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HTHRHSC 5370 EXAM 1 (CHAPTERS 1-6) SCORED A+
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HTHRHSC 5370 EXAM 1 (CHAPTERS 1-6) SCORED A+
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HTHRHSC 5370 EXAM 1 (CHAPTERS 1-6)SCORED A+
access Answer - the ability or persons needing health services to obtain
appropriate care in a timely manner
capitation Answer - a reimbursement mechanism under which the provider is
paid a set monthly fee per enrollee
enrollee Answer - a person enrolled in a health plan, especially in a managed
care plan
health maintenance organization (HMO) Answer - type of managed care plan
integrated delivery system (IDS) Answer - a network of organizations that
provides or arranges to provide a coordinated continuum of services to a
defined population and is willing to be held clinically and fiscally accountable
for the outcomes and health status of the population serviced
item-based pricing Answer - refers to the cost of ancillary services that often
accompany major procedures such as surgery
long-term care Answer - a variety of individualized, well-coordinated services
that are designed to promote the maximum possible independence for people
with functional limitations. These services are provided over an extended
period to meet the patients' physical, mental, social, and spiritual needs, while
maximizing quality of life
,managed care Answer - a system of health care delivery that (1) seeks to
achieve efficiencies by integrating the four functions of health care delivery, (2)
employs mechanisms to control (manage) utilization of medical services, and
(3) determines the price at which services are purchased and, consequently,
how much the providers get paid
market justice Answer - a distributional principle according to which health
care is most equitably distributed through the market forces of supply and
demand, rather than government interventions
national health insurance (NIH) Answer - tax-supported mechanism in which
the government guarantees a basic package of health services to all citizens
and finances health care through tax dollars, but the actual care is delivered by
private providers
national health system (NHS) Answer - an NIH program but goes further by
managing the infrastructure of delivery of medical care. medical institutions
are operated by the government and healthcare providers like physicians are
government employees
need Answer - the amount of medical care that medical experts believe a
person should have to remain or become healthy
package pricing Answer - bundling of fees for an entire package of related
services
preferred provider organization (PPO) Answer - created by insurance
companies in response to HMOs
social justice Answer - a distribution principle, according to which health care
is most equitably distributed by a government run national health program
, socialized health insurance (SHI) Answer - health care is financed through
government mandated contributions by employers and employees
socialized medicine Answer - any large-scale government-sponsored expansion
of health insurance or intrusion in the private practice of medicine
children's health insurance program (CHIP) Answer - provides low-income
families with children health insurance coverage
tricare Answer - a program that is financed by the military. this insurance
program permits the beneficiaries to receive care from both private and
military medical care facilities
veterans integrated service networks (VISNs) Answer - responsible for
coordinating the activities of the hospitals, outpatient clinics, nursing homes,
and other facilities located withing its jurisdiction
acute condition Answer - relatively severe, episodic, and often treatable. it is
subject to recovery, and treatment is generally provided in a hospital
behavioral factors Answer - individual lifestyles are also a key determinant of
health. for example, diet, exercise, a stress-free lifestyle, risky or unhealthy
behaviors, and other individual choices have been found to play a major role in
most of the significant health problems of today
chronic condition Answer - less severe but of long and continuous duration.
the patient may not fully recover. the disease may be kept under control
through appropriate medical treatment, but if left untreated, the condition
may lead to severe and life-threatening health problems. examples include
asthma, diabetes, and hypertension
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