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Health Care Exam I
Study Cards for the First Exam
| Question | Answer |
|---|---|
| Health care spending affects... | * Disposable income of consumers * Employment * Profits and Investments of Businesses |
| Number of People Employed in Health Care does what each year? | The number of people employed increases around half a million each 2 years |
| In which of the following areas does employment increases faster? Hospitals, Ambulatory Health Care Services, or Nursing and residential care facilities | Ambulatory Health Care Services |
| Health Care Spending also Provides: | * Increased wages for employees * Expands local tax revenues |
| When it comes to medical care Americans expect: | * The best quality of care * Access to the best specialists * Access to the latest technology * Cost not an issue (expect to be inexpensive) * Available Today |
| What is the trend of health care expenditures based off of race? | The major minority groups (hispanic, African American, Asian) each spend less money on health care services than white and all other races |
| How much do health care costs increase every 10 years? | It doubles |
| The National Health Expenditures percent change has what from the previous years? | The overall percent change for the last 20 years has gradually decreases, to only 3.9% change in 2010 |
| What is the average spending per capita by demographics? (age and sex) | The older you are, the more like you are to spend more money on health care and if you are a female, you are more likely to spend more money on health care than a male. |
| In the U.S. population, what is the concentration of Health Care Spending based off of pay? | The bottom 50% only spends 2.9% of the total Health Care Spending, while the top 50% spends 97.1% |
| The National Health Care Expenditures are projected to what? and have a spike at what year? | It is expected to gradually increase with a spike at 2014 due to the new legislation |
| What is the percent of expenditures by service for Hospital, Physician, Rx, and Nursing Home? | * Hospital ~30 % * Physician ~20% * Rx ~ 10%, Nursing home ~5% |
| What are the payment sources and their percents of health care expenditures? | * Federal Govt. 37%, * Private insurers - 35%, * Out of Pocket - 12%, * State/Local Govt - 10%, * Other - 11% |
| Which medical care service is responsible for the largest out-of-pocket spending ($) per capita? | Rx Drugs |
| Which medical care service is responsible for the largest out-of-pocket payments (%) per service? | Dentists |
| What is the greatest driver of health care spending? | Increased Demand accounts for 32% of increase |
| Why is there an increased demand of health care? | * Growth of elderly, they consume 4 times as much medical care as non-elderly and increased intensity of services * Increase in advertising * Increase in use of diagnostics * Health insurance effect |
| What is the health insurance effect? | Since it is not costing the consumer as much, the consumers get as much service and as best of service as they can |
| General Inflation: | Accounts for 27% increased health care expenditures and it determined by various factors. |
| Medical Advances: | Accounts for 22% of increased health care expenditures. * Prices high to return research and development costs * Market is expanded * Does not reflect future savings |
| Increasing Provider Expenses: | Accounts for 13% of increased health care expenditures. * Mergers between hospitals and physicians results them in having better negotiating leverage with insurers, increasing rates. * Less managed care, fewer providers accepting risk contracts |
| Litigation and Risk Management | Accounts for 10% of total costs * Class action lawsuits * Large rewards * Defensive medicine * Increased malpractice premiums * Varies by provider |
| The U.S. Expenditures for Rx Drugs has what in cost in the past years? | Every 10 years it approx. doubles. |
| What is the trend of Rx Drug Expenditures with Out of Pocket, Private Insurance, and government over the past 20 years? | Out of pocket costs has decreased while the governments spending has increases. The Private Insurance increased then plateau. |
| What is the most recent Rx Drug Expenditures by payment source? | * Private Insurers: 45% * Medicare: 23% * Out of Pocket: 19% * Medicaid: 9% * Other: 5% |
| What are some causes of long-term trends with Rx Drugs? | * changes in conditions to treat * development of new types of therapies * more prescriptions * return to investors and competition with other industries |
| Continued dramatic deceleration in drug spending from a peak of 18.2% in 1999 to a low of 1.2% in 2010. This was lower than in the previous years due to? | * Number of prescriptions increased only 1.2% * Fewer new blockbuster drug introductions * Increased use of generics * Effect of economy on utilization * Increase on drug manufacturers' rebates to Medicaid |
| Other trends in prescription drug spending? | * Change in trend of prescription sales from primary care doctors to specialists * Change in mix of pharmaceuticals vs. biologics vs. vaccines |
| Things to remember about health care costs: Spending trend is _____ and hospital care accounts for ____. Hospital care spending____ | Spending trend is slowing. Hospital care accounts for the largest amount of costs. Hospital Care spending increased from prices and use, however, increases have slowed. |
| Things to remember about Health Care Costs. Movement from managed care to _____ and Demographics contribute ____. | * Movement from managed care to consumer directed health care. (Medical Savings Accounts) * Demographics contribute slightly to increasing costs. |
| Things to remember about Health Care Costs: New technology is _____ and health insurance premiums cost trending______. | New technology is driving long-term costs. HI premiums cost trending higher than health care costs. |
| Things to Remember about health care costs. Efficiency of health care spending becomes ____. With the downturn in the economy the share of GDP devoted to health care costs ____ | * Efficiency of health care spending becomes more important and leads to interest in quality, outcomes, and disease management. * With downturn in economy, the share of GDP devoted to health care costs will be watched |
| What are the three types of teams? | * Multidisciplinary * Trans-disciplinary * Interdisciplinary |
| What is a Multidisciplinary team? | * cooperative, but separate work * follow individual line of therapy with distinct goals by discipline |
| What is a Trans-disciplinary team? | *independent, interchangeable work * requires each member to be multi-skilled, highly trained * individuals engage skills learned from other disciplines * one patient may be under care of one individual |
| What is a Interdisciplinary team? | * Goal-focused, collaborative * Work to achieve shared goals for patient within a given time period * Share responsibilities for complementary tasks * Established ongoing communication with team members, patients, families |
| What are the key roles of a pharmacist? | * Practice principles of pharmaceutical care * Drug delivery and safety * Patient education and advocacy * Monitoring drug therapy * Collaboration with other healthcare professionals * Research and clinical studies |
| What is pharmaceutical care? | * Patient-centered, outcomes oriented * Promote health * Prevent disease * Medication |
| Medication, AIMM, stands for: | * Assess * Initiate * Monitor * Modify |
| What are postgraduate opportunities? | * Workforce: retail, hospital * Residency: Clinician preparation. PGY-1: general, PGY-2: specialty * Fellowship: Researcher preparation |
| What are types of retail pharmacies? | Chain, Independent, Compounding (sterile & non-sterile), Clinics, Hospitals |
| What is the role of a home care/long term care pharmacist? | * Similar to role of hospital pharmacist: work directly with nurses, physicians, patients outside the hospital setting * "consultant" pharmacist: monitoring medication use in extended-care facilities, may or may not be dispensing |
| What are managed care / pharmacy benefits managers (PBMs)? | * Insurance * designed to facilitate oversight that all members of the health care team are delivering the best care at the best costs * work with employers to create pharmacy benefits packages |
| What is an industry-based pharmacist? | * Pharmaceutical sciences * Pharmaceutical Research * Pharmaceutical Sales/Marketing/Public Relations * Medical Information * Regulatory Affairs |
| What are drug information centers? | Serve as a resource to answer questions from patients, doctors, and other health care providers |
| What is health? | complete physical, mental, and social well being |
| What is a disease? | disorder that an organ has |
| What is an illness? | disorder that a human has |
| What are factors influencing health? | Biological, Psychological,Social |
| What are biological factors? | microorganisms, genetics |
| What are psychological factors? | different views on health and disease, mental disorders, varying tolerance levels of pain |
| What are social factors? | varying cultural perceptions, the sick role, the presence of a support group |
| Health care systems do what? | They organize and fund health care services to provide an optimal mix of access, quality, and cost |
| What is primary care? | Ambulatory care: daily routine needs of patients (primary diagnosis), pharmacy, family practice doctor |
| What is secondary care? | Local hospitals: more highly trained providers, doctor refers to a specialist, more advanced diagnostic testing, routine hospitalizations (birth) |
| What is tertiary care? | Teaching and research hospitals: most specialized type of care, testing for more serious types of disorders. most of the time can provide primary and secondary care. |
| What is the logic behind health insurance? | * Consumer pays insurer a premium to cover medical expenses in coming year * Premium will be higher or lower than medical expenses * But the insurer can pool or spread risk among many insurees * Sum of premiums will exceed the sum of medical expenses |
| What are the 2 goals of health insurance? | * Minimize risk in an uncertain future * ensure that there is access to health care when it is needed. |
| What are the determinants of health insurance demand? | * Price of insurance * degree of risk aversion: greater risk aversion increases the demand for health insurance * Income * Probability of illness |
| Strong association between health care and access to _____ | * primary and preventive care * treatment of acute conditions * management of chronic illness |
| The amount of employer health insurance coverage has what since 2000? | Gradually declined |
| What are basic health insurance concepts? | * spreading risks * varying types of health insurance * how health insurance coverage changes |
| What is adverse selection? | * Medical underwriting * Pre-existing exclusions * Risk-based rating * Benefit design |
| What is risk selection? | The insurance cherry picks healthy people |
| Employer-sponsored coverage: | * Often comprehensive, but not always * Variation in benefits covered as well as premium and deductible costs |
| Individually-purchased policies: | * Typically less comprehensive * less coverage of maternity, mental health, and prescription drugs * can have high deductibles as well |
| Health insurance coverage is not static, coverage options can change with: | * loss or change of job * change in family status * birthday * change in health status * college graduation |
| Employer-Sponsored Insurance is up to the employers and is less likely to be offered to ____ and eligibility cannot be based on health status. | * employees of small (vs. large) firms\ * Part time/seasonal workers (vs. full time) * Low wage workers * Newly hired workers (waiting periods) * Dependents (vs. employees) * Retirees |
| What is individual insurance? | * Purchased by individuals * Age and health status are a determining factor, called Medical Underwriting |
| Cost of health insurance depends on: | * Who is covered (age, gender, health) * What is covered (benefits, deductible, terms, pre-existing conditions) * Insurer profits * Subsidies * underlying health care costs |
| COBRA: | * job-based plans sponsored by employers with > 20 employees * Temporary continuation of coverage after qualifying event * Employer premium contribution not required * Can be very costly for individuals to afford |
| What are qualifying events for continuation of COBRA insurance? | * Loss of employment: 18 months * Change in family/dependent status: 36 months * Disability: 29 months |
| The percent of the population without health insurance has been ______ and what age group are most likely to be with out health insurance? | The percent of the population without health insurance has been increasing over the past 10 years and 18 to 34 yo are most likely to be with out insurance |
| Which race has the higher percent of population uninsured? | Hispanic |
| The less you make the more likely you _____ health insurance? | The less you make the more likely you do not have health insurance. |
| Who are the Uninsured? | * Self-employed, construction, retail, services * In a company of fewer than 10 employees * Income of less than $20,000 per year * Single without children * Age 19-24 yo * Non-white |
| The increase in the last 10 years on the number of uninsured is mostly due to: | * Economic recession and job loss * Population growth * Immigration * Individual choice |
| What is the chronically uninsured? | the working poor, whose income is too little to afford health insurance but too much to qualify for Medicaid |
| What are examples of low health levels? | * Age-specific mortality levels * Infant mortality rates * Certain populations affected differently |
| The U.S. Life Expectancy compared to other developed countries is _____, the infant mortality rate is _____, and the health care spending per capita is _____. | The U.S. Life Expectancy compared to other developed countries is lower, the infant mortality rate is higher, and the health care spending per capita is much higher. |
| Why does the U.S. have a higher infant mortality rate? | * The U.S. counts all births, including premature and stillborn. * Cultural diversity and variables (exercise, diet, stress) * Increase in fertility treatments * Percentage of teenage mothers with poor prenatal ca |
| What two determinants contribute most to premature death? | Behavioral patterns and genetic predisposition |
| The infant mortality rate among African Americans, Native Americans, and Alaska Native infants as compared to Caucasians is ____. | Twice as high |
| Southerners and Blacks are more likely to die of Stroke than other Americans. Blacks are ____ | Blacks are 40% more likely to die of stroke than whites (hypertension, less access to health care, obesity, smoking and lack of physical activity) |
| Native Americans, Hispanics, African Americans, and Asian Americans and Pacific Islanders are at particular high risk of developing ____. | Type 2 diabetes |
| The prevalence of diabetes is _______ in African Americans than in Caucasians. | nearly 70 percent higher |
| What are some causes of health disparities? | * Genetic Variation * Environmental Factors * Specific Health Behaviors * Lower Quality of Health Care |
| What can cause unequal access to health care? | * Language barriers * Inadequate insurance coverage * Bias among doctors and nurses * Lack of minority physicians |
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