Long-Term Care and Medical Ethics

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Which level of care is the most costly?

Tertiary

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

Dawson Model

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

Secondary

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

Dispersed Model Signup and view all the answers

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

SNF provides skilled nursing and rehabilitative services Signup and view all the answers

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

Not enough medical students going into PCP training Signup and view all the answers

Which one of the following is true about custodial care?

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

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

Employment of physicians by the medical group organization Signup and view all the answers

Which one of the following is true about hospice care?

Hospice care is provided at home and at facilities Signup and view all the answers

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

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

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

Home health care requires the patient to be homebound Signup and view all the answers

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

All of the above Signup and view all the answers

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

Paying by capitation or aggregated method Signup and view all the answers

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

Misuse and errors in healthcare practices Signup and view all the answers

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

Custodial care only Signup and view all the answers

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

Pay for Performance 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?

Employer Mandate Signup and view all the answers

What is the main purpose of an advanced directive?

To assign a proxy for decision-making Signup and view all the answers

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

Withdrawal of treatment 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?

Individual health insurance mandate Signup and view all the answers

Which country has a Single Payer system funded by taxes?

United Kingdom Signup and view all the answers

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

Anyone who pays taxes to the government Signup and view all the answers

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

Cost of care is significantly less in the NHS system Signup and view all the answers

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

Incredibly long wait times for elective surgeries Signup and view all the answers

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

16% Signup and view all the answers

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

Higher in Switzerland Signup and view all the answers

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

The On Lok program Signup and view all the answers

What are the four principles of medical ethics?

Beneficence, nonmaleficence, autonomy, and justice Signup and view all the answers

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

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

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

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

Which level of care deals with rare and complex problems?

Tertiary Signup and view all the answers

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

Highly structured organization Signup and view all the answers

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

Dispersed Model Signup and view all the answers

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

Allows patients to go where they wish Signup and view all the answers

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

Patient cost sharing Signup and view all the answers

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

Underuse of effective care Signup and view all the answers

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

Skilled nursing facility Signup and view all the answers

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

Custodial care only Signup and view all the answers

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

All of the above Signup and view all the answers

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

Lack of coordination Signup and view all the answers

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

All of the above Signup and view all the answers

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

All of the above Signup and view all the answers

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

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

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

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

Under what conditions does Medicare cover hospice care?

A doctor certifies that a patient is terminally ill and the care is provided by a Medicare-participating hospice 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?

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

Which country has a Single Payer system funded by taxes?

United Kingdom Signup and view all the answers

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

16% Signup and view all the answers

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

Long wait times for elective surgeries Signup and view all the answers

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

Higher in Switzerland Signup and view all the answers

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

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

Who is required to have health insurance in Australia?

Everyone Signup and view all the answers

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

The On Lok program Signup and view all the answers

What are the four principles of medical ethics?

Beneficence, nonmaleficence, autonomy, and justice Signup and view all the answers

What is the main purpose of an advanced directive?

To specify healthcare preferences in advance Signup and view all the answers

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

The Integrated Medical Group (IMG) Model Signup and view all the answers

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

Expansion of Medicaid eligibility 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?

Approximately $2000 per employee Signup and view all the answers

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

To require virtually all Americans to have health insurance Signup and view all the answers

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

To require companies with >50 employees to provide their employees insurance Signup and view all the answers

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

Vertical Integration Model Signup and view all the answers

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

Allows insurers to respond to market changes Signup and view all the answers

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

Decreasing interest from medical students Signup and view all the answers

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

Lack of coordination Signup and view all the answers

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

Secondary Signup and view all the answers

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

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

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

It provides highly structured care beginning with primary care physicians. 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?

Strict eligibility criteria for Medicare coverage Signup and view all the answers

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

Medicare does not cover custodial care. Signup and view all the answers

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

Medicaid covers nursing home care but not custodial home care. Signup and view all the answers

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

Medicare covers hospice care for terminally ill patients. 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?

Their chronic illnesses are not covered by the policies. Signup and view all the answers

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

Supply Limits Signup and view all the answers

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

Inefficiency and Waste Signup and view all the answers

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

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

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

Overuse of services Signup and view all the answers

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

It can be assigned informally in certain circumstances Signup and view all the answers

What is the main purpose of the Best Interest Standard?

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

What is the main purpose of Informed Consent?

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

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

Adults who possess DMC have the right to refuse medical treatment 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?

Government taxes 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?

Lower cost of care Signup and view all the answers

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

Switzerland Signup and view all the answers

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

High cost of care 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?

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

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

16% Signup and view all the answers

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

On Lok program Signup and view all the answers

What are the four principles of medical ethics?

Beneficence, nonmaleficence, autonomy, and justice Signup and view all the answers

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

Ask patients about their advance directives 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?

ACA reforms 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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