Public Health Nursing Population Centered Health Care in the Community 9th Edition by Marcia Stanhope - Test Bank Instant Download - Complete Test Bank With Answers Sample Questions Are Posted Below Chapter 05: Economics of Health Care Delivery Stanhope: Public Health Nursing: Population-Centered Health Care in the Community, 9th Edition …
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Sample Questions Are Posted Below
Chapter 05: Economics of Health Care Delivery
Stanhope: Public Health Nursing: Population-Centered Health Care in the Community, 9th Edition
MULTIPLE CHOICE
| a. | Millions of people in the United States are without health insurance. |
| b. | The poor in the United States are as healthy as persons with higher incomes. |
| c. | Persons with money or health insurance are less likely to seek health care. |
| d. | The poor are more likely to receive health care through private agencies. |
ANS: A
In 2012, 48 million people were without health insurance in the United States. The poor in the United States are generally not as healthy as persons with middle or higher incomes. Persons with money and/or health insurance are more likely to seek health care. The poor are less likely to receive health care through private agencies.
DIF: Cognitive level: Understanding REF: p. 95
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | economics. |
| b. | health economics. |
| c. | public health economics. |
| d. | microeconomic theory. |
ANS: B
Health economics is the allocation of scarce resources within the health care sector and the focus on resource allocation issues related to producing and distributing health care. Economics is the science concerned with the use of resources, including the production, distribution, and consumption of goods and services. Public health economics focuses on the production, distribution, and consumption of goods and services as related to public health and where limited public resources might best be spent to save lives or increase the quality of life. Microeconomic theory deals with the behaviors of individuals and organizations and the effects of those behaviors on prices, costs, and the allocation and distribution of resources.
DIF: Cognitive level: Remembering REF: p. 96
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | use of resources. |
| b. | availability and usage of goods and services related to public health. |
| c. | scarcity of resources in the health care industry. |
| d. | management and use of monies to improve the health of populations. |
ANS: B
Public health economics focuses on producing, distributing, and consuming goods and services related to public health. Economics is the science concerned with the use of resources, including the production, distribution, and consumption of goods and services. Health economics is the allocation of scarce resources within the health care sector and the focus on resource allocation issues related to producing and distributing health care. Public health finance involves the acquiring, managing, and use of monies to improve the health of populations through disease prevention and health promotion strategies.
DIF: Cognitive level: Understanding REF: p. 96
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | Family planning |
| b. | Counseling |
| c. | Policy making |
| d. | Prevention of communicable diseases |
ANS: C
Policy making is offered at the federal level. Family planning, counseling, and preventing communicable and infectious disease are offered at the state and local levels.
DIF: Cognitive level: Applying REF: p. 97
TOP: Nursing process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | Macroeconomic theory |
| b. | Efficiency |
| c. | Supply and demand |
| d. | Microeconomic theory |
ANS: D
Microeconomic theory is examining the behaviors of individuals and organizations that result from trade-offs in utility and budget constraints of health care. Efficiency refers to producing maximum output using a given set of resources. Supply and demand are two basic principles of microeconomic theory. Macroeconomic theory focuses on the “big picture.”
DIF: Cognitive level: Applying REF: p. 97
TOP: Nursing process: Evaluation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | The demand for nurses in public health is low, but the supply is high. |
| b. | Few goods or services are available, the price tends to rise. |
| c. | Supplies are low, nurses must find alternate resources. |
| d. | Lesser-developed countries receive supplies from other countries. |
ANS: B
Supply and demand is in force when few goods or services are available, and then the price tends to rise. The other examples do not demonstrate the use of the laws of supply and demand.
DIF: Cognitive level: Analyzing REF: pp. 97-98
TOP: Nursing process: Evaluation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | The evaluation of client access to services |
| b. | A health policy that makes the development of a new program possible |
| c. | Informing clients and others of the cost of service |
| d. | The referral of clients to available services |
ANS: B
Macroeconomics focuses on the “big picture,” such as a program, whereas microeconomics focuses on the individual or organization.
DIF: Cognitive level: Analyzing REF: p. 98
TOP: Nursing process: Evaluation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | The nurse is concerned with factors that determine prices and affect resource allocation. |
| b. | The nurse is concerned with the positive effect of competitiveness on health care costs. |
| c. | The nurse is concerned with the supply, demand, and costs of services available to their clients. |
| d. | The nurse is concerned with the policies to support programs to improve the health of the community. |
ANS: D
Macroeconomic theory focuses on the “big picture”—the total, or aggregate, of all individuals and organizations (e.g., behaviors such as growth, expansion, or decline of an aggregate). The primary focuses of macroeconomics are the business cycle and economic growth. These cycles are influenced by a number of factors, such as political changes, policy changes, knowledge and technology advances, or simply the belief by a recognized business leader that the cycle is or should be shifting. Microeconomics focuses on the individual or an organization. Factors such as levels of income, employment, general price levels, and rate of economic growth are important in microeconomics.
DIF: Cognitive level: Applying REF: pp. 98-99
TOP: Nursing process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | Effectiveness |
| b. | Efficiency |
| c. | Microeconomics |
| d. | Production |
ANS: A
Effectiveness refers to the extent to which a health care service meets a stated goal or objective, or how well a program or service achieves what is intended. Efficiency refers to producing maximum output using a given set of resources. Microeconomic theory is examining the behaviors of individuals and organizations that result from trade-offs in utility and budget constraints of health care. Production refers to how goods are produced or created.
DIF: Cognitive level: Applying REF: p. 98
TOP: Nursing process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
| a. | Supply and demand |
| b. | Macroeconomics theory |
| c. | Efficiency |
| d. | Effectiveness |
ANS: C
Efficiency refers to producing maximum output, such as a good or service, or using a given set of resources or inputs, such as labor, time, and available money. Teaching one topic to many people is an example of this. Macroeconomic theory focuses on the “big picture.” Supply and demand is in force when few goods or services are available, and then the price tends to rise. Effectiveness refers to the extent to which a health care service meets a stated goal or objective, or how well a program or service achieves what is intended.
DIF: Cognitive level: Applying REF: p. 98
TOP: Nursing process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
| a. | Evaluating how well a program of service achieves what was intended |
| b. | Trying new products provided by sales representatives |
| c. | Using time wisely by delegating non-nursing tasks to unlicensed care providers |
| d. | Setting up a clinic to look aesthetically pleasing to clients |
ANS: C
Efficiency relates to producing maximal output given a set of resources. Using time wisely through delegation is the best example of using efficiency. Program evaluation, trying new products, and setting up a clinic are not examples of producing maximal output given a set of resources.
DIF: Cognitive level: Analyzing REF: p. 98
TOP: Nursing process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | Nurses are often the ones to allocate resources to solve a problem. |
| b. | Nurses are often involved in federal policy making. |
| c. | Health care policy can be influenced using these principles. |
| d. | Health care supplies can be very costly and nurses must use them wisely. |
ANS: A
Nurses often allocate resources, design, plan, coordinate, and evaluate community-based health services. Policy making addresses a macroeconomics issue. It is true that nurses need to know about microeconomics in order to use resources appropriately, but the scope of quality of care and use of health care supplies is larger than the scope of only microeconomics.
DIF: Cognitive level: Analyzing REF: p. 99
TOP: Nursing process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | Cost-effectiveness analysis |
| b. | Cost-benefit analysis |
| c. | Supply and demand |
| d. | Microeconomic theory |
ANS: B
Cost-benefit analysis involves the listing of all costs and benefits that are expected to occur from an intervention during a prescribed time. Cost-effectiveness analysis expresses the net direct and indirect costs and cost savings in terms of a defined health outcome. Supply and demand is in force when few goods or services are available, and then the price tends to rise. Microeconomic theory is examining the behaviors of individuals and organizations that result from trade-offs in utility and budget constraints of health care.
DIF: Cognitive level: Analyzing REF: p. 99
TOP: Nursing process: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
| a. | An 82-year-old woman with chronic medical problems |
| b. | A 2-year-old whose mother is on welfare |
| c. | A 50-year-old businessman who works for a large corporation |
| d. | A 32-year-old man who works part-time at a small business |
ANS: D
The typical uninsured person is one who works at a low-paying job, part-time or temporary, or at a small business. The elderly person would be eligible for Medicare, and the 2-year-old is probably eligible for Medicaid. The man who works at the large corporation probably has health insurance, since most large businesses provide it.
DIF: Cognitive level: Analyzing REF: p. 100
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | Obesity |
| b. | Marital status |
| c. | Health insurance |
| d. | Age |
ANS: A
Personal behavior/lifestyle (obesity) has the greatest effect on health. Environmental factors (marital status) and human biology (age) are next followed by the health care system (health insurance).
DIF: Cognitive level: Applying REF: p. 102
TOP: Nursing process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
| a. | A 40-year-old female who speaks English |
| b. | A 25-year-old female with health insurance |
| c. | A 50-year-old male with hypertension |
| d. | A 30-year-old male who is unemployed |
ANS: D
Barriers to accessing care include the inability to afford health care, lack of transportation, physical barriers, communication problems, child care needs, lack of time or information, or refusal of services by providers. The unemployed male is most likely to experience a barrier because of not having a job, which may reduce his access to health insurance and limit his income.
DIF: Cognitive level: Analyzing REF: p. 101
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | Development of a smoking prevention program |
| b. | Development of a support group for widows |
| c. | Development of a hypertension screening program |
| d. | Development of a hospice care program |
ANS: A
Primary prevention’s aim is preventing disease. Development of a smoking prevention program is primary prevention. Development of a support group for widows and development of a hospice care program are examples of tertiary prevention. Development of a hypertension screening program is an example of secondary prevention.
DIF: Cognitive level: Applying REF: p. 102
TOP: Nursing process: Planning
MSC: NCLEX: Health Promotion and Maintenance
| a. | the rise in technology. |
| b. | epidemics of infectious disease, such as typhoid, influenza, and malaria. |
| c. | physicians and nurses who attained their skills in scientifically based programs. |
| d. | an expansion of hospital clinics and long-term care facilities. |
ANS: B
Phase one was concerned with epidemics and infectious disease control. Technology is characteristic of phase four, and physicians and nurses attained skills in scientifically based programs in phase two. Phase three included the expansion of hospital clinics and long-term care facilities.
DIF: Cognitive level: Understanding REF: pp. 103-104
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | nurses in the United States being predominantly women. |
| b. | the expansion of the number and type of health care facilities. |
| c. | dependence on technology for patient care. |
| d. | the discovery and development of pharmacological advances. |
ANS: C
Nurses have become dependent on technologies to monitor client progress, make decisions about care, and deliver care in innovative ways as part of the fourth phase. The discovery and development of pharmacological advances is only one way that technology has increased during the fourth phase. Phase one was concerned with epidemics and infectious disease control. Physicians and nurses attained skills in scientifically based programs in phase two. Phase three included the expansion of hospital clinics and long-term care facilities.
DIF: Cognitive level: Understanding REF: p. 105
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | Health Maintenance Organization (HMO) Act |
| b. | Marine Hospital Service |
| c. | Medicare |
| d. | Medicaid |
ANS: B
The Marine Hospital Service was created in 1798 by the federal government to provide medical service for sick and disabled sailors and to protect the nation’s borders against the importing of disease through seaports. The HMO Act provided assistance and expansion for HMOs in the 1970s. Medicare and Medicaid were established in 1965 to provide health care services to certain populations.
DIF: Cognitive level: Remembering REF: p. 110
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | Health Insurance Portability and Accountability Act (HIPAA) |
| b. | Omnibus Budget Reconciliation Act |
| c. | Balanced Budget Act of 1997 |
| d. | Social Security Act of 1935 |
ANS: A
HIPAA is a federal intervention to protect health insurance coverage for workers and families following a job change or loss. The Omnibus Budget Reconciliation Act was a major effort to regulate and control the costs of physician fees. The Balanced Budget Act of 1997 determined that payments to Medicare skilled nursing facilities (SNFs) would be made on the basis of prospective payment system (PPS). The Social Security Act of 1935 signaled the federal government’s increasing interest in addressing social welfare problems.
DIF: Cognitive level: Applying REF: p. 115
TOP: Nursing process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | Part A provides coverage for hospitalization. |
| b. | Part A requires payment of a monthly premium for coverage. |
| c. | Part B provides payment for home health services and extended care facilities. |
| d. | Part B is available without cost to all elderly people who have paid social security taxes. |
ANS: A
Medicare Part A covers hospital care, home care, and skilled nursing care. Medicare Part B is a supplemental program available to all Medicare-eligible persons for a monthly premium.
DIF: Cognitive level: Understanding REF: p. 110
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | available to any citizen who wishes to enroll. |
| b. | two federal programs that provide insurance to special groups. |
| c. | private insurance providers. |
| d. | funded by the state government. |
ANS: B
Medicare provides insurance for persons over 65, and Medicaid provides financial assistance to states and counties to pay for medical services for the aged poor, the blind, the disabled, and families with dependent children who are below state poverty income levels. Medicare is financed by the federal government. Medicaid is jointly financed by state and federal government. They are not private insurance providers by definition.
DIF: Cognitive level: Understanding REF: p. 110
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | Part A |
| b. | Part B |
| c. | Part C |
| d. | Part D |
ANS: B
Medicare Part B is a supplemental (voluntary) program; it provides coverage for services that are not covered by Part A, such as laboratory services, ambulance transportation, prostheses, equipment, and some supplies. Part A provides coverage for hospital care, home care, and skilled nursing care. Part C is an option that can be chosen for additional coverage. Part C includes services of both Parts A and B. The Part C plans are coordinated care plans that include HMOs, private fee-for-service plans, and medical savings accounts (MSAs). Part C provides for all health care coverage costs after a high deductible. Part D provides prescription coverage.
DIF: Cognitive level: Applying REF: p. 111
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | Medicaid |
| b. | Blue Cross |
| c. | Medicare |
| d. | HMO |
ANS: C
Medicare is available to anyone on dialysis regardless of age. Blue Cross and HMO are both private insurance options. Medicaid provides financial assistance to states and counties to pay for medical services for the aged poor, the blind, the disabled, and families with dependent children who are below state poverty income levels.
DIF: Cognitive level: Applying REF: p. 113 (Table 5-4)
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | Blood draw to assess prothrombin time (PT)/International Normalized Ratio (INR) |
| b. | Physical therapy visit |
| c. | Stay in skilled nursing facility |
| d. | Transportation by an ambulance |
ANS: C
Medicare Part A covers hospital care, home care, and skilled nursing care. Laboratory and physical therapy services and transportation by ambulance would be covered by Medicare Part B.
DIF: Cognitive level: Analyzing REF: p. 110
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | An 85-year-old female who has hypertension |
| b. | A 25-year-old female who is pregnant |
| c. | A 50-year-old male who is blind |
| d. | A 70-year-old male who is hearing impaired |
ANS: C
Medicaid provides financial assistance to states and counties to pay for medical services for the aged poor, the blind, the disabled, and families with dependent children who are below state poverty income levels. Medicaid does not provide coverage to those who have hypertension, are pregnant, or are hearing impaired unless they meet income guidelines.
DIF: Cognitive level: Analyzing REF: p. 112
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | retrospective reimbursement. |
| b. | prospective reimbursement. |
| c. | fee-for-service. |
| d. | capitation. |
ANS: A
Retrospective reimbursement is the method whereby fees for the delivery of health care services in an organization are set after services are delivered. Prospective reimbursement is whereby the third-party payer establishes the amount of money that will be paid for the delivery of a particular service before offering services to the client. Fee-for-service is the traditional method of paying the health care practitioner; the practitioner determines the costs of providing a service, delivers the service, and submits a bill for the delivered service to a third-party payer who then pays the bill. Capitation is similar to prospective reimbursement for health care organizations; third-party payers determine the amount that practitioners will be paid for a unit of care.
DIF: Cognitive level: Understanding REF: p. 116
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | Medicare |
| b. | Medicaid |
| c. | MSAs |
| d. | Health maintenance organizations |
ANS: D
Health maintenance organizations and preferred provider organizations are types of managed care. Medicare and Medicaid are government insurance programs. MSAs are not a type of health insurance.
DIF: Cognitive level: Applying REF: p. 115
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | retrospective reimbursement. |
| b. | prospective reimbursement. |
| c. | fee-for-service. |
| d. | capitation. |
ANS: B
Prospective reimbursement is the method of paying an organization whereby the third-party payer establishes the amount of money that will be paid for the delivery of a particular service before offering the services to the client. Retrospective reimbursement is the method whereby fees for the delivery of health care services in an organization are set after services are delivered. Fee-for-service is the traditional method of paying the health care practitioner; the practitioner determines the costs of providing a service, delivers the service, and submits a bill for the delivered service to a third-party payer who then pays the bill. Capitation is similar to prospective reimbursement for health care organizations; third-party payers determine the amount that practitioners will be paid for a unit of care.
DIF: Cognitive level: Understanding REF: p. 116
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | Retrospective reimbursement |
| b. | Prospective reimbursement |
| c. | Fee-for-service |
| d. | Capitation |
ANS: D
Capitation describes the practice of paying physicians and other practitioners a set amount to provide care to a given client or group of clients for a set period of time and amount of money. This is similar to prospective reimbursement for health care organizations. Prospective reimbursement is the method of paying an organization whereby the third-party payer establishes the amount of money that will be paid for the delivery of a particular service before offering the services to the client. Retrospective reimbursement is the method whereby fees for the delivery of health care services in an organization are set after services are delivered. Fee-for-service is the traditional method of paying the health care practitioner; the practitioner determines the costs of providing a service, delivers the service, and submits a bill for the delivered service to a third-party payer who then pays the bill.
DIF: Cognitive level: Applying REF: p. 117
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
| a. | Reimbursement for health care services can be directed only to physicians. |
| b. | Nurse practitioners and clinical nurse specialists are reimbursed for Medicare Part B services. |
| c. | Nursing care is a separate budget item in determining hospital service costs. |
| d. | Nursing care is reimbursed separately from medical care in outpatient settings. |
ANS: B
Nurse practitioners and clinical nurse specialists were granted third-party reimbursement for Medicare Part B services only on January 1, 1998 under Public Law 105-33. Nursing care is not billed for or reimbursed for in hospital or outpatient settings.
DIF: Cognitive level: Understanding REF: p. 117
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
MULTIPLE RESPONSE
| a. | Technology and intensity |
| b. | Demographics—the aging population |
| c. | Chronic illness |
| d. | Use of the health care system |
| e. | Type of health care insurance |
ANS: A, B, C
Technology and intensity, demographics (especially the aging population), and chronic illness all influence health care costs. The fact that individuals have, over time, consumed more health care is not an adequate explanation for an influence of health care costs. The type of health care insurance does not influence health care costs.
DIF: Cognitive level: Understanding REF: pp. 108-110
TOP: Nursing process: Assessment
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
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