PHP Final

What is one major downside of having multiple competing interests in the regulation of health care according to Robert Field?

A. Healthcare policy is enacted hastily and without much thought B. Compromises between competing factions are rarely made C. Medical schools are struggling to teach future doctors about all of the rules they must follow D. Some regulatory bodies do not have an interest in protecting the public

What is one major downside of having multiple competing interests in the regulation of health care according to Robert Field?

A. Healthcare policy is enacted hastily and without much thought B. Compromises between competing factions are rarely made C. Medical schools are struggling to teach future doctors about all of the rules they must follow D. Some regulatory bodies do not have an interest in protecting the public

D. Some regulatory bodies do not have an interest in protecting the public

Which government division under the Department of Health and Human Services helps to regulate the health workforce? A. The Health Resources and Services Administration (HRSA) B. The Centers for Disease Control and Prevention (CDC) C. The National Institutes of Health (NIH) D. The Food and Drug Administration (FDA)

A. The Health Resources and Services Administration (HRSA)

Since WWII, government oversight of medicine and public health services has A. Wavered B. Increased C. Decreased D. Stagnated

B. Increased

According to Robert Field, what is the primary reason health care regulation is so complex? A. There are a variety of regulatory bodies with competing interests B. The lobbying power of the American Medical Association is too strong C. Many practicing doctors are not trained in America and medical procedures are not standardized D. The average patient is becoming more and more knowledgeable

A. There are a variety of regulatory bodies with competing interests

According to Robert Field, which level of government has the most power to regulate health care? A. The federal level B. The state level C. The municipal level D. The local level

B. The state level

Which amendment to the constitution outlines the concept of federalism? A. First Amendment B. Third Amendment C. Fifth Amendment D. Tenth Amendment

D. Tenth Amendment

The ________ provides health care to veterans, Native Americans, and military personnel A. federal government B. state government of each state C. American Medical Association D. Indian Health Service

A. federal government

The American Medical Association is a _______ regulator of healthcare A. Federal B. State C. Private D. A and C

C. Private

The Centers for Medicare and Medicaid Services administer A. Medicare and Medicaid B. CHIP C. Indian Health Service (IHS) D. A and B

D. A and B

Which federal agency is the most important for the provision of health services? A. The Environmental Protection Agency B. The Department of Labor C. The Department of Agriculture D. The Department of Health and Human Services

D. The Department of Health and Human Services

What is one major benefit of having multiple competing interests in the regulation of health care according to Robert Field? A. It ensures that no one regulatory power becomes too powerful B. It drives down the price of delivering healthcare C. It stimulates compromise between physician and patient D. All of the above

A. It ensures that no one regulatory power becomes too powerful

True or False: The U.S constitution clearly outlines the function of federal and state governments in healthcare

False

All of the following are principle features of U.S health policy except: A. Dominant role of the private sector B. Emphasis on public health services C. Highly influential interest groups D. Incremental and fragmented policies

B. Emphasis on public health services

According to Shi and Singh, what was the key factor contributing to the passage of the ACA? A. The large numbers of Americans who are uninsured B. The high cost of health care expenditures C. The declining quality of care D. Democratic control of congress

D. Democratic control of congress

Which of the following could be classified as being the highest health care cost and is continuing to increase? A. Multipayer system B. Prospective payment system C. Clinical research D. Prescription drugs

D. Prescription drugs

True or False: State governments play a significant role in the development and implementation of health policies

True

True or False: States continue to have the right to decide to expand their Medicaid programs through the ACA.

True

Employer-provided health insurance benefits arose in the mid-20th century as a result of A. A Supreme Court ruling that health insurance could be included in the collective bargaining process B. Unions and employee-rights groups demanding access to health insurance C. An executive order requiring employers to provide health insurance to employees D. The passing of the Social Security Act of 1965

A. A Supreme Court ruling that health insurance could be included in the collective bargaining process

True or False: The Center for Medicare and Medicaid Innovation is housed under the Centers for Medicare and Medicaid Services

True

True or False: The Center for Medicare and Medicaid Services houses more than 16 different offices and centers

True

True or False: the existence of so many specialty areas gives physicians greater power in health care policy

False

Which of the following branches of government is a supplier of policy? A. Executive B. Legislative C. Judicial D. All of these are correct

D. All of these are correct

According to Shi and Singh, which of the following will be a focus of further health care reform? A. Developing standardized care B. Hospital-based models C. Preventative services D. Chronic disease management

C. Preventative services

Which of the following would be an example of the mission of the Agency for Healthcare Research and Quality? A. The cost of a generic prescription drug increases due to research and development costs B. The cost of health insurance premiums has increased to offset the law that protects patients from being denied coverage C. The use of urinary catheters in hospitals has significantly decreased because evidence has shown they cause more harm than good D. Community health centers are reserved for use by underprivileged populations

C. The use of urinary catheters in hospitals has significantly decreased because evidence has shown they cause more harm than good

Which of the following is a reason that no specific programs exist to serve the health needs of minority populations in the United States? A. There is little consensus among policy makers on what can or should be done to design professional education, sensitivity to special needs, and services in appropriate areas B. The Office of Minority Health did not receive authorization to improve the health of minority populations C. Policy makers could not get enough support to approve a budget for programs that will only serve minority populations D. Programs for nonminority populations are already lacking and are a priority first within the United States

A. There is little consensus among policy makers on what can or should be done to design professional education, sensitivity to special needs, and services in appropriate areas

True or False: U.S physicians have no issue with accessing prior data about their patients

False

What was the name of the medical software used by Gawande in his 2018 article "Why Physicians Hate Their Computers"? A. Epic B. MedNote C. HVAC D. Canvas

A. Epic

True or False: Most private insurers incentivize use of a standard open API in EHR use within their provider networks?

False

Which occupational group has developed to assist physicians with computer-related tasks? A. Nursing assistants B. Phlebotomists C. Physician assistants D. Medical scribes

D. Medical scribes

The disadvantages of digitized medicine, as articulated by Gawande in "Why Physicians hate Their Computers", include A. Less face-to-face time with patients B. Additional after-hours work for physicians C. Physician burnout D. All of the above

D. All of the above

Which is a recommendation made by Adler and Milstein for improving health IT from the patient's perspective? A. Improve patient's access to data created at the point of care B. Enable patient participation and contribution to care delivery and health management C. More readily engage patients in research D. All of the above

D. All of the above

According to the Gawande 2018 article, about what percentage of hospitals have been computerized within the last decade? A. 10% B. 50% C. 90% D. 100%

C. 90%

According to the New Yorker article, "Why Physicians Hate Their Computers", for every hour spent face to face with a patient, physicians spend ________ doing computer work A. 1 hour B. 2 hours C. 3 hours D. 4 hours

B. 2 hours

In an ideal health IT world, providers should be able to: A. Refer patients to whatever to specialists across the world B. Spend minimal amounts of time on documentation C. Prevent patients from making notes on their patient records D. All of the above

B. Spend minimal amounts of time on documentation

What is the next step in promoting interoperability between APIs? A. Substitutable apps B. EHR smartphones C. Siri for EHR D. None of the above

A. Substitutable apps

How much money did the HITECH Act invest in promoting EHR use? A. $1 billion B. $3 billion C. $10 billion D. $34 billion

D. $34 billion

What does API stand for? A. American Public Health Institute B. Application Programming Interface C. Association for Physician Information and Technology D. Acute Publishing Intercom

B. Application Programming Interface

The 21st Century Cures Act requires that A. Existing certified EHR products must allow health information to be accessed and exchanged across different formats B. All private practicing physicians use an EHR system C. All health IT must demonstrate evidence-based effectiveness in reducing disease D. Providers eliminate communication through fax entirely

A. Existing certified EHR products must allow health information to be accessed and exchanged across different formats

Which government program significantly increased the use of informatics tools across health care settings? A. The information systems health law of 2003 B. The EHR incentive program (otherwise known as Meaningful Use) C. The Social Security Act of 1965 D. The Office of Minority Services

B. The EHR incentive program (otherwise known as Meaningful Use)

According to the New Yorker article, "Why Physicians Hate Their Computers", the fastest growing consumers of electronic health records are A. Patients B. Physicians C. Clinical researchers D. Politicians

A. Patients

True or False: Managed care increased the rate of growth in health spending between 1993 and 2000?

False

True or False: Since 1975, the rates of change in medical inflation have remained consistently and continuously above the rates of change in the Consumer Price Index?

True

Which is not one of the reasons for rising health care expenditures as articulated by Shi & Singh? A. Growth of technology B. Increase in the elderly population C. Cost-insensitive consumers D. Increase in the population of foreign-born physicians

D. Increase in the population of foreign-born physicians

True or False: providers and payers use a standardized set of outcome measures and definitions of healthcare quality

False

A service is cost efficient when: A. The desired health outcome is achieved B. The patient's insurance plan saves money C. The benefit received is greater than the cost incurred to provide the service D. The insurance company did not lose money and the patient did not have to pay out of pocket

C. The benefit received is greater than the cost incurred to provide the service

Which of the following groups benefited the most from health insurance coverage due to Medicaid expansion under the Affordable Care Act? A. Retired adults B. Uninsured children C. Low-income adults D. Disabled children

C. Low-income adults

Which of the following is the most reported issue faced by the newly insured under the ACA? A. Lack of expanded services B. Provider capacity C. Lifestyle modifications D. Affordability of coverage

B. Provider capacity

Which of the following issues does Porter raise in discussing the measurement of health care quality? A. The US medical system overemphasizes process measures which has limited effect on quality B. Outcome measurements are mainly performed among specialists and specialty societies C. Outcome measurements traditionally focus on clinical status rather than functional status D. All of the above

D. All of the above

What does the Consumer Price Index measure? A. Medical inflation B. General inflation C. Health care expenditures D. Overall government expenditures

B. General inflation

What is the primary purpose of certificate-of-need statutes? A. To increase utilization of primary care services B. To decrease Medicaid reimbursements for specialty care C. To control capital expenditures by health facilities D. To reduce provision of unnecessary health care services

C. To control capital expenditures by health facilities

True or False: The elements of the Donabedian model include outcomes, structure, and process?

True

In the Gawande 2009 article, Doctors Hospital at Renaissance is known for

A. Incentivizing physicians to send their patients there for procedures and tests which are probably unnecessary B. Offering highly specialized care C. Charitable donations to international NGOs D. None of the above

A. Incentivizing physicians to send their patients there for procedures and tests which are probably unnecessary

In Gawande's 2009 article, the town of McAllen in Texas is distinctive because A. It is the town with the lowest health care expenditure in the nation B. It is the town with the highest health care expenditure in the nation C. It is the town with the most specialists in the nation D. It is the town with the greatest number of doctors in the nation

B. It is the town with the highest health care expenditure in the nation

What treatment did doctors provide for Gawande's mother when she fainted in a grocery store? A. Nothing, they sent her home B. Oral rehydration therapy C. Cardiac catherization D. Antibiotics

C. Cardiac catherization

How did the Mayo Clinic control health care costs according to Gawande in the 2009 article? A. They got rid of expensive unnecessary technology B. They shifted costs to physicians C. They paid all doctors a salary D. The increased specialist reimbursement fees

C. They paid all doctors a salary

True or false: Most thyroid microcarcinomas are not life threatening

True

According to the Gawande 2015 article, what happened to care costs and overutilization in McAllen, TX in the years following the publication of his 2009 article? They: A. Increased B. Stayed the same C. Declined D. Increased then decreased

C. Declined

According to Berwick in "Avoiding Overuse - The Next Quality Frontier," what objectives have the WHO and other organizations pursued in order to improve care? A. Reducing costs of prescription drugs B. Reducing inappropriate uses of antibiotics C. Reducing overuse of ineffective care D. Reducing underuse of effective care

B. Reducing inappropriate uses of antibiotics

What is information asymmetry? A. When experienced doctors know more about practical medicine than recent medical school graduates B. When patients understand more about a medical treatment than their insurance company C. When doctors know more about the value of a medical treatment than their patients D. When congress enacts legislation based on faulty medical studies

C. When doctors know more about the value of a medical treatment than their patients

According to the IOM 2010 report, what percentage of health care spending goes to waste? A. 30% B. 40% C. 50% D. 60%

A. 30%

True or False: In the Gawande 2009 article, he makes the argument that physician decision-making is highly dependent on what city the physician works in.

True

True or False: In the 2009 Gawande article, he notes that more patients die from complications in surgery than from car crashes in America

True

In "Avoiding Overuse - The Next Quality Frontier," Berwick states that approximately how many total knee replacements in the US are inappropriate per year? A. 10% B. 16% C. 26% D. 34%

D. 34%

In the Gawande 2009 article, Doctors Hospital at Renaissance is known for

A. Incentivizing physicians to send their patients there for procedures and tests which are probably unnecessary B. Offering highly specialized care C. Charitable donations to international NGOs D. None of the above

A. Incentivizing physicians to send their patients there for procedures and tests which are probably unnecessary

_________ is the erroneous diagnosis of a disease while __________ is the correct diagnosis of a disease that will not bother you in your lifetime. A. Overdiagnosis; misdiagnosis B. Overtesting; misdiagnosis C. Misdiagnosis; overdiagnosis D. Overdiagnosis; overtesting

C. Misdiagnosis; overdiagnosis

According to Bailey's article "How Structural Racism Works," what is an example of unequal health care? A. The perception that the pain of black patients is less severe than that of white patients B. Performing experimental operations without informed consent or anesthesia C. Disinvesting in healthcare facilities located in overserved areas D. A and B E. All of the above

D. A and B

Which of the following is true according to "What Are Health Disparities and Health Equity? We Need to Be Clear"? A. Health disparities describe all differences in between two different populations B. A higher prevalence of hip fractures in older populations compared to younger ones is an example of a health disparity C. A social disadvantage may be due to income, race, ethnicity, or sexual orientation D. An economic disadvantage relates to living in neighborhoods with concentrated poverty E. None of the above

C. A social disadvantage may be due to income, race, ethnicity, or sexual orientation

Based on the NEJM article "How Structural Racism Works, " all of the following are true EXCEPT: A. Incarcerated people face a higher risk of death after release B. Our current policing system has roots to slave patrols used to capture runaways C. The "War and Drugs" and the "War on Crime" disproportionately impacted Black Americans D. The Civil Rights Act of 1964 led to a dramatic decrease in lynching and the convict-leasing system E. Police violence indirectly harms mental health for communities due to constant surveillance and threats of violence

D. The Civil Rights Act of 1964 led to a dramatic decrease in lynching and the convict-leasing system

According to the Bailey's NEJM article, "How Structural Racism Works" the effects of redlining: A. Led to a disinvestment in infrastructure, such as transport and schools, in formerly redlined neighborhoods B. Led to an increase in carcinogens and air pollution in better HOLC neighborhoods C. Ended after the Housing Act of 1968 D. Led to declined private but not federal mortgages based on race E. A and B

A. Led to a disinvestment in infrastructure, such as transport and schools, in formerly redlined neighborhoods

Which of the following is found more in neighborhoods that were originally marked green or blue based on "How Decades of Racist Housing Policy Left Neighborhoods Sweltering"? A. Highways B. Dark colored asphalt C. Playgrounds with shade and vegetation D. Public housing E. New industries

C. Playgrounds with shade and vegetation

Based on "What Are Health Disparities and Health Equity? We Need to Be Clear," achieving health equity involves: A. Protecting and promoting human rights B. Worsening the health of advantaged groups C. Working to eliminate social and economic factors that contribute to disparities D. A and C E. B and C

D. A and C

Based on "How Decades of Racist Housing Policy Left Neighborhoods Sweltering," all of the following are true EXCEPT: A. Some redlined neighborhoods in Richmond can get up to 15° hotter than wealthier, whiter parts of town B. Forerly blue-lined neighborhoods have more paved surfaces that absorb more heat C. Higher temperatures may lead to increased hospitalizations for asthma and cardiac arrest D. Having green space may help mental well-being E. The effects of redlining are seen throughout the country

B. Forerly blue-lined neighborhoods have more paved surfaces that absorb more heat

According to the NYT article "How Decades of Racist Housing Policy Left Neighborhoods Sweltering" neighborhoods that were redlined: A. Were deemed "hazardous" for mortgage loans and investments B. Were marked solely based on income levels C. Were most often Black neighborhoods D. A and B E. A and C

E. A and C

True or False: Research about healthcare disparities and structural racism is now frequently published in major medical journals according to Bailey's NEJM article.

False

"How Decades of Racist Housing Policy Left Neighborhoods Sweltering," states that the difference in life expectancy between Gilpin and Westover Hills may be due to: A. Increased air pollution due to highway proximity B. Old electric wiring cannot handle the air-conditioners provided by the city C.Lack of proximity to grocery stores, public transportation, and primary care physicians D. Increased incidents of chronic conditions, such as asthma, diabetes, and high blood pressure E. All of the above

E. All of the above

According to Koller's editorial, "Provider Payment Reform: Right Course, Wrong Students?" recent research has found that: A. In the Medicare Shared Savings Program, equal amounts of savings came from hospital-integrated and physician sponsored ACOs B. Practices with a higher share of PCPs had lower costs and higher quality of care C. Practices with one to two PCPs had significantly worse outcomes for very ill patients compared to larger practices D. A and B only E. B and C only

B. Practices with a higher share of PCPs had lower costs and higher quality of care

What is the effect of implementing medical homes on health care expenditures? A. Medical homes have little to no effect on health care expenditures, except when providing care to chronically ill patients B. Medical homes dramatically decrease health care expenditures, especially among children C. Medical homes have no effect on health care expenditures D. Medical homes increase health care expenditures, especially among the chronically ill

A. Medical homes have little to no effect on health care expenditures, except when providing care to chronically ill patients

According to Austin Frakt in his NYT article, "Value of Care was a Big Goal. How Did it Work Out?" which of the following is true about current value-based programs? A. Despite promising early analyses, the Hospital Readmissions Reduction Program has not had much of an impact on spending or quality B. Initial studies found that the Hospital Value-Based Purchasing Program improved quality of care and patient satisfaction C. Later studies found improvements in mortality rates, but not patient satisfaction in hospitals participating in the Hospital Value-Based Purchasing Program D. Despite strong financial incentives, the Hospital Value-Based Purchasing Program has not had much success

A. Despite promising early analyses, the Hospital Readmissions Reduction Program has not had much of an impact on spending or quality

Frakt's NYT article, "Value of Care was a Big Goal. How Did it Work Out?" states that bundled payments: A. Provide a set amount of money to cover a certain condition in a certain time period B. Have been found to save money without reducing quality of care C. Are meant to encourage hospitals to treat their patients in the most efficient way D. More than one of the above E. All of the above

E. All of the above

In "Professionalism, Performance, and the Future of Physician Incentives", Khuller argues for A. The banning of physician incentives due to their ability to corrupt the profession B. A standardized incentive system based on value instead of volume C. Different incentive systems that take into account the heterogeneity of physicians D. The return of employer-sponsored retirement funds as the main incentives for physicians

A. The banning of physician incentives due to their ability to corrupt the profession

In "Accountable Care at the Frontlines" by Ganguli and Ferris, challenges to implementing ACOs include: A. Financial sustainability of ACOs due to conflicting financial incentives B. Inconsistent quality metrics from commercial and public payers C. Poor enrollment due to consumer disinterest D. All of the above E. A and B only

E. A and B only

In "Professionalism, Performance, and the Future of Physician Incentives", all of the following are suggested as alternatives to pay-for-performance incentives except: A. Performance reviews by supervisors/peers B. Team-based rewards C. Using targets developed with the input of local clinicians D. Scholarships

D. Scholarships

When the year-end costs of an ACO is below a set risk-adjusted benchmark, they profit from A. Reimbursements B. Shared savings C. Fee-for-service D. Physician bonuses

B. Shared savings

The JAMA article, "Presidential Powers and Response to COVID-19" says that: A.Public health interventions must be evidence-based and not political B. The Public Health Service Act was used to facilitate telemedicine and increase hospital capacity C. The CDC had not used its federal quarantine powers in past 50 years except to quarantine single cases of a disease D. A and B E. A and C

E. A and C

True or False: According to Dr. Tufekci's NYT article, "American Dysfunction is the Biggest Barrier to Fighting Covid", despite much of the elderly population being Republican and consumers of misinformation, most of them have been vaccinated.

True

Which of the following difficulties brought by the pandemic and faced by public health are mentioned in "Why Public Health Faces a Crisis Across the U.S."? A. Personal attacks B. A growing number of empty public health positions D. Policy turnovers of public health work E. A growing prevalence of non-communicable diseases F. All of the above G. Only three of the above

G. Only three of the above

Dr. Tufekci recommends all of the following in her NYT opinion piece, "American Dysfunction is the Biggest Barrier to Fighting Covid", EXCEPT: A. Reducing the number of flights coming in and out of the U.S. B. Increasing outreach to racial minorities in regards to vaccination efforts C. Implementing more widespread vaccine mandates D. Continuing mask mandates until higher levels of vaccination have been achieved

A. Reducing the number of flights coming in and out of the U.S.

What is the purpose of the Public Health Service Act (PHSA)? A. Allows the President to appoint additional public health officers into the Cabinet B. Creates a center of emergency preparedness in each state in order to appropriately respond to public health emergencies C. Authorizes the HHS secretary to prevent spread of communicable diseases regardless of emergency declarations D. Separates public health officials' proceedings from those of government officials'

C. Authorizes the HHS secretary to prevent spread of communicable diseases regardless of emergency declarations

What is the problem with germ theory as Ed Yong puts it in his Atlantic article? A. Germ theory is not accurate. B. Germ theory undermines social causes of disease. C. Germ theory is an outdated theory that does not account for modern technology. D. Germ theory was advocated by people whose priorities were profit, not health.

B. Germ theory undermines social causes of disease.

Tufekci's article, "The Unvaccinated May Not Be Who You Think," mentions research done by the KFF on the uninsured. What was the most powerful predictor of who remained unvaccinated according to this research? A. Lack of health insurance B. Political orientation C. Believing that the vaccine is a hoax D. Race

A. Lack of health insurance

Which of the following is NOT a reason public health officials are facing burnout, as mentioned in the NYT article, "Why Public Health Faces a Crisis Across the U.S."? A. State and local legislative restrictions on health mandates B. Being left out of conversations over changes to public health laws C. Threats and personal attacks D. Vaccine hesitancy

D. Vaccine hesitancy

The JAMA article, "Presidential Powers and Response to COVID-19" says that: A. Public health interventions must be evidence-based and not political B. The Public Health Service Act was used to facilitate telemedicine and increase hospital capacity C. The CDC had not used its federal quarantine powers in past 50 years except to quarantine single cases of a disease D. A and B E. A and C

E. A and C

True or False: Local public health is less equipped to confront a pandemic now as compared to the beginning of 2020.

True

True or False: According to Ed Yong's Atlantic article, the U.S. is spending a larger proportion of each medical dolar on public health.

False

True or False: The CDC has been tracking breakthrough Delta variant cases diligently because it has been shown to be more infectious.

False

Which of the following statements about vaccine hesitancy were established in Tufekci's "The Unvaccinated May Not Be Who You Think"? A. The minority of the unvaccinated believe that they would not benefit from a vaccine. B. People with ideological commitments will refuse vaccines even when mandated. C. We have tracked sociological trends of the pandemic closely. D. All of the above E. A and B

E. A and B

What is Dr. Tufekci's MAIN argument in her NYT opinion piece, "American Dysfunction is the Biggest Barrier to Fighting Covid"? A. We need to rush FDA approval of Pfizer and Moderna vaccines to decrease vaccine hesitancy, which is the biggest barrier to vaccination rates. B. We need to increase vaccine outreach and enact clearer public health guidelines. C. The Delta variant may mean that we will need booster shots. D. We should provide incentives for vaccinating in order to boost vaccination rates.

B. We need to increase vaccine outreach and enact clearer public health guidelines.

True or False: according to Tufekci's article, "The Unvaccinated May Not Be Who You Think," most of the unvaccinated population in the U.S. is resistant to vaccines.

False

Which of the following are principles mentioned by the JAMA article, "Presidential Powers and Response to COVID-19", key to achieving a careful balance between public health and individual rights? A. Interventions should be evidence-based, without political considerations B. Coercive measures should be proportionate to the threat faced C. Health officials should make individualized risk assessments D. More than one of the above E. All of the above

E. All of the above

Which of the following is true about travel restrictions, according to the JAMA article "Presidential Powers and Response to COVID-19"? A. President Trump banned entry of all people coming from the Schengen area, the UK, Ireland, China, and Iran B. A cordon sanitaire would be much more effective than rigorous social distancing and quarantining but is harder legally implement C. Large-scale domestic travel bans are legally problematic, since judicial precedents suggest this is a constitutional right D. More than one of the above E. All of the above

C. Large-scale domestic travel bans are legally problematic, since judicial precedents suggest this is a constitutional right