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Chapter 002

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Potter & Perry: Fundamentals of Nursing, 7th Edition Test Bank Chapter 2: The Health Care Delivery System MULTIPLE CHOICE 1. Regulatory interventions were initiated to reduce the rise in health care costs. These interventions include: 1. Prospective payment systems 2. State limits on health care fees 3. Federal guidelines for treatment 4. Court review of insurance coverage ANS: 1 As a means to reduce health care costs, in 1983 Congress established the prospective payment system in which hospital
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  Potter & Perry: Fundamentals of Nursing, 7 th  Edition Test Bank Chapter 2: The ealth Care !eli ery #ystem$%T'PE C('CE 1.Regulatory interventions were initiated to reduce the rise in health care costs. These interventions include:1.Prospective payment systems2.State limits on health care fees3.Federal guidelines for treatment.!ourt review of insurance coverage #S:1 s a means to reduce health care costs$ in 1%&3 !ongress esta'lished the prospective  payment system in which hospitals are reim'ursed a set dollar amount for each diagnosis(related group$ regardless of the length of stay or use of services in the hospital.State limits on health care fees have not 'een used nationwide to reduce health care costs.Federal guidelines for treatment have not 'een used to reduce the cost of health care. Rather$ the focus has 'een on financial reim'ursement.!ourt review of insurance coverage has not 'een a primary intervention to lower health care costs.)*F: R+F:1,-/:!omprehensionT-P:#ursing Process: ssessment0S!:#!+ test plan designation: Safe$ +ffective !are +nvironment40anagement of !are2.evels of prevention are used 'y the nurse to provide a framewor5 or guide for nursing interventions. Focus is 'ased on the client6s needs and the care or service that is provided. n e7ample of a true health promotion service is a8n9:1. ero'ic dance class 2.*mmuniation clinic3.)ia'etic support group.Smo5ing cessation clinic #S:1+7amples of health promotion activities include e7ercise classes$ prenatal care$ well('a'ycare$ nutrition counseling$ and family planning. n immuniation clinic is an e7ample of an illness prevention service. dia'etic support group may 'e an e7ample of a reha'ilitation service to adapt to a change in lifestyle. smo5ing cessation clinic may 'e a part of reha'ilitation or offered as an illness  prevention service.)*F: R+F:1%-/:!omprehensionT-P:#ursing Process: ssessment 0os'y items and derived items ; 2<<%$ 2<<= 'y 0os'y$ *nc.$ an affiliate of +lsevier *nc.  Test an5 0S!:#!+ test plan designation: Safe$ +ffective !are +nvironment40anagement of !are3.There are many types of health care delivery agencies. n e7ample of a secondary level care agency is a:1.School2.#ursing home 3.)rug reha'ilitation center .State(owned psychiatric hospital #S: state(owned psychiatric hospital is an e7ample of the secondary level of care in which clients who present with signs and symptoms of disease are diagnosed and treated. school is an e7ample of preventive or primary care. nursing home is an e7ample of continuing care. drug reha'ilitation center is an e7ample of restorative care.)*F: R+F:2<-/:!omprehensionT-P:#ursing Process: ssessment0S!:#!+ test plan designation: Safe$ +ffective !are +nvironment40anagement of !are.>hich of the following fits within the occupational safety and health categories?1.#oise e7posure 2.Firearms6 safety3.Swimming lessons .0otorcycle helmets #S:1+7posure to environmental haards within the wor5place$ such as noise e7posure$ is one aspect of occupational safety and health.Firearms do not fit within the occupational safety and health category.Swimming lessons do no fit within the occupational safety and health category.0otorcycle helmets do not fit within the occupational safety and health category.)*F: R+F:2<-/:!omprehensionT-P:#ursing Process: ssessment0S!:#!+ test plan designation: Safe$ +ffective !are +nvironment40anagement of !are=. contractual agreement 'etween a hospital and a corporation to pay the health care e7penses of the corporation6s employees is an e7ample of a8n9: 1.PP-2.@0-3.Private insurance.Third(party payment #S:1 0os'y items and derived items ; 2<<%$ 2<<= 'y 0os'y$ *nc.$ an affiliate of +lsevier *nc. 2(2  Test an5  preferred provider organiation 8PP-9 is characteried 'y a contractual agreement  'etween a set of providers 8e.g.$ hospitals$ physicians$ or clinics9 and a purchaser 8e.g.$ the corporation6s insurance plan9. !omprehensive health services are provided at a discount to the companies under contract. +nrollees are limited to a list of ApreferredB hospitals$ physicians$ and providers. n enrollee pays more out(of(poc5et e7penses for using a provider not on the list. 0edicare @0- is the same as a managed care organiation 8all care provided 'y a  primary care physician9 'ut designed to cover costs of senior citiens.Private insurance is the traditional fee(for(service plan where payment is computed after services are provided 'ased on the num'er of services used.Third(party payment is when an entity 8other than the client or health care provider9 reim'urses health care e7penses. Third(party payers include insurance companies$ governmental agencies$ and employers.)*F: R+F:1&-/:!omprehensionT-P:#ursing Process: ssessment0S!:#!+ test plan designation: Safe$ +ffective !are +nvironment40anagement of !are,.The 0edicaid insurance program is 'est descri'ed as:1. cute care hospital insurance for the older adult population2. funded health care program for older and disa'led persons 3. state(regulated health care program for persons of low income . fee(for(service insurance plan that supports preventive health care #S:30edicaid is a federally funded$ state(operated program of medical assistance to people with low incomes. *ndividual states determine eligi'ility and 'enefits.This option descri'es 0edicare.This option descri'es 0edicare Part .This option does not descri'e 0edicaid.)*F: R+F:1&-/:!omprehensionT-P:#ursing Process: ssessment0S!:#!+ test plan designation: Safe$ +ffective !are +nvironment40anagement of !areC.Duality health care is an innovative approach to delivering health care. The maEor factor for its success is that it:1.Focuses on the nursing process2.ses outcomes to manage client care3.*s used e7clusively in the acute care setting. llows a high degree of fle7i'ility delivering the care #S:2 0os'y items and derived items ; 2<<%$ 2<<= 'y 0os'y$ *nc.$ an affiliate of +lsevier *nc. 2(3  Test an5 @ealth care providers are defining and measuring Guality in terms of outcomes. n outcome is a measure of what actually does or does not happen as a result of a process of care.The focus in Guality health care is on the outcome$ not the process.Duality health care is not used e7clusively in the acute care setting. *t may 'e used in various health care settings.ecause Guality health care is 'ased on achieving outcomes$ it does not allow a high degree of fle7i'ility for the nurse in delivering care.)*F: R+F:2C-/:!omprehensionT-P:#ursing Process: ssessment0S!:#!+ test plan designation: Safe$ +ffective !are +nvironment40anagement of !are&.!ase management is one strategy for coordinating health care services. >hat 'est descri'es this caregiving approach?1.!ontinuity of care is the primary concern.2.This focus of care may 'e more e7pensive. 3.The physician is the coordinator of client care. .*t is designed to provide minimal to moderate levels of care. #S:1>ith the case management model of care$ the case manager coordinates the efforts of all disciplines to achieve the most efficient and appropriate plan of care. !ontinuity of care isof primary importance.*f the efforts of all disciplines are well managed$ repetition or delays may 'e avoided witha resultant shortened hospital stay. Therefore this focus of care may not 'e more e7pensive.The physician may or may not 'e the coordinator of client care. The case manager typically is a nurse or social wor5er.!ase management is not entirely 'ased on the level of care reGuired.)*F: R+F:21-/:!omprehensionT-P:#ursing Process: ssessment0S!:#!+ test plan designation: Safe$ +ffective !are +nvironment40anagement of !are4!ase 0anagement%.The payment mechanism that 0edicare uses within its health care financing is:1.!apitation2.Fi7ed payments3.)irect contracting.Prospective payment #S:2*npatient hospital services for 0edicare clients are reim'ursed a set amount for each )RH$ regardless of the client6s length of stay or use of services in the hospital. 0os'y items and derived items ; 2<<%$ 2<<= 'y 0os'y$ *nc.$ an affiliate of +lsevier *nc. 2(

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