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HSM 310 final Exam with complete solutions 2024_2025.
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HSM 310 final Exam with complete solutions 2024_2025.
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HSM 310 final Exam with completesolutions 2024/2025
Social conditions of health - ANSWER-involve a person's relationships to others
in their society, including positions occupied with the social and economic
structures of society, and how these impact a person's health status
Triple Aim
How to measure it - ANSWER-1) improve experience of care for patients; 2)
improve population health; 3) reduce per-capita spending
1) need a defined population, 2) need for data over time, 3) need to distinguish
outcome vs. process measures AND population vs. project measures
Why do costs/prices differ throughout the US? - ANSWER-1) some areas have
sicker patients and thus spend more due to underlying patient risk factors
2) if additional spending led to better health, than it would be a good thing
Dartmouth atlas research has shown that underlying risk factors do not explain
the differences in spending - physical practices do - and that additional spending
does not improve outcomes, and may actually worsen them
Why do researchers conduct research using observational data even though
randomized control trials are generally considered preferable? Give at least 2
specific reasons why a researcher might use observational research over
conducting a randomized control trial. What are two potential issues with using
observational data for research? - ANSWER-While randomized control trials
(RCTs) are considered the "gold standard" of research, researchers often use
observational data because RCTs are not always realistic or practical.
, For example, RCTs can be cost prohibitive and researchers may not be able to
afford to pay for them, controlled settings may be unrealistic and pragmatic trials
not possible, or an RCT might not be ethical in in a given situation. Potential
issues with using observational data for research are being able to separate
correlation from causality, external validity concerns, and differentiating between
statistical significance and meaningful differences.
Assessing causality - Bradford hill criteria - ANSWER-1) cause should precede
effect
2) association should be plausible
3) results from different studies should be consistent
4) association should be strong
5) dose-response relationship between cause and effect
6) removal of cause should reduce risk of effect
IOM measurement (vital signs) - improve efficiency and focus - ANSWER-1)
measurement is a means to accomplish health goal not end
2) need to be broad and include set of metrics
3) still important measurement gaps
4) report does not establish a final set of fully-specific metrics that meets all
countries measurement goals
Data sources to measure population health - ANSWER-1) life expectancy, 2) self-
reported health status, 3) incidence and prevalence of chronic illness, 4)
behavioral and physiological factors
How does the ACA address population health - ANSWER-1) expanding insurance
coverage, 2) provisions aimed at improving the quality of care delivered, 3)
prevention and health promotion measures, 4) promotion community and
population-based activities
Three-legged stool - ANSWER-1) guaranteed issue - policy is offered to an eligible
applicant regardless of health status
2) individual mandate - requirement by law to purchase health insurance
3) Subsidies - help people to afford health insurance
The purpose of the individual mandate is to help overcome two main concerns.
Explain each of these concerns briefly. What was the main concern about
revoking the individual mandate (despite its lack of political popularity)? -
ANSWER-The purpose of the individual mandate was to combat concerns about
adverse selection and freeriders. Adverse selection means that sicker patients
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