HE210 FINAL EXAM QUESTIONS WITH
CORRECT ANSWERS
What vvis vvHealth?? vv- vvAnswer vv"Health vvis vva vvstate vvof vvcomplete vvphysical,
vvmental, vvand vvsocial vvwell-being vvand vvnot vvmerely vvthe vvabsence vvof vvdisease vvor
vvinfirmity." vvIt vvwas vvadopted vvin vv1946 vvand vvhas vvnot vvbeen vvamended vvsince
vv1948 vv(WHO, vv1948, vvp. vv100). vvMany vvsubsequent vvdefinitions vvhave vvtaken vvan
vvequally vvbroad vvview vvof vvhealth, vvincluding: vvA vvstate vvcharacterized vvby
vvanatomical, vvphysiological vvand vvpsychological vvintegrity; vvability vvto vvperform
vvpersonally vvvalued vvfamily, vvwork, vvand vvcommunity vvroles; vvability vvto vvdeal vvwith
vvphysical, vvbiological, vvpsychological vvand vvsocial vvstress; vva vvfeeling vvof vvwell-being;
vvand vvfreedom vvfrom vvthe vvrisk vvof vvdisease vvand vvuntimely vvdeath.
Determinants vvof vvHealth vv- vvAnswer vvGenetic vvInheritance, vvPhysical vvEnvironment,
vvSocial vvEnvironment, vvand vvHealth vvBehavior.
Health vvCare vvas vva vvDeterminant vvof vvHealth vv- vvAnswer vvPrimary, vvtertiary, vvand
vvsecondary vvcare. vvPRIMARY vvis vvPREVENTING. vvHealth vvcare vvis vvconcerning
vvwith vvSecondary vvand vvTertiary. vvSecondary vvprevention vvis vvconcerned vvwith
vvreducing vvthe vvburden vvof vvexisting vvdisease vvafter vvit vvhas vvdeveloped; vvearly
vvdetection vvis vvemphasized. vvSecondary vvprevention vvactivities vvare vvintended vvto
vvidentify vvthe vvexistence vvof vvdisease vvearly vvso vvtreatments vvthat vvmight vvnot vvbe
vvas vveffective vvwhen vvapplied vvlater vvcan vvbe vvof vvbenefit. vvTertiary vvprevention
vvfocuses vvon vvthe vvoptimum vvtreatment vvof vvclinically vvapparent, vvclearly vvidentified
vvdisease vvso vvas vvto vvreduce vvthe vvincidence vvof vvlater vvcomplications vvto vvthe
vvgreatest vvpossible vvdegree. vvIn vvcases vvwhere vvdisease vvhas vvbeen vvassociated
vvwith vvadverse vveffects, vvtertiary vvprevention vvinvolves vvrehabilitation vvand vvlimitation
vvof vvdisability. vvThe vvhealth vvcare vvsystem vvis vvless vvspent vvon vvprimary vvcare.
The vvPopulation vvServed vv- vvAnswer vv12.6% vvwas vvBlack vvor vvAfrican vvAmerican,
vv4.8% vvwas vvAsian, vvand vv10.2% vvwas vvsome vvother vvrace, vvor vvtwo vvor vvmore
vvraces. vvAbout vv16% vvof vvthe vvpopulation vvwas vvof vvHispanic vvor vvLatino vvorigin.
vvAs vva vvpercentage vvof vvtotal vvpopulation, vvevery vvracial vvand vvethnic vvgroup
vvincreased vvbetween vv2000 vvand vv2010 vvexcept vvfor vvnon-Hispanic vvWhites
There vvis vvalso vva vvbroad vvrange vvof vvsocial vvclasses vvwith vvlarge vvincome
vvdifferentials vvthat vvare vvbecoming vvwider vvover vvtime vvUnfortunately, vvthe vvUnited
,vvStates vvhas vvthe vvgreatest vvdisparity vvbetween vvthe vvrich vvand vvpoor vvof vvall vvthe
vvWestern vvEuropean vvcountries vvand vvJapan vvThese vvdisparities vvadd vvto vvthe
vvcomplexity vvand vvfragmentation vvof vvthe vvU.S. vvhealth vvcare vvsystem vvthrough
vveffects vvsuch vvas vvdifferential vvcare, vvpayment vvissues, vvcost vvsharing, vvand
vvaccess vvproblems. vvAge vvstructure vvalso vvaffects vvthe vvU.S. vvhealth vvcare vvsystem.
vvThe vvpopulation vvforecast vvfor vvthe vvyear vv2020 vvundoubtedly vvforeshadows vvmajor
vvchanges vvon vvthe vvsystem, vvas vvthe vvbaby vvboomer vvgeneration vvages. vvAs vva
vvresult, vvhealth vvcare vvconsumption vvpatterns vvthat vvhave vvremained vvfairly vvconstant
vvover vvtime vvwill vvmove vvmore vvunevenly vvin vvthe vvdirection vvof vvelderly vvcare.
vvPhysicians vvwill vvneed vvto vvspend vvmore vvtime vvproviding vvservices vvfor vvthe
vvelderly, vvincreasing vvfrom vv32% vvof vvpatient vvcare vvhours vvin vv2000 vvto vv39% vvin
vv2020
U.S. vvHealth vvCare vvSystem vv- vvAnswer vvThe vvfive vvcomponents vvof vvhealth vvcare
vvsystems— vvfacilities, vvworkforce, vvsuppliers vvof vvmedical vvproducts, vveducational
vvand vvresearch vvorganizations, vvand vvfinancing vvmechanisms— vvare vvorganized vvto
vvprovide vvhealth vvservices. vvIn vvevery vvsystem, vvthere vvis vvsome vvkind vvof
vvorganizational vvstructure vvthat vvenables vvthe vvsystem's vvcomponents vvto vvinteract
vvand vvfunction vvto vvproduce vvhealth vvservices vvfor vvthe vvpeople. vvTypically vvthis
vvrequires vvorganizations vvthat vvfunction vvas vvhealth vvcare vvpayers, vvhealth vvcare
vvproviders, vvhealth vvcare vvpolicy vvmakers, vvor vvsome vvcombination vvof vvthese.
vvThese vvorganizations vvor vventities vvmay vvbe vvgovernmental vvhealth vvauthorities
vvand vvother vvagencies vvof vvgovernment vvwith vvhealth vvcare vvfunctions vv(government
vvsector), vvprivate, vvnonprofit vvhealth vvcare vvorganizations, vvwhich vvincludes vvthe
vvvoluntary vvhealth vvcare vvagencies vvand vvprofessional vvassociations, vvor vvprivate,
vvfor-profit vventerprises vvwith vvhealth vvcare vvfunctions.
Components vvof vvthe vvU.S. vvHealth vvCare vvSystem vv- vvAnswer vvThe vvfive vvmain
vvmajor vvcomponents vvare: vvFacilities, vvworkforce, vvtraining vvand vvresearch,
vvsuppliers vvof vvmedical vvproducts, vvand vvfinancing.
As vvthe vvphysicians vvhave vvshifted vvto vvjoining vvlarger vvorganizations, vvambulatory
vvcare, vvor vvcare vvprovided vvto vvpatients vvnot vvexpected vvto vvsleep vvat vvan
vvinstitution, vvhas vvshifted vvto vvstandalone vv(but vvhospital-owned) vvphysician
vvpractices, vvambulatory vvclinics vvthat vvare vvpart vvof vvhospital vvfacilities, vvFederally
vvQualified vvHealth vvCenters vv(FQHC), vvand vvcommunity vvmental vvhealth vvcenters.
vvThe vvother vvmajor vvclass vvof vvinstitutions vvare vvthose vvhousing vvand vvcaring vvfor
vvpatients vvin vvbed, vvof vvwhich vvthe vvhospital vvis vvthe vvmost vvfamiliar. vvAcute vvcare
vvhospitals vvare vvalso vvthe vvlargest vvsingle vvcomponent vvof vvhealth vvcare
vvexpenditures vv(see vvChapter vv5). vvOther vvinpatient vvfacilities vvinclude vvhospices,
vvskilled vvnursing vvfacilities vvand vvother vvnursing vvfacilities, vvand vvintermediate vvcare
vvfacilities, vvincluding vvthose vvfor vvthe vvmentally vvretarded vv(Centers vvfor vvMedicare
vv& vvMedicaid vvServices vv[CMS], vv2015). vvThere vvare vvalso vvdisease-specific vvand
vvother vvspecialty vvhospitals.Health vvcare vvand vvsocial vvassistance vvconsists vvof
vvthree vvsubgroups: vv(a) vvhospitals; vv(b) vvhealth vvservices vvlike vvoffices vvof vvhealth
vvpractitioners, vvoutpatient vvcare vvcenters, vvhome vvhealth vvcare vvservices, vvother
vvhealth vvcare vvservices, vvnursing vvcare vvfacilities, vvresidential vvcare vvfacilities; vvand
,vv(c) vvsocial vvassistance vvlike vvindividual vvand vvfamily vvservices, vvcommunity vvfood
vvand vvhousing, vvand vvemergency vvservices, vvvocational vvrehabilitation vvservices,
vvand vvchild vvday vvcare vvservices. vvThe vvhealth vvcare vvand vvsocial vvassistance
vvsector vvcomprises vvestablishments vvproviding vvhealth vvcare vvand vvsocial
vvassistance vvfor vvindividuals.
A vvvariety vvof vvmedical vvproducts, vvincluding vvequipment vvand vvpharmaceuticals, vvare
vvrequired vvin vvthe vvhealth vvcare vvsystem. vvThey vvare vvgenerally vvcategorized vvas
vvprescription vvdrugs, vvthe vvlargest vvof vvthe vvcategories; vvdurable vvmedical
vvequipment; vvand vvother vvnondurable vvmedical
Organization vvof vvthe vvU.S. vvHealth vvCare vvSystem vv- vvAnswer vvThere vvis vvnot vva
vvsingle vvnational vvstructure vvfor vvpaying vvfor vvor vvoperating vvthe vvhealth vvcare
vvsystem. vvThe vvfederal vvgovernment vvplays vvan vvimportant vvrole, vvbut vvthe vvstates
vvdo, vvtoo. vvThere vvis vvno vvsingle-payer vvsystem. vvRather, vvthe vvsystem vvis vva vvmix
vvof vvprivate vvand vvpublic vvorganizations vvproviding, vvpaying, vvand vvto vvvarying
vvextents vvsetting vvpolicy vvfor vvhealth vvcare vvat vvevery vvlevel vvof vvthe vvsystem.
In vvthe vvUnited vvStates, vveach vvof vvthe vvthree vvlevels vvof vvgovernment— vvfederal,
vvstate, vvand vvlocal— vvprovides vvleadership vvand vvgovernance vvdirectly vvand
vvindirectly vvthrough vvthe vvregulation vvof vvthe vvdelivery vvof vvhealth vvservices, vvtheir
vvsuppliers, vvand vvpayers vvwith vvthe vvopportunity vvto vvdrive vvmarket vvshifts vvthrough
vvthe vvoperation vvof vvtheir vvown vvhealth vvservices vvdelivery vvand vvpayer vvprograms.
The vvprincipal vvhealth vvagency vvof vvthe vvU.S. vvfederal vvgovernment vvis vvthe
vvDepartment vvof vvHealth vvand vvHuman vvServices, vvheaded vvby vva vvcabinet-level
vvsecretary. vvThe vvagency vvis vvresponsible vvfor vvthe vvfederal vvSocial vvSecurity
vvprogram, vvthe vvfederal vvrole vvin vvthe vvstate-run vvpublic vvassistance vvprograms, vvand
vvthe vvmain vvfederal vvprograms vvin vvbiomedical vvresearch, vvregulation, vvfinancing,
vvand vvpublic vvhealth. vvMany vvof vvthe vvdepartment's vvresponsibilities vvare vvmet vvby
vvallocation vvof vvmoney vvand vvdelegation vvof vvauthority vvto vvthe vvmany vvother vvpublic
vvand vvprivate vventities vvthroughout vvthe vvnation vvthat vvare vvconcerned vvwith vvhealth
vvmatters. vvIn vveach vvof vvthe vv50 vvstates, vvthere vvis vva vvmajor vvhealth vvagency vvthat
vvis vvpart vvof vvstate vvgovernment. vvAs vvat vvthe vvfederal vvlevel, vvin vvsome vvstates vvthe
vvagency vvis vvcombined vvwith vvagencies vvfor vvsocial vvwelfare vvor vvother vvfunctions.
vvThe vvadministrative vvconfiguration vvand vvscope vvof vvfunctions vvof vvthe vvstate
vvhealth vvcare vvagencies vvare vvhighly vvvariable. vvThe vvheads vvof vvthese vvagencies
vvare vvordinarily vvappointed vvby vvthe vvstate's vvgovernor. vvAdministratively, vvthey vvare
vvresponsible vventirely vvto vvthe vvgovernor vvand vvnot vvat vvall vvto vvthe vvDepartment vvof
vvHealth vvand vvHuman vvServices. vvOnly vvinsofar vvas vvcertain vvs
Types vvof vvHealth vvService vvProvided vv- vvAnswer vvPrimary: vvCommon vvforms vvof
vvpersonal vvpreventive vvmeasures vvare vvthe vvpromotion vvof vvpersonal
vvlifestyle/behavior vvchange vv(e.g., vvbecoming vva vvregular vvexerciser), vvimmunization,
vvprenatal vvcare, vvand vvperiodic vvhealth vvexamination vvfor vvearly vvdisease vvdetection.
vvMost vvof vvthe vvmajor vvcauses vvof vvacute vvand vvchronic vvmorbidity vv(sickness) vvare
vvtreated vvin vvthe vvprimary vvcare vvsetting. vvAs vvof vv1996 vv(the vvmost vvrecent vvyear
vvfor vvwhich vvthe vvfollowing vvdata vvwere vvavailable vvat vvthe vvtime vvof vvwriting), vvthe
vvmajor vvcauses vvof vvacute vvand vvchronic vvmorbidity vvwere vvrespiratory vvconditions,
, vvinfluenza, vvthe vv"common vvcold," vvinjuries, vvother vvinfective vvand vvparasitic
vvdiseases, vvhearing vvimpairment, vvchronic vvsinusitis, vvarthritis, vvhypertension, vvheart
vvconditions, vvorthopedic vvimpairments vv(including vvlow-back vvpain), vvand vvasthma
vvand vvhay vvfever.
Secondary vvand vvTertiary: vvSecondary vvcare vv(the vvmost vvdifficult vvlevel vvto vvdefine)
vvincludes vvservices vvthat vvare vvavailable vvin vvboth vvcommunity vvhospitals vvand
vvphysicians' vvoffices. vvIdeally, vvsecondary vvcare vvis vvarranged vvthrough vvreferral vvor
vvconsultation vvafter vva vvpreliminary vvevaluation vvby vva vvprimary vvcare vvpractitioner.
vvSecondary vvservices vvinclude vvmost vvsurgical vvprocedures vvand vvthe vvcommon
vvdiagnostic vvand vvtreatment vvinterventions vvof vvsuch vvspecialists vvas vvradiologists,
vvcardiologists, vvand vvophthalmologists. vvTertiary vvcare vvconsists vvof vvhighly
vvspecialized vvdiagnostic, vvtherapeutic, vvand vvrehabilitative vvservices, vvrequiring vvstaff
vvand vvequipment vv"that vvtranscend vvthe vvcapabilities vvof vvthe vvaverage vvcommunity
vvhospital" vv(Rogatz, vv1970, vvp. vv47). vvSuch vvcare, vvavailable vvlargely vvat vvmajor
vvmedical vvcenters, vvincludes vvorgan vvtransplantation, vvopen-heart vvsurgery, vvand
vvother vvtechnically vvcomplex vvprocedures, vvcomplex vvchemotherapy vvand
vvradiotherapy vvfor vvcancer, vvand vvthe vvpreservation vvof vvvery-low-birth-weight
vvpremature vvinfants.
In vvthe vvUnited vvStates, vvboth vvsecondary vvand vvtertiary vvhealth vvservices vvare
vvhighly vvdeveloped. vvThat vvdevelopment vvhas vvnot vvalways vvoccur
Health vvCare vvSystem vvPerformance vv- vvAnswer vvQuality, vvEquality, vvProficiency
The vvIron vvTriangle vv- vvAnswer vvThe vvIron vvTriangle vvis vva vvterm vvreferring vvto vvthree
vvaspects vvthat vvaffect vvevery vvdecision vvabout vvhealth vvcare vvdelivery vv- vvcost,
vvaccess,choice, vvand vvquality. vvCost vvincludes vvsuch vvthings vvas vvthe vvamount vvpaid
vvfor vvservices, vvdeductibles vvand vvco-pays, vvworkers' vvsalaries, vvtechnology,
vvphysical vvstructures vvof vvfacilities, vvresearch, vvpharmaceuticals, vvdiagnostics vvand
vvsupplies... vvthe vvlist vvgoes vvon vvand vvon. vvQuality vvinvolves vvpatient vvoutcomes
vv(did vvthe vvpatient vvget vvbetter vvor vvdie, vvhave vvcorrect vvtreatments/procedures, vvwas
vvthe vvcare vvtimely.) vvAccess vvincludes vvwhether vvservices vvare vvavailable vvto
vvpatients vvand vvproviders, vvgeographically vvand vvfinancially. vvChoice vvrefers vvto vvthe
vvpatient's vvability vvto vvpick vvtheir vvprovider, vva vvprovider's vvability vvto vvprescribe vvthe
vvpreferred vvmedication/order vvthe vvchosen vvtest vvand vva vvpayer's vvpreference vvfor
vvreimbursement. vvCitizens vvof vvthe vvUS vvare vvVERY vvused vvto vvhaving vvchoices!
Major vvStakeholders vvin vvHealth vvCare vv- vvAnswer vvThe vvmajor vvstakeholders vvin
vvthe vvhealthcare vvsystem vvare vvpatients, vvphysicians, vvemployers, vvinsurance
vvcompanies, vvpharmaceutical vvfirms vvand vvgovernment. vvInsurance vvcompanies vvsell
vvhealth vvcoverage vvplans vvdirectly vvto vvpatients vvor vvindirectly vvthrough vvemployer
vvor vvgovernmental vvintermediaries.
Components vvof vvthe vvU.S. vvHealth vvCare vvSystem vv2(Modules) vv- vvAnswer
vvComponents vvof vvU.S. vvHealth vvCare vvSystem: vvUsing vvthe vvWHO vvdefinition vvas
vva vvbuilding vvblock vvconsider vvthe vvcomponents vvof vvthe vvU.S. vvHealth vvCare
vvSystem vvidentified vvin vvyour vvtext.