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C425 Healthcare Delivery Systems, Regulations, and Compliance Question and Answers.pdf, Exams of Nursing

C425 Healthcare Delivery Systems, Regulations, and Compliance Question and Answers.pdf

Typology: Exams

2024/2025

Available from 07/03/2025

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C425 Healthcare Delivery Systems,
Regulations, and Compliance Question
and Answers
This kind of medicine treats the whole person. (Physical, Mental, Spiritual) -
Holistic
Relatively severe, episodic (short duration) and often treatable -
Acute
Less severe, but long and continuous. Can be controlled but can lead to serious
complications -
Chronic
The market tells us what type of healthcare we need. If a service is not being used,
there will not be a lot of that particular service. -
Market Justice
Individual responsibility for health.
Benefits are based on individual purchasing power.
Rationing based on ability to pay.
Limited obligation to the collective good. -
Market Justice
Healthcare viewed as a social resource.
Requires active government involvement.
Single payer system.
Highly controlled by government. -
Social Justice
Ability to pay is inconsequential to receiving medical care.
Right to free medical care.
Everyone entitled to basic package of benefits. -
Social Justic
Three distinct time periods of health care's evolution -
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C425 Healthcare Delivery Systems,

Regulations, and Compliance Question

and Answers

This kind of medicine treats the whole person. (Physical, Mental, Spiritual) - ✔ Holistic Relatively severe, episodic (short duration) and often treatable - ✔ Acute Less severe, but long and continuous. Can be controlled but can lead to serious complications - ✔ Chronic The market tells us what type of healthcare we need. If a service is not being used, there will not be a lot of that particular service. - ✔ Market Justice Individual responsibility for health. Benefits are based on individual purchasing power. Rationing based on ability to pay. Limited obligation to the collective good. - ✔ Market Justice Healthcare viewed as a social resource. Requires active government involvement. Single payer system. Highly controlled by government. - ✔ Social Justice Ability to pay is inconsequential to receiving medical care. Right to free medical care. Everyone entitled to basic package of benefits. - ✔ Social Justic Three distinct time periods of health care's evolution -

✔ - Preindustrial Era

  • Postindustrial Era
  • Corporate Era Quality care and Access to care is very low in - - ✔ Rural Areas Quality of care is lower than typical but access to care is pretty standard in - - ✔ Urban Areas Covers only the very poor. - ✔ Medicaid Covers all elderly persons, nonelderly disabled persons, and nonelderly persons with end-stage renal disease. - ✔ Medicare For hospitalization and short-term nursing home stay. Financed through social security taxes. - ✔ Part A Medicare For physician and other outpatient services. Subsidized through general taxes, but participants pay part of the premium costs. - ✔ Part B Medicare Nationally uniform program - ✔ Medicare Program varies from state to state. Income criteria established by states. - ✔ Medicaid Both ___ and ___ provide financial support to private and public institutions for biomedical research. - ✔ AHRQ NIH A mechanism of providing health care services where a single organization takes on the management of: Financing, Insurance, Delivery, Payment. (Supply side rationing) - ✔ Managed Care

Allows the market to determine when services are rendered. - ✔ Market Justice Quality can be improved while reducing costs. Cookie cutter diagnoses. Eliminate ambiguity in treatment. - ✔ Evidence Based Care Absence of illness and disease. Person free of symptoms, does not require medical treatment. - ✔ Health Emphasizes illness rather than wellness - ✔ Medical model __ Concepts of healthcare, along with ___ and health promotional efforts, need to be adopted to significantly improve the health of Americans - ✔ Holistic Preventive .._'s hold the promise of encouraging patient-centered care and further developing the patient-centered care model. - ✔ ACO ____ _____ requires : Management of utilization. Limit reimbursement to providers. Supply side rationing - ✔ Cost Control An issue with the ACA system is it's primary focus on ____ illnesses. - ✔ Acute An issue with the ACA system is it's inadequate access to _______ care. (Overuse of ERs) - ✔ Primary Patient-centered care that emphasizes chronic care by employing evidence-based guidelines. (While being accountable for the quality of care provided) - ✔ Medical Home Model

Blending primary care delivery with a population-based approach to identify and address community health problems. - ✔ Community Oriented Primary Care T/F - Nurses should not be allowed to practice to the full extent of their education and training and take on more to handle the deficit. - ✔ F - They should take on more. T/F Unifying license requirements across states for advanced practice nurses is a good idea for the growing issues with future healthcare. - ✔ T - Very good idea _____ Need to be trained in community health, public health and ______ - ✔ Nurses Geriatrics _____ Need training to function as comprehensivists as well as preparation to manage complex pharmacology, understand end-of-life issues and medical ethics, and lead health care teams. - ✔ PCP's _____ and _______-_______ changes to clinical and organizational practices will drive greater efficiency and quality in healthcare. - ✔ Technological Evidence-Based The US ______ _________ is increasingly influenced by and modeled after systems and practices in other developed countries. - ✔ Healthcare Market Practitioners, payers and policy makers need to become _______. - ✔ Stakeholders Computer-based models will help incorporate ____ into medical decision making. - ✔ EBM (Evidence Based Medicine) The vulnerability model is ______. It focuses on the total population rather than on the traits of _______. - ✔ Comprehensive