Long-Term Care and Medical Ethics
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Questions and Answers

Which level of care is the most costly?

  • Primary
  • Secondary
  • Tertiary (correct)
  • All levels of care have the same cost

    • Which model of regionalized care relies on resources coordinated in a geographic region?

  • Fluid Model
  • HMO Model
  • Dawson Model (correct)
  • Dispersed Model

    • Which level of care deals with problems that require more specialized clinical expertise?

  • Primary
  • Tertiary
  • All levels of care deal with specialized clinical expertise
  • Secondary (correct)

    • Which model of regionalized care allows patients to go where they wish and emphasizes tertiary expertise?

    <p>Dispersed Model</p> Signup and view all the answers

    Which one of the following is true about Skilled Nursing Facilities (SNF)?

    <p>SNF provides skilled nursing and rehabilitative services</p> Signup and view all the answers

    According to the text, why has the supply of U.S. generalist physicians been decreasing?

    <p>Not enough medical students going into PCP training</p> Signup and view all the answers

    Which one of the following is true about custodial care?

    <p>Custodial care includes activities of daily living that the patient needs help with</p> Signup and view all the answers

    According to the text, what is the main advantage of the Integrated Medical Group (IMG) Model?

    <p>Employment of physicians by the medical group organization</p> Signup and view all the answers

    Which one of the following is true about hospice care?

    <p>Hospice care is provided at home and at facilities</p> Signup and view all the answers

    According to the text, what is the main problem with gatekeepers in HMOs?

    <p>Physicians do not know which hospital or specialist would accept a patient</p> Signup and view all the answers

    Which one of the following is true about home health care?

    <p>Home health care requires the patient to be homebound</p> Signup and view all the answers

    According to the text, what is the main challenge to controlling the quantity of healthcare costs?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is a method used for cost control in healthcare financing?

    <p>Paying by capitation or aggregated method</p> Signup and view all the answers

    What is one of the primary reasons why quality of healthcare is lacking in the United States?

    <p>Misuse and errors in healthcare practices</p> Signup and view all the answers

    Which of the following is a characteristic of long-term care?

    <p>Custodial care only</p> Signup and view all the answers

    What is one of the methods used to achieve malpractice reform in healthcare?

    <p>Pay for Performance</p> Signup and view all the answers

    Which component of the ACA requires companies with more than 50 employees to provide health coverage or pay a penalty?

    <p>Employer Mandate</p> Signup and view all the answers

    What is the main purpose of an advanced directive?

    <p>To assign a proxy for decision-making</p> Signup and view all the answers

    What is the equivalent of withholding treatment in terms of healthcare ethics?

    <p>Withdrawal of treatment</p> Signup and view all the answers

    What is the key coverage measure that eliminates provisions allowing health insurers to deny coverage based on pre-existing conditions?

    <p>Individual health insurance mandate</p> Signup and view all the answers

    Which country has a Single Payer system funded by taxes?

    <p>United Kingdom</p> Signup and view all the answers

    Who has access to the NHS system in the United Kingdom?

    <p>Anyone who pays taxes to the government</p> Signup and view all the answers

    How does the cost of care in the NHS system compare to the United States?

    <p>Cost of care is significantly less in the NHS system</p> Signup and view all the answers

    What is a weakness of the NHS system in the United Kingdom?

    <p>Incredibly long wait times for elective surgeries</p> Signup and view all the answers

    On average, what percentage of income do Swiss citizens spend on health insurance premiums?

    <p>16%</p> Signup and view all the answers

    Are co-payments higher or lower in Switzerland compared to the United States?

    <p>Higher in Switzerland</p> Signup and view all the answers

    Which program provides comprehensive care to those over 55 who qualify for nursing home care?

    <p>The On Lok program</p> Signup and view all the answers

    What are the four principles of medical ethics?

    <p>Beneficence, nonmaleficence, autonomy, and justice</p> Signup and view all the answers

    What is the purpose of the Money Follows the Person program?

    <p>To assist states in transitioning institutionalized individuals back to the community</p> Signup and view all the answers

    What does distributive justice require in terms of access to medical services?

    <p>Equal access based on medical need, regardless of ability to pay</p> Signup and view all the answers

    Which level of care deals with rare and complex problems?

    <p>Tertiary</p> Signup and view all the answers

    What is the main advantage of the Dawson Model of Regionalized Care?

    <p>Highly structured organization</p> Signup and view all the answers

    Which model of regionalized care has grown in the U.S.?

    <p>Dispersed Model</p> Signup and view all the answers

    What is the primary reason why the Dispersed Model of regionalized care has grown in the U.S.?

    <p>Allows patients to go where they wish</p> Signup and view all the answers

    Which of the following is a primary method used for cost control in healthcare financing?

    <p>Patient cost sharing</p> Signup and view all the answers

    What is one of the main reasons why quality of healthcare is lacking in the United States?

    <p>Underuse of effective care</p> Signup and view all the answers

    Which level of care deals with problems that require more specialized clinical expertise?

    <p>Skilled nursing facility</p> Signup and view all the answers

    What is one of the main characteristics of long-term care?

    <p>Custodial care only</p> Signup and view all the answers

    According to the text, what was the emphasis of the reformed medical training under the Biomedical Model?

    <p>All of the above</p> Signup and view all the answers

    According to the text, what is one of the arguments against a dispersed model of healthcare?

    <p>Lack of coordination</p> Signup and view all the answers

    According to the text, why is the supply of U.S. generalist physicians a problem?

    <p>All of the above</p> Signup and view all the answers

    According to the text, what is the main advantage of the Integrated Medical Group (IMG) Model?

    <p>All of the above</p> Signup and view all the answers

    Which statement accurately describes the coverage provided by Medicare and insurance for skilled care?

    <p>Medicare and insurance cover short term skilled care for up to 100 days</p> Signup and view all the answers

    What is the main difference between Skilled Nursing Facilities (SNF) and Nursing Homes?

    <p>SNFs provide skilled nursing and rehabilitative services, while nursing homes provide only custodial care</p> Signup and view all the answers

    Under what conditions does Medicare cover hospice care?

    <p>A doctor certifies that a patient is terminally ill and the care is provided by a Medicare-participating hospice</p> Signup and view all the answers

    What is the main reason why many patients need 24-hour care but only receive intermittent care under Medicare coverage?

    <p>Medicare coverage is based on an episode of illness model and only provides a lump sum for 60 days of care</p> Signup and view all the answers

    Which country has a Single Payer system funded by taxes?

    <p>United Kingdom</p> Signup and view all the answers

    What is the average percentage of income spent on health insurance in Switzerland?

    <p>16%</p> Signup and view all the answers

    What is the main weakness of the NHS system in the United Kingdom?

    <p>Long wait times for elective surgeries</p> Signup and view all the answers

    Are co-payments higher or lower in Switzerland compared to the United States?

    <p>Higher in Switzerland</p> Signup and view all the answers

    What is the main purpose of the Health Insurance Marketplace Exchanges in the United States?

    <p>To provide a portal for people to shop for individual health insurance</p> Signup and view all the answers

    Who is required to have health insurance in Australia?

    <p>Everyone</p> Signup and view all the answers

    Which program provides comprehensive care to those over 55 who qualify for nursing home care?

    <p>The On Lok program</p> Signup and view all the answers

    What are the four principles of medical ethics?

    <p>Beneficence, nonmaleficence, autonomy, and justice</p> Signup and view all the answers

    What is the main purpose of an advanced directive?

    <p>To specify healthcare preferences in advance</p> Signup and view all the answers

    Which model of regionalized care allows patients to go where they wish and emphasizes tertiary expertise?

    <p>The Integrated Medical Group (IMG) Model</p> Signup and view all the answers

    Which of the following is a key component of the National Health Reform under the ACA?

    <p>Expansion of Medicaid eligibility</p> Signup and view all the answers

    What is the penalty for employers with more than 50 employees if they don't offer an employer-sponsored plan to at least 95% of full-time employees?

    <p>Approximately $2000 per employee</p> Signup and view all the answers

    What is the main purpose of the Individual Mandate under the ACA?

    <p>To require virtually all Americans to have health insurance</p> Signup and view all the answers

    What is the main purpose of the Employer Mandate under the ACA?

    <p>To require companies with &gt;50 employees to provide their employees insurance</p> Signup and view all the answers

    Which model of regionalized care consolidates all levels of care, staff, and facilities under one organizational ownership?

    <p>Vertical Integration Model</p> Signup and view all the answers

    What is the main advantage of the Independent Practice Associations (IPAs) Model?

    <p>Allows insurers to respond to market changes</p> Signup and view all the answers

    What is the main reason why the supply of U.S. generalist physicians is a problem?

    <p>Decreasing interest from medical students</p> Signup and view all the answers

    What is one of the main arguments against a dispersed model of healthcare?

    <p>Lack of coordination</p> Signup and view all the answers

    Which level of care deals with problems that require more specialized clinical expertise?

    <p>Secondary</p> Signup and view all the answers

    What is the main difference between Skilled Nursing Facilities (SNF) and Nursing Homes?

    <p>SNFs provide short-term rehabilitation services, while Nursing Homes provide long-term care.</p> Signup and view all the answers

    What is the main advantage of the Integrated Medical Group (IMG) Model?

    <p>It provides highly structured care beginning with primary care physicians.</p> Signup and view all the answers

    What is the main reason why many patients need 24-hour care but only receive intermittent care under Medicare coverage?

    <p>Strict eligibility criteria for Medicare coverage</p> Signup and view all the answers

    Which of the following is true about Medicare coverage for custodial care?

    <p>Medicare does not cover custodial care.</p> Signup and view all the answers

    Which one of the following is true about Medicaid coverage for nursing homes?

    <p>Medicaid covers nursing home care but not custodial home care.</p> Signup and view all the answers

    What type of care does Medicare cover for terminally ill patients?

    <p>Medicare covers hospice care for terminally ill patients.</p> Signup and view all the answers

    What is the main reason why people with chronic illnesses are often rejected for private long-term care insurance?

    <p>Their chronic illnesses are not covered by the policies.</p> Signup and view all the answers

    Which of the following is a primary method used for cost control in healthcare financing?

    <p>Supply Limits</p> Signup and view all the answers

    What is one of the main reasons why quality of healthcare is lacking in the United States?

    <p>Inefficiency and Waste</p> Signup and view all the answers

    What is the main difference between Skilled Nursing Facilities (SNF) and Nursing Homes?

    <p>SNFs provide custodial care while Nursing Homes provide comprehensive medical management</p> Signup and view all the answers

    According to the text, what is the main challenge to controlling the quantity of healthcare costs?

    <p>Overuse of services</p> Signup and view all the answers

    Which one of the following is true about the Advanced Directive?

    <p>It can be assigned informally in certain circumstances</p> Signup and view all the answers

    What is the main purpose of the Best Interest Standard?

    <p>To make decisions that are felt to be in the patient's best interest</p> Signup and view all the answers

    What is the main purpose of Informed Consent?

    <p>To inform the patient of the risks and benefits of a proposed diagnostic procedure or treatment</p> Signup and view all the answers

    Which one of the following is true about Refusal of Treatment?

    <p>Adults who possess DMC have the right to refuse medical treatment</p> Signup and view all the answers

    According to the text, what is the main source of funding for the NHS system in the United Kingdom?

    <p>Government taxes</p> Signup and view all the answers

    What is the main advantage of the NHS system in the United Kingdom compared to the healthcare system in the United States?

    <p>Lower cost of care</p> Signup and view all the answers

    Which country has a healthcare system where health insurance is separate from employment?

    <p>Switzerland</p> Signup and view all the answers

    What is the main weakness of the healthcare system in Switzerland?

    <p>High cost of care</p> Signup and view all the answers

    According to the text, what is one of the efforts made by the United Kingdom to improve prevention efforts?

    <p>Establishment of a National Council for Prevention/Wellness</p> Signup and view all the answers

    On average, what percentage of income do Swiss citizens spend on health insurance premiums?

    <p>16%</p> Signup and view all the answers

    Which program provides comprehensive cost-effective care to people 55+ who qualify for nursing home care?

    <p>On Lok program</p> Signup and view all the answers

    What are the four principles of medical ethics?

    <p>Beneficence, nonmaleficence, autonomy, and justice</p> Signup and view all the answers

    What does the Patient Self-Determination Act require healthcare facilities to do?

    <p>Ask patients about their advance directives</p> Signup and view all the answers

    What is the key coverage measure that eliminates provisions allowing health insurers to deny coverage based on pre-existing conditions?

    <p>ACA reforms</p> Signup and view all the answers

    Study Notes

    Long-Term Care and Medical Ethics

    • Social insurance principles include making small payments when well and earning money against sickness, unemployment, and retirement.
    • The Pepper Commission in 1990 recommended expanding Medicare.
    • Funding is a significant issue in long-term care.
    • The On Lok program, now known as Program of All-Inclusive Care for the Elderly (PACE), provides comprehensive care to those over 55 who qualify for nursing home care.
    • Smaran Ramidi's ACA reforms for LTC include the Community First Choice Option and the Balancing Incentive Program.
    • Money Follows the Person is a program that assists states in transitioning institutionalized individuals back to the community.
    • Medical Homes aim to manage chronic care and incentivize keeping older adults at home.
    • The four principles of medical ethics are beneficence, nonmaleficence, autonomy, and justice.
    • Rationing and cost control in healthcare are not the same; rationing may be necessary for painful cost control.
    • The Four-Box model of clinical decision making includes considerations of medical indications, patient preferences, quality of life, and contextual features.
    • Distributive justice requires equal access to medical services based on medical need, regardless of ability to pay.
    • The Patient Self-Determination Act requires healthcare facilities to inquire about patients' advance directives and provide education on their rights.
    • Competence is assumed in adults unless proven otherwise, while decision-making capacity is assessed clinically and task-specific.

    Long-Term Care and Medical Ethics

    • Social insurance principles include making small payments when well and earning money against sickness, unemployment, and retirement.
    • The Pepper Commission in 1990 recommended expanding Medicare.
    • Funding is a significant issue in long-term care.
    • The On Lok program, now known as Program of All-Inclusive Care for the Elderly (PACE), provides comprehensive care to those over 55 who qualify for nursing home care.
    • Smaran Ramidi's ACA reforms for LTC include the Community First Choice Option and the Balancing Incentive Program.
    • Money Follows the Person is a program that assists states in transitioning institutionalized individuals back to the community.
    • Medical Homes aim to manage chronic care and incentivize keeping older adults at home.
    • The four principles of medical ethics are beneficence, nonmaleficence, autonomy, and justice.
    • Rationing and cost control in healthcare are not the same; rationing may be necessary for painful cost control.
    • The Four-Box model of clinical decision making includes considerations of medical indications, patient preferences, quality of life, and contextual features.
    • Distributive justice requires equal access to medical services based on medical need, regardless of ability to pay.
    • The Patient Self-Determination Act requires healthcare facilities to inquire about patients' advance directives and provide education on their rights.
    • Competence is assumed in adults unless proven otherwise, while decision-making capacity is assessed clinically and task-specific.

    Long-Term Care and Medical Ethics

    • Social insurance is a principle of making small payments against sickness, unemployment, and retirement, recommended by the Pepper Commission in 1990.
    • The On Lok program, now called Program of All-Inclusive Care for the Elderly (PACE), provides comprehensive cost-effective care to people 55+ who qualify for nursing home care.
    • ACA reforms for long-term care include the Community First Choice Option and the Balancing Incentive Program.
    • The Money Follows the Person program assists states in transitioning institutionalized individuals back to the community.
    • Medical Homes are designed to manage chronic care and keep older adults at home through access to multiple doctors.
    • The four principles of medical ethics are beneficence, nonmaleficence, autonomy, and justice.
    • Rationing and cost control in healthcare do not always involve limiting beneficial medical care.
    • The Four-Box model of clinical decision making emphasizes the importance of medical indications and effectiveness.
    • Distributive justice requires equal access to medical services based on medical need, regardless of ability to pay.
    • The Patient Self-Determination Act requires healthcare facilities to ask patients about their advance directives.
    • Decision-making capacity refers to a patient's ability to make authentic, self-determining decisions, while competence is a global description assumed in adults.
    • Advance directives, such as living wills and durable power of attorney for health care, allow individuals to state their wishes for future medical decisions.

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    Description

    Test your knowledge on long-term care and medical ethics with this quiz. Explore topics such as social insurance principles, funding issues in long-term care, medical ethics principles, and various programs and reforms related to long-term care. Challenge yourself and see how well you understand these important aspects of healthcare.

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