types of personnel and facilities are assigned to either be at the Primary, Secondary or
Tertiary levels. Flow is orderly add regulated
· Emphasis on Primary Care
· Population-oriented framework for healthcare planning
· NHS and some large integrated delivery systems
·Ex) pt first seen by GP who may refer to specialist, pt does not refer themselves directly to specialist
Dispersed (model of healthcare) - CORRECT ANSWER✅✅· More FLUID ROLES for caregivers
· More free-flowing movement of patients across all levels of care
,· Places higher value on services at tertiary care than PCP
· US healthcare as a whole
·Ex) pt can refer themselves to several different specialist's w/o needed to seek care of PCP, use ER more
frequently
Function of primary care in the delivery of health care: - CORRECT ANSWER✅✅Key tasks of PCP
· First contact care- performs initial evaluations
· Longitudinally- sustaining patient-caregiver relationship over time
· Comprehensiveness- manages a wide range of healthcare needs.
· Coordination- Builds up longevity, integration of other caregivers through referral and follow-up
ER can provide first contact but do not provide continuity of care or coordinate care for patients on an
ongoing basis
"triple aim" of healthcare improvement - CORRECT ANSWER✅✅· Better patient experience
· Better patient outcomes
·Lower cost
Given a scenario, apply the concept of "gatekeeper" in the delivery of health care - CORRECT
ANSWER✅✅· PCP's help patients navigate the healthcare system, coordinating care with different
specialists.
·Ex) patient has been seeing several specialists for nausea, many tests and visits go by, patient still has
nausea. Patient sees PCP who is able to spend more time with patient discussing medications,
determines it could be do to a combination of a cancer drug and advil. Coordinates w/oncologist to stop
taking medicine for a week, nausea resolves, able to taper back onto medication eventually with
resolution in problem.
Explain the purpose of the patient-centered medical home - CORRECT ANSWER✅✅Care delivery model
where the patient treatment is coordinated through there PCP to ensure they receive necessary care
when and where they need it.
, Providers (health departments) - CORRECT ANSWER✅✅· "core of industry" Directly affect outcome of
provided service
·Responsible for quality and cost of HC system
Payers (employers/insurance companies) - CORRECT ANSWER✅✅· Influential stakeholders
· Proactive roles in determining costs and negotiating w/insurance companies
·Considerable influence in Congress
Government (role in delivery of health care) - CORRECT ANSWER✅✅· Dominant authority over the
system
·Medicare/Medicaid
·Health policies
·Public health
Insurers (BC/BS plans) - CORRECT ANSWER✅✅· "unrestrained" stakeholder
· Influence access to care
·Contribute to healthcare cost
Suppliers (role in delivery of health care) - CORRECT ANSWER✅✅· Prod medical technology for
treatments and diagnosits
·Contribute to HC cost
Education and research (role in delivery of health care) - CORRECT ANSWER✅✅· Clinical trials
·Develop medical technology for treatment and dx
·Training of future health care providers
US Health Care Medical Care Structures - CORRECT ANSWER✅✅1) Traditional
2) Multispecialty Group
3) Commuity Health Centers
Models of healthcare are determined by: - CORRECT ANSWER✅✅-Levels of care (primary, secondary,
tertiary)
-Regionalized vs. Dispursed
Primary: Level of Care (model of healthcare) - CORRECT ANSWER✅✅Common health problems and
preventative measures
- Account for 80-90% of visits to physician or caregiver
Ex) sore throat, HTN, vaccinations
Secondary: Level of Care (model of healthcare) - CORRECT ANSWER✅✅Problems that require more
specialized clinical expertise
Ex) Hospital care for renal failure
Tertiary: Level of Care (model of healthcare) - CORRECT ANSWER✅✅at apex of organizational pyramid.
- Management of RARE and COMPLEX DISORDERS
Ex) pituitary tumor
Regionalized (model of healthcare) - CORRECT ANSWER✅✅· Dawson Model- the organization and
coordination of all health resources and services within a defined area
· Different types of personnel and facilities are assigned to either be at the Primary, Secondary or
Tertiary levels. Flow is orderly add regulated
· Emphasis on Primary Care
· Population-oriented framework for healthcare planning
· NHS and some large integrated delivery systems
·Ex) pt first seen by GP who may refer to specialist, pt does not refer themselves directly to specialist
Dispersed (model of healthcare) - CORRECT ANSWER✅✅· More FLUID ROLES for caregivers
· More free-flowing movement of patients across all levels of care
,· Places higher value on services at tertiary care than PCP
· US healthcare as a whole
·Ex) pt can refer themselves to several different specialist's w/o needed to seek care of PCP, use ER more
frequently
Function of primary care in the delivery of health care: - CORRECT ANSWER✅✅Key tasks of PCP
· First contact care- performs initial evaluations
· Longitudinally- sustaining patient-caregiver relationship over time
· Comprehensiveness- manages a wide range of healthcare needs.
· Coordination- Builds up longevity, integration of other caregivers through referral and follow-up
ER can provide first contact but do not provide continuity of care or coordinate care for patients on an
ongoing basis
"triple aim" of healthcare improvement - CORRECT ANSWER✅✅· Better patient experience
· Better patient outcomes
·Lower cost
Given a scenario, apply the concept of "gatekeeper" in the delivery of health care - CORRECT
ANSWER✅✅· PCP's help patients navigate the healthcare system, coordinating care with different
specialists.
·Ex) patient has been seeing several specialists for nausea, many tests and visits go by, patient still has
nausea. Patient sees PCP who is able to spend more time with patient discussing medications,
determines it could be do to a combination of a cancer drug and advil. Coordinates w/oncologist to stop
taking medicine for a week, nausea resolves, able to taper back onto medication eventually with
resolution in problem.
Explain the purpose of the patient-centered medical home - CORRECT ANSWER✅✅Care delivery model
where the patient treatment is coordinated through there PCP to ensure they receive necessary care
when and where they need it.
, Providers (health departments) - CORRECT ANSWER✅✅· "core of industry" Directly affect outcome of
provided service
·Responsible for quality and cost of HC system
Payers (employers/insurance companies) - CORRECT ANSWER✅✅· Influential stakeholders
· Proactive roles in determining costs and negotiating w/insurance companies
·Considerable influence in Congress
Government (role in delivery of health care) - CORRECT ANSWER✅✅· Dominant authority over the
system
·Medicare/Medicaid
·Health policies
·Public health
Insurers (BC/BS plans) - CORRECT ANSWER✅✅· "unrestrained" stakeholder
· Influence access to care
·Contribute to healthcare cost
Suppliers (role in delivery of health care) - CORRECT ANSWER✅✅· Prod medical technology for
treatments and diagnosits
·Contribute to HC cost
Education and research (role in delivery of health care) - CORRECT ANSWER✅✅· Clinical trials
·Develop medical technology for treatment and dx
·Training of future health care providers
US Health Care Medical Care Structures - CORRECT ANSWER✅✅1) Traditional
2) Multispecialty Group
3) Commuity Health Centers
