1. What is the principal factor behind ongoing legislation on the federal level related to health care?
Efforts to control constantly increasing costs
In the past, legislation reflected the need to improve the health of populations and coping with changing health care needs. During the last 20 years, concerns about increasing health care costs have stimulat
2. What has happened to the hospitals built or expanded by Hill-Burton Act funds?
Many such hospitals have consolidated or closed.
The Hill-Burton Act authorized federal assistance in construction of hospitals, making hospitals more accessible. However, with the high cost of health care and the decreasing lengths of stay and increasing
3. What was one effect of the Welfare Reform Act of 1996?
Individuals who were required to obtain employment lost their health coverage.
The law decreased the number of people on welfare and forced many individuals to take low-paying jobs, many of which did not offer health insurance. Many individuals, particula
4. What might be noticeable about the State Child Health Improvement Act (SCHIP) of 1997?
The law was extended, then not renewed by the Bush administration, then renewed again by the Obama administration.
The law was extended several times, and then it was not renewed by the Bush administration. In January 2009 the law was renewed again by the
5. What was notable about the Medicare Modernization Act of 2003?
The revision included a prescription drug benefit.
After being implemented, the Medicare Modernization Act of 2003 provides seniors and people living with disabilities with some prescription drug benefit coverage, as well as more choices and better benefi
6. What has been slowly increasing in consistency among states in their approach to health care?
States frequently develop new programs as federal funds become available to pay for them.
Many state and local government programs were developed on the basis of availability of federal funds. Funds are accompanied by regulations, which apply to all recip
7. Despite multiple bills by Congress, what major health problem remains?
Rising number of underinsured and uninsured citizens
With the rising number of uninsured and underinsured, universal coverage continues to be a critical concern that has not been solved despite multiple bills proposed in Congress.
8. What is the most common organization for receiving personal health care in the U.S. today?
Managed care organization with capitated payments to providers, both professionals and organizations
Managed care has become the dominant paradigm in health care.
9. How do voluntary health agencies fit into the overall health care system?
They support research, education, and services for particular groups of patients.
Voluntary health agencies are committed to specific diseases, organ or body structures, health and welfare of special groups, or particular phases of health. Philanthropic g
10. Which federal agency is responsible for administering most of the federal health-related activities?
Department of Health and Human Services
Most health-related activities at the federal level are implemented and administered by the Department of Health and Human Services (DHHS).
11. Which federal agency is responsible for the Women, Infants, and Children Program, food stamps, and school-based nutrition programs?
Department of Agriculture
The Department of Agriculture administers the inspection of meat and milk and provides funds for the Women, Infants, and Children Program (supplemental nutrition), the food stamp program, and the school-based nutrition program.
12. What has led to the more recent focus on cooperation between the state and the federal level in relation to public health?
The threat of bioterrorism
Cooperation between the state and federal levels has been brought to the forefront with efforts to plan for bioterrorism, an event that would necessitate cooperation and sharing. In addition, the state is highly dependent on the
13. Which level of government primarily establishes regulations and provides funding for health care?
Federal government
The federal government has been assuming a larger role in the protection of the population through regulation and funding.
14. Who primarily provides care for military personnel, their families, and veterans, as well as Native Americans?
Federal government
The federal government is responsible for the health care of specified populations including military personnel, their families, and veterans. The federal government also is responsible for health care for Native Americans.
15. As funds become more limited, which health care providers are actually seeing an increase in demand for their services?
Long-term-care facilities
Hospital stays have shortened and patients who are admitted are more acutely ill and require more intensive care. Consequently, decreased hospital stays result in more home care admissions and more discharges to long-term-care fa
16. Which advanced nurse does not have advanced education in a clinical specialty?
Clinical nurse leader
All the nurses have advanced education in some aspect of clinical care, such as obstetrics or primary care. However, the clinical nurse leader is a manager of care at some point of care and does not have a clinical specialty.
17. What is the significance of the Health Plan Effectiveness Data and Information Set (HEDIS)?
Data are used to measure performance in the accreditation of MCOs' process.
The National Committee for Quality Assurance accredits MCOs and uses HEDIS to measure performance and consumer satisfaction. Some outcome data are available to informed consumers
18. What effect did President Clinton's Advisory Commission on Consumer Protection and Quality in the Health Care Industry report (1999) have?
Stimulated the Institute of Medicine to explore quality in more depth
The report had a major impact in that it stimulated a series of more in-depth explorations of the health care delivery system, which resulted in a series of reports developed by the Ins
19. What was the primary conclusion of the report To Err Is Human: Building a Safer Health System?
System failures are resulting in an incredible amount of harm from medical errors.
First was emphasis on the incredible magnitude of harm resulting from medical errors, which are largely due to system problems, not individual failure. Error reporting prog
20. What suggestion was in the Health Professions Education report?
Interdisciplinary teams should utilize informatics to provide patient-centered care
The Health Professions Education report concluded there were five core competencies�provide patient-centered care, work in interdisciplinary teams, employ evidence-based p
21. How might the U.S. total health care costs be reduced by at least 10%?
Decrease current fraud and abuse
Officials estimate that up to 10% of total health care expenditures, or about $170 billion in 2003, were lost to fraud and abuse.
22. What was a conclusion of the report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care?
Provider bias and stereotyping contribute to inequalities.
The report observed that bias and stereotyping on the part of heath care providers might contribute to differences in care.
23. What was the poverty guideline for a family of four in mainland United States in 2009?
Above $22,000
A four-person household must make less than $22,000 to be considered under the poverty guideline according to the U.S. DHHS.
1. Who may receive benefits under Medicare? Select all that apply.
Persons with end-stage renal disease
Those over 65 years of age if eligible for Social Security benefits
Those with permanent disabilities
Medicare pays specified health care services for all people 65 years of age and older who are eligible to receive So
2. The Omnibus Budget Reconciliation Act influenced funding and set up regulations. What were some of the notable changes that resulted? Select all that apply.
Change from process to outcome in evaluating care
Guidelines on use of restraints
Prescription drug benefits for Medicaid recipients
The Budget Reconciliation Act influenced funding and set up guidelines and regulations about several issues including a mo
3. What were among the outcomes of the 1979 report Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention? Select all that apply.
The Health Objectives Planning Act of 1990 was passed.
The federal government began to identify and monitor national health care goals.
The federal government began to take a directive approach in identifying and monitoring national health care goals afte
4. The Health Insurance Portability and Accountability Act of 1996 was passed to address what critical issues in health care? Select all that apply.
Portability of insurance coverage, Insurance companies setting limits on coverage of longer than 12 months
The Health Insurance Portability and Accountability Act of 1996 addressed insurance issues. Critical were the portability of coverage and preexistin
5. Which functions are responsibilities of the states? Select all that apply.
Delegating power to localities and holding them accountable for results,
Licensure of professional health care providers
Overseeing all insurance programs
Providing access to necessary health services
State governments focus particularly on financing and
6. Which activities by some managed care organizations (MCOs) are ethically questionable? Select all that apply.
Financial incentive to physicians if some treatments are not given
Requirements that only certain treatment options be discussed with patients
Protection is needed for health care providers. Gag rules have been an area of concern when MCOs control what th
7. What are some of the current state legislation acts limiting what managed care organizations (MCOs) are allowed to do? Select all that apply.
Allowing patients to see a specialist without having to obtain approval from their primary care provider
Allowing patients to go to the emergency department without first telephoning for approval
Allowing new mothers to stay in hospital longer than 24 hou
8. Which activities would be a responsibility of local health departments? Select all that apply.
Determining the safety of residents' wells
Providing free health screenings
Providing health education programs on proper nutrition
Inspecting restaurants
Local health departments are responsible for the health needs of their constituents. Community healt
9. In what ways are complementary and alternative therapies different from traditional health care? Select all that apply.
Providers vary in training and licensure.
Reimbursement is often unavailable.
Alternative or complementary therapies are expanding because of consumer demand, although reimbursement for these services is lagging. The National Center for Complementary and
10. What current activities are consistent with the conclusions of the report Crossing the Quality Chasm? Select all that apply.
Focus on evidence-based practice,
Increased attention to patients' needs for health education and self-management
Move to information technology (electronic medical records and data management)
The report suggested changes including need for evidence-base
11. What were the conclusions when Congress asked for a report on the federal government's quality enhancement process on the care the federal government gave? Select all that apply.
A clear responsibility at the federal level is to lead by example.
Federally sponsored education and training programs have a strong impact.
Writing regulations influences nonfederal health care providers and organizations.
The report Leadership by Exampl