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insurance is based on
protection against unanticipated events, unwanted events, undesireable events and large numbers of people
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health insurance may include?
medical and dental insurance, vision care, and prescription drug benefits
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define deductible
the sum of money that must be paid, typically every year before the insurabce policy becomes active.
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self insurance is...
patients are liable to insurer for any costs over what the employer paid.
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blue cross has been historically associtaed with
hospitals
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Blue shield has been historically associated with...
physicians
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historically, HMOs and the "Blues" have relied on which type of rating system to set premiums?
community rating
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most Americans who have health insurance have which kind of coverage?
Group coverage
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the oldest form of health insurance design is called?
idemnity design
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managed care include:
- it involves both insurers and providers of health care
- it uses financial incentives to reach its goal
- its purpose is to increase efficiancy and reduce health care costs
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A type of Managed-Care Plan is:
HMO, PPO, and point of service plan
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when an organized medical group contracts with an HMO to provide care to an enrolled population is called?
The Group Model
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utilization management includes a utilization control system in which the primary care physician serves in the following role?
Gatekeeper
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Among the concerns regarding the future of health insurance is the consolidation among health insurance plan. The concerns surrounding this trend are?
health plans will become so large that they will have an unfair advantage in dealing with purchasers and provoders
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an important issue facing managed care in the future is conflict of interest. Tis concern is over:
placing tight controls on the use of health services
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Characterisitics generally describe the unisured population:
working uninsured, medically uninsurable, nonworking uninsured
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The "need" for health care is defined as:
an interpretation of an individuals evaluated req for obtaining professional care through the health service system
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Demand for health services is described as
a function of an individuals actually seeking out, but not necessarily obtaining, helath services
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psychosocial and psychological factors impact health care services in which ways
psychological reactions to signs & symptoms can affect care seeking behavior
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societal factors influence care seeking behavior, as illustrated by all except which one of the following examples
- all of the above
- availabilty of supply services
- public info and awareness
- the strength of the economy, job participation rates, and other financial issues
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the decline in fertility rates in the US since the 1950s is most likely affected by one of these trends
increasing female labor force participation
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measures of fertility behavior include all except
- birth rates
- fertility rates
- age-specific fertility rates
- number of lives birth
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in the US, the most births per population of women occurs in what age group?
25-29
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what affected US fertility patterns during the 2nd half of the 20th century
- increasing age at 1st marriage
- increased divorce rate
- delayed initiation of childbearing
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what is the measure of mortality in a population
- life expectancy
- age specific mortality rates
- maternal mortality
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which country has a higher overall mortality rate compared to the US
Puerto Rico
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what population of groups has the lowest life expectancy
black males
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what cause of death have declined in the US from 1950-2000
malignant neoplasms
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for white males in the US, which cancer sites has the lowest 5 yr survival rate
pancreas
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which of the following tobbacco consumption in the US is not true
anot 10 percent of smokers are women
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death rates for HIV infection are greatest for which age group regardless of gender
35-44
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Causes of morbidity and mortality is not assciated with lifestyle and behavior
- alcohol consumption
- drug abuse
- vehicular accidents
- stds
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classifications of health care technology includes
- pharmaceuticals
- medical devices health info technology
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Phase II of clinical testing in humans include
testing of a larger group of patients with the target disease or illness
-
classification of pharmaceuticals can be subdivided into
biological and chemical pharmaceuticals
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NIH is:
- a branch of the federal govn't
- an agency the provides funds of establishment of research institutes
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when developing a product, most companies must be approved by
FDA
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insurance companies usually have a formulary which is
a list of drugs approved for coverage
-
one of the most important factors in whether a new technology will be successful is
approval for payment by insurance companies
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before a drug can enter the 1st phase of clinical testing, a sponosor of a new drug or biological must
evaluate the products safety and biological activity in vitro and in vivo laboratory animal testing
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how many criteria does the california technology assessment forum have for assessing products
5
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one of the 3 primary realms of evaluation applied to medical technology are
all of the above
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