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Chapter 05 Economics of US Health Care Delivery
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Chapter 05 Economics of US Health Care Delivery
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lOMoAR cP SD |12827 373Chapter 05: Economics of US Health Care Delivery
Stanhope: Foundations for Population Health in Community/Public Health Nursing,
MULTIPLE CHOICE
1. A nurse is discussing how health care rationing occurs in the United States. Which of the following wo
as the criterion that is used to ration health care?
a. Clinic operating hours
b. Ability to pay for services
c. Availability of local provider services
d. Transportation availability
ANS: B
Because there are not enough health care services available to provide desired services to everyone, th
reducing costs by controlling the use of services. All of the factors listed affect health care access and t
rationing (either directly or indirectly). The primary determinant, however, is the ability to pay for serv
services are denied; therefore, those without insurance that is accepted by a provider or institution or w
to pay out of pocket are unable to obtain services regardless of operating hours, transportation issues, o
2. Which of the following must a nurse be knowledgeable about to make decisions regarding the most co
health care resources?
a. Insurance resources
b. Health care rationing
c. Health economics
d. Medical technology
ANS: C
Economics is the science concerned with the use of resources; health economics is concerned with how
health care industry. Insurance resources, health care rationing, and medical technology are important
economics but by themselves do not provide the broad understanding called for in this question.
3. Which of the following individuals would most likely experience a barrier when accessing health care?
a. A 40-year-old female who speaks English as a second language
b. A 25-year-old female with co-pay health insurance
c. A 50-year-old male with hypertension
d. A 30-year-old male who is unemployed
ANS: D
Barriers to accessing care include the inability to afford health care, lack of transportation, physical ba
problems, childcare needs, lack of time or information, or refusal of services by providers. The unemp
experience a barrier because of not having a job, which may reduce his access to health insurance and
who speak English as a second language and have health insurance even with co-pay requirements sho
access health insurance than someone who is unemployed since the inability to afford health care is a p
diagnoses, such as having hypertension, do not present a barrier to accessing health care.
4. Which person is most likely to be uninsured?
a. An 82-year-old woman with chronic medical problems
b. A 2-year-old whose mother is on welfare
c. A 50-year-old business man who works for a large corporation
d. A 24-year-old man who works part-time at a small business
ANS: D
Young adults (ages 19 to 25 years) account for a disproportionately large share of the uninsured, largel
The elderly person would be eligible for Medicare, and the 2-year-old is probably eligible for Medicai
the large corporation probably has health insurance, because most large businesses provide it.
5. Which of the following is most closely correlated with poor health?
a. Age and gender (i.e., older males)
b. Low socioeconomic status
, lOMoAR cP SD |12827 373
6. A pregnant teenager has approached a nurse asking about ways to improve the health outcomes for her
of the following statements would be most appropriate for the nurse to make?
a. “Don’t drop out of school.”
b. “Sign up for childbirth classes.”
c. “Sign up for the WIC program.”
d. “Take your prenatal vitamins daily.”
ANS: A
The question specifies the health of both the mother and the child. Socioeconomic conditions improve
socioeconomic status is inversely related to mortality and morbidity, by becoming better educated, the
likely to live a life of poverty and, as a consequence, will enjoy a greater chance of better health for he
priority of the nurse should be to encourage the teenager to stay in school as this choice will provide fo
for the client. Signing up for childbirth classes, the WIC program, and taking prenatal vitamins all add
which are not as important as the future of the teenager raising this child.
7. A nurse is providing care to a child whose parents do not receive health insurance as an employee bene
financial resources to pay for health care out of pocket. Which of the following resources should the nu
family?
a. A managed care organization
b. An emergency department
c. Medicaid
d. Medicare
ANS: C
Medicaid provides coverage for adults with low income and their children. Managed care is a type of p
Medicare is available to persons aged 65 and older. The emergency department would charge a co-pay
the child and the parents.
8. Which of the following best explains how the government unintentionally encourages low-income pers
departments as their primary care provider?
a. A huge amount of paperwork is required when Medicaid clients go to a
physician’s office.
b. Government regulations require Medicaid clients to use emergency
departments when their primary health care provider is unavailable.
c. Legally, emergency departments must see clients even if clients can’t pay.
d. Physicians’ limited office hours make them unavailable during evenings and
weekends.
ANS: C
People on Medicaid frequently have no primary care provider and may not be able to pay for their care
choose clients based on their ability to pay, emergency departments are required by law to evaluate ev
ability to pay. Emergency department co-payments are modest and are frequently waived if the client i
out-of-pocket costs provide incentives for Medicaid clients and the uninsured to use emergency depart
services. Limited physician office hours over the weekend does make it difficult for low-income perso
primary care provider; however, this is not influenced by a government decision. The government doe
clients to use the emergency department when their primary care provider is unavailable, rather the po
department
to see all clients regardless of ability to pay may inadvertently encourage them to use this service. The
office that needs to be completed by a Medicaid client is not any different than any other client receivi
9. Which of the four main factors that affect health, is the most important?
a. Environment
b. Human biology
c. Lifestyle choices
d. Health care system
ANS: C
Personal biology and behavior (or lifestyle), environmental factors and policies (including physical, so
economic environments), social networks, living and working conditions, and the health care system—
have the least effect. Behavior and lifestyle have been shown to have the greatest effect on longevity, w
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