chapt 1-8

  1. insurance is based on
    protection against unanticipated events, unwanted events, undesireable events and large numbers of people
  2. health insurance may include?
    medical and dental insurance, vision care, and prescription drug benefits
  3. define deductible
    the sum of money that must be paid, typically every year before the insurabce policy becomes active.
  4. self insurance is...
    patients are liable to insurer for any costs over what the employer paid.
  5. blue cross has been historically associtaed with
  6. Blue shield has been historically associated with...
  7. historically, HMOs and the "Blues" have relied on which type of rating system to set premiums?
    community rating
  8. most Americans who have health insurance have which kind of coverage?
    Group coverage
  9. the oldest form of health insurance design is called?
    idemnity design
  10. 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
  11. A type of Managed-Care Plan is:
    HMO, PPO, and point of service plan
  12. when an organized medical group contracts with an HMO to provide care to an enrolled population is called?
    The Group Model
  13. utilization management includes a utilization control system in which the primary care physician serves in the following role?
  14. 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
  15. 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
  16. Characterisitics generally describe the unisured population:
    working uninsured, medically uninsurable, nonworking uninsured
  17. The "need" for health care is defined as:
    an interpretation of an individuals evaluated req for obtaining professional care through the health service system
  18. Demand for health services is described as
    a function of an individuals actually seeking out, but not necessarily obtaining, helath services
  19. psychosocial and psychological factors impact health care services in which ways
    psychological reactions to signs & symptoms can affect care seeking behavior
  20. 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
  21. 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
  22. measures of fertility behavior include all except
    • birth rates
    • fertility rates
    • age-specific fertility rates
    • number of lives birth
  23. in the US, the most births per population of women occurs in what age group?
  24. 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
  25. what is the measure of mortality in a population
    • life expectancy
    • age specific mortality rates
    • maternal mortality
  26. which country has a higher overall mortality rate compared to the US
    Puerto Rico
  27.  what population of groups has the lowest life expectancy
    black males
  28. what cause of death have declined in the US from 1950-2000
    malignant neoplasms
  29. for white males in the US, which cancer sites has the lowest 5 yr survival rate
  30. which of the following tobbacco consumption in the US is not true
    anot 10 percent of smokers are women
  31. death rates for HIV infection are greatest for which age group regardless of gender
  32. Causes of morbidity and mortality is not assciated with lifestyle and behavior
    • alcohol consumption
    • drug abuse
    • vehicular accidents
    • stds
  33. classifications of health care technology includes
    • pharmaceuticals
    • medical devices health info technology
  34. Phase II of clinical testing in humans include
    testing of a larger group of patients with the target disease or illness
  35. classification of pharmaceuticals can be subdivided into
    biological and chemical pharmaceuticals
  36. NIH is:
    • a branch of the federal govn't
    • an agency the provides funds of establishment of research institutes
  37. when developing a product, most companies must be approved by
  38. insurance companies usually have a formulary which is
    a list of drugs approved for coverage
  39. one of the most important factors in whether a new technology will be successful is
    approval for payment by insurance companies
  40. 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
  41. how many criteria does the california technology assessment forum have for assessing products
  42. one of the 3 primary realms of evaluation applied to medical technology are
    all of the above
Card Set
chapt 1-8
class HC1000