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Delivering Health Care in America

HCA 501 -Health Care in America 
Text: Delivering Health Care in America 
Fourth Edition, 2008 
ISBN-13: 9780763745127, ISBN-10:076374512X 
Leiyu Shi and Douglas A. Singh 
Jones & Bartlett Learning

Multiple Choice Questions (Enter your answers on the enclosed answer sheet) 
1. When providers deliver unnecessary services with the objective of protecting themselves against lawsuits, this practice is called 
defensive medicine 
supplier-induced demand 
primary protection 
legal risk 
2. Reimbursement is associated with which of the quad functions? 
3. Which central agency manages the health care delivery system in the United States? 
Centers for Disease Control and Prevention 
Department of Health and Human Services 
Department of Commerce 
4. National health care programs in other countries often use which of the following mechanism to control total health care expenditures? 
Third parties 
Global budgets 
A single-payer system 
5. In the United States, who does not generally have access to basic and routine medical services? 
People who need catastrophic care 
Those eligible only for public programs 
The uninsured 
Those without private health insurance

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6 .Which country utilizes socialized health insurance for employees? 
United States 
Great Britain 
7. All of the following are main elements of the systems framework EXCEPT: 
system inputs 
system foundations 
system structure 
system processes 
8. Deontology asserts: 
That no one has a duty to do what is right 
That it is society’s duty to do what is right 
That it is an individual’s duty to do what is right 
None of the above 
9. Utilitarianism emphasizes: 
Happiness and welfare for the poor 
Happiness and welfare for the deserving 
Happiness and welfare for the rich 
Happiness and welfare for the masses 
10. Supply-side rationing is also referred to as: 
Nonprice rationing 
Price rationing 
Both a and b 
None of the above 
11. Prevalence is: 
The total number of cases at a specific point in time divided by the specified population 
The total number of cases at a wide range in time divided by the specified population 
The number of new cases occurring during a specified period divided by the total population 
The number of new cases occurring during a specified period divided by the population at risk 
12. The limitations of market justice include: 
Social problems are not adequately addressed 
Society is not always protected from the consequences of ill health 
It leads to inequitable access to health care 
All of the above 
13. Crude rates refer to: 
A specific age group 
The total population 
A specific gender 
None of the above 
14. Holistic health adds which element to the World Health Organization definition of health? 
15. All of the following were factors explaining why the medical profession remained largely an insignificant trade in preindustrial America EXCEPT: 
Medical practice was in disarray 
Medical procedures were primitive 
High demand for prescription drugs 
Demand was unstable

16.The American system for delivering health care took its current shape during this period: 
Twentieth century 
none of the above 
17. Today, are the leading cause of illness, disability, and death in the US. 
chronic conditions 
acute illness 
none of the above 
18. This group was primarily responsible for leading the successful drive for 
workers’ com pensation. 
a.lnternal Revenue Code 
American Medical Association 
Blue Cross 
the American Association of Labor Legislation 
19. Capitation is: 
integration of telecommunications in healthcare 
umbrella fund for everyone 
flat rate per worker per month 
none of the above 
20. All of the following are modes of economic interrelationships EXCEPT: 
use of advanced telecommunications infrastructures in medicine 
health professionals remain in the United States 
consumers travel abroad to receive medical care 
foreign direct investment in health services enterprises

21. What is an example of health care delivery existing due to social and political needs: 
State Children’s Health Insurance Program 
Multispecialty centers 
None of the above. 
22. All states require this to be licensed in order to practice. What is a require- 
ment needed to be licensed? 
graduation from an accredited medical school that awards a Doctor of Medicine 
score of 85 on board exam 
enrollment in internship program 
none of the above 
23. What is a main difference between primary care and specialty care? 
primary care follows specialty care 
primary care focuses on disease while specialty care focuses on the whole person 
primary care is longitudinal and specialty care is episodic 
none of the above 
24. What is the principal source of funding for graduate medical education? 
Private corporations 
International companies 
none of the above. 
25. Why are physicians most likely to concentrate in metropolitan and suburban areas? 
better opportunities for high income 
greater access to modern facilities and technology 
cultural diversity 
All of the above

26. Dental do not have to be licensed. 
none of the above 
27. This act authorizes a variety of grants and scholarships to keep nurses in the field: 
American Nursing Association Act 
Reimbursement Act 
Nurse Reinvestment Act of 2002 
None of the above 
28. Who is responsible for operational, clinical and financial outcomes of organizations that deliver health services? 
Health Service Administrators 
Allied Health Professionals 
Physical Therapists 
None of the above 
29. This made additional resources available to the FDA, and resulted in a shortened approval process for new drugs. 
Kefauver-Harris Drug Amendments, 1962 
Food and Drug Administration Modernization Act, 1997 
Orphan Drug Act, 1983 
Prescription Drug User Fee Act, 1992 
30. What was the purpose of certificate of need (CON) laws? 
Monitor the diffusion of new technology 
Control the flow of federal funds for private projects 
Control new health service programs 
Control new construction and modernization projects

31. Which area of personal health expend itures has seen the greatest rise in recent years? 
Long-term care 
Hospital services 
Prescription drugs 
Durable medical equipment 
32. What is the role of an Institutional Review Board (IRB)? 
Establish guidelines for the method of conducting research 
Verify the results of clinical trials 
Approve and monitor research that involves human subjects 
All of the above 
33. Generally, at the start of medical treatment 
benefits exceed costs 
cost-efficiency is minimum 
costs exceed benefits 
safety is not a major concern 
34. Health technology assessment in the US is conducted primarily by 
various government agencies 
the NIH 
the FDA 
the private sector 
35. According to the Institute of Medicine, the rise in prescription drug costs is 
mainly attributed to 
price inflation 
increased use of existing drugs 
research and development costs 
replacement of older drugs by newer ones

36. What is the main factor that determines the level of demand for health 
services in the US health care delivery system? 
health services 
none of the above 
37. Which of the following is NOT a fundamental principle that underlies the concept of insurance? 
Risk is unpredictable for the individual insured. 
Risk can be predicted with a reasonable degree of accuracy for a group. 
Insurance provides a mechanism for transferring risk from the group to the individual. 
Actual losses are shared on some equitable basis by all member of the insured group. 
38. Most Americans obtain health insurance coverage through: 
individual plans 
employer-sponsored programs 
none of the above. 
39. The Medicare program finances medical care for: 
persons 65 years and older 
disabled individuals who are entitled to social security benefits 
people who have end-stage renal disease. 
All of the above 
40. Who is eligible for Medicaid? 
Children and pregnant women whose family income is at or below l33 percent of the Federal Poverty Level. 
Families with children 
The elderly 
none of the above

41. How does workers’ compensation differ from regular health insurance? 
it becomes supplemental coverage for eligible employees 
employers are required by law to bear the full cost of the benefits 
it is regionally managed 
none of the above 
42. This Act authorized by Congress supports “safety net” hospitals in inner cities and rural ares. 
Consolidated Omnibus Budget Reconciliation Act of 1985 
Indian Reconciliation Act of 1989 
Cost Plus Act of 1992 
None of the above 
43. What is the point of entry into the health services system? 
primary care 
coordination of care 
essential care 
44. Which factor has NOT contributed to the increase in outpatient care? 
45. are the backbone of ambulatory care and constitute the majority 
of primary care. 
home health care 
hospice services 
physicians as office-based practitioners 
alternative medicine

46. Hospice services include: 
pain management 
psychosocial support 
spiritual support 
all of the above 
47. What is a characteristic of a free clinic? 
services are provided at no charge or nominal charge 
they are not directly supported by government agencies 
services are delivered mainly by volunteer trained staff 
all of the above. 
48. ____________ are regarded as nontraditional and include a wide range of treatments. 
complementary medicine 
alternative medicine 
material medicine 
none of the above 
49. In 2004, what type of office visits were visited the most? 
a, physicians in general and family practice 
physicians in specialty services 
physicians in internal medicine 
physicians in gynecology 
50. ALOS is an indicator of 
use of hospital capacity 
frequency of use 
severity of illness 

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