Podcast
Questions and Answers
What was a significant legal outcome of the Stenberg v. Carhart case?
What was a significant legal outcome of the Stenberg v. Carhart case?
Which factor contributes to a higher infant mortality rate in a state?
Which factor contributes to a higher infant mortality rate in a state?
What is one of the reasons for the increase in maternal mortality rates in the U.S. since the 1990s?
What is one of the reasons for the increase in maternal mortality rates in the U.S. since the 1990s?
Why have abortion opponents shifted their efforts to the states?
Why have abortion opponents shifted their efforts to the states?
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Which statement regarding emergency contraception is true?
Which statement regarding emergency contraception is true?
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What has been the impact of Medicaid expansion under the ACA on infant mortality?
What has been the impact of Medicaid expansion under the ACA on infant mortality?
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What defines partial-birth abortion according to the provided information?
What defines partial-birth abortion according to the provided information?
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What is one of the challenges faced by poor women seeking abortions?
What is one of the challenges faced by poor women seeking abortions?
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What was a significant delay in the approval of over-the-counter emergency contraception?
What was a significant delay in the approval of over-the-counter emergency contraception?
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What population experiences a notable disparity in maternal mortality rates?
What population experiences a notable disparity in maternal mortality rates?
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What is the primary factor contributing to poor quality of nursing home care in the U.S.?
What is the primary factor contributing to poor quality of nursing home care in the U.S.?
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Which of the following is a characteristic of for-profit nursing homes compared to nonprofit facilities?
Which of the following is a characteristic of for-profit nursing homes compared to nonprofit facilities?
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What impact does regulatory stringency have on nursing home quality?
What impact does regulatory stringency have on nursing home quality?
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Why is the enforcement of nursing home regulations often inadequate?
Why is the enforcement of nursing home regulations often inadequate?
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What common issue arises from the Medicare reimbursement methods for nursing homes?
What common issue arises from the Medicare reimbursement methods for nursing homes?
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What was a key finding about states with higher minimum staffing standards for nursing homes?
What was a key finding about states with higher minimum staffing standards for nursing homes?
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What can result from inadequate federal and state resources for nursing home regulatory activities?
What can result from inadequate federal and state resources for nursing home regulatory activities?
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What was a significant consequence of private equity ownership in nursing homes?
What was a significant consequence of private equity ownership in nursing homes?
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The estimated median annual cost of nursing home care for a semi-private room is approximately how much?
The estimated median annual cost of nursing home care for a semi-private room is approximately how much?
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What is a significant change regarding contraceptive funding that occurred in 2019?
What is a significant change regarding contraceptive funding that occurred in 2019?
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Which foundational principle of primary care emphasizes the importance of initial healthcare access?
Which foundational principle of primary care emphasizes the importance of initial healthcare access?
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Which dimension of patient-centered care focuses on understanding and responding to a patient’s fears and anxieties?
Which dimension of patient-centered care focuses on understanding and responding to a patient’s fears and anxieties?
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What is a primary characteristic of Nurse Managed Health Clinics (NMHCs)?
What is a primary characteristic of Nurse Managed Health Clinics (NMHCs)?
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What is one challenge facing the expansion of Nurse Managed Health Clinics?
What is one challenge facing the expansion of Nurse Managed Health Clinics?
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Which group does the Affordable Care Act (ACA) exempt from providing preventive health services without copays?
Which group does the Affordable Care Act (ACA) exempt from providing preventive health services without copays?
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Which factor is NOT mentioned as influencing maternal and infant mortality rates in the US?
Which factor is NOT mentioned as influencing maternal and infant mortality rates in the US?
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What type of care is a significant focus of Nurse Managed Health Clinics (NMHCs)?
What type of care is a significant focus of Nurse Managed Health Clinics (NMHCs)?
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Which legislation addressed maternal morbidity and mortality in the US, yet had minimal success?
Which legislation addressed maternal morbidity and mortality in the US, yet had minimal success?
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What aspect of patient-centered care involves the engagement of significant others in the care process?
What aspect of patient-centered care involves the engagement of significant others in the care process?
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What is a proposed policy option to address excessive profits in nursing homes?
What is a proposed policy option to address excessive profits in nursing homes?
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What percentage of nursing home resident emergency department visits are potentially preventable?
What percentage of nursing home resident emergency department visits are potentially preventable?
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Which factor contributes to the high rates of hospital readmissions from nursing homes?
Which factor contributes to the high rates of hospital readmissions from nursing homes?
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Which of the following was a significant change introduced by the Protecting Access to Medicare Act (PAMA)?
Which of the following was a significant change introduced by the Protecting Access to Medicare Act (PAMA)?
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What is one of the major issues faced by the Veterans Health Administration (VHA)?
What is one of the major issues faced by the Veterans Health Administration (VHA)?
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What percentage of nursing home residents are eligible for palliative care services according to a recent study?
What percentage of nursing home residents are eligible for palliative care services according to a recent study?
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What aspect of nursing home management has been linked to poor quality of care?
What aspect of nursing home management has been linked to poor quality of care?
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What is one of the health policy issues affecting Veterans Health Administration patients?
What is one of the health policy issues affecting Veterans Health Administration patients?
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Which organization is known for its focus on ethical nurse recruitment and retention globally?
Which organization is known for its focus on ethical nurse recruitment and retention globally?
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What major change has occurred in skilled nursing facilities since the implementation of readmission penalties?
What major change has occurred in skilled nursing facilities since the implementation of readmission penalties?
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Study Notes
Reproductive Health Policy
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Abortion legislation emerged in the latter half of the 20th century.
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Stenberg v. Carhart: Supreme Court struck down a Nebraska law prohibiting "partial-birth abortions," requiring exceptions for maternal health.
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"Partial-birth abortion" is an intact dilation and evacuation procedure, often performed due to fetal defects or maternal health risks.
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Anti-abortion groups prioritize state-level legislation to challenge Roe v. Wade.
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Access to abortion varies greatly by state, with barriers impacting low-income women (distance to clinics, mandatory waiting periods, TRAP laws).
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Reduced access and fewer providers limit abortion options.
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Infant Mortality Rate (IMR): Several factors influence pregnancy outcomes: mother's age at conception, pregnancy spacing, and number of children.
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States failing to offer Medicaid funding for contraception are correlated with higher IMR.
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Infant mortality rates decreased more in states expanding Medicaid than other states, post-ACA.
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Maternal Mortality: Maternal mortality rates have risen in the US since the 1990s, unlike many other developed nations.
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Persistent disparities exist with Black women experiencing three to four times higher mortality rates compared to white women, preventable via timely interventions.
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Emergency Contraception (EC): EC (e.g., Plan B, Ella) was used internationally before U.S. approval.
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EC is a safe medication, often one or two doses of common birth control pills, and is effective if taken within three to five days of unprotected intercourse.
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U.S. Food and Drug Administration's scientific panel supported over-the-counter availability, but political opposition delayed approval.
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Affordable Care Act (ACA) mandates comprehensive gynecological care, including contraception, for women.
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Medicaid coverage of contraception is state-specific and does not apply uniformly and covers contraception for all women.
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Religious organizations are exempt from copay requirements for women's preventive care.
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Title X funding (contraception and family planning) was restructured in 2019 with changes in eligibility criteria for government funding.
Advancing New Models of Primary Care
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Patient-Centered Care: Principles include accessibility, affordability, first contact services, proximity to patients, preventive and curative services, community engagement.
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Dimensions of patient-centered care also embrace respect for values, preferences, needs, access to information, emotional support, family involvement, continuity of care, physical comfort, and coordination of care.
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Nurse-Managed Health Clinics (NMHCs):
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Typically community-based, nurse-led primary care clinics serving vulnerable populations (homeless, rural).
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Often associated with education institutions, providing clinical training.
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Provide team-based primary care for patients.
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Expansion is constrained by insurer recognition (e.g., Medicaid) and funding.
Long-Term Services and Supports Policy
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Nursing Home Care Quality:
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Nursing homes experience generally poor quality of care.
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State surveys and certifications, funded by the government, aim to ensure care quality.
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Problems include poor infection control, inadequate environments, deficient food, and overall quality.
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Enforcement weakness: Surveys and investigation findings can be inaccurate or delayed; sanctions for violations are rare.
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Staffing levels are consistently inadequate.
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Higher nurse staffing levels result in better patient outcomes, including reduced mortality, improved physical functioning, and lower rates of infections, hospitalizations, and hospital readmissions.
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Corporate Ownership: For-profit nursing homes frequently have lower costs and staffing compared to nonprofit facilities.
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For-profit chains dominate the nursing home sector.
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Financial accountability and ownership transparency issues pose challenges to oversight.
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The Affordable Care Act (ACA) mandates reporting on ownership and expenditures for staffing on Medicare's Nursing Home Compare website.
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Financial Accountability:
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Medicare and Medicaid cover nursing home care.
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Costs vary by state; The median annual cost of nursing home care is approximately $80,300.
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Reimbursement methods and per diem rates influence care quality and costs.
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Medicaid reimbursement often prioritizes cost containment over quality, resulting in low payment rates affecting wages & staffing.
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Medicare's Prospective Payment System (PPS) affects reimbursement, possibly leading to budget shifting towards profits.
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Excessive profits and declining direct care spending negatively affects quality.
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Other Issues: Addressing hospital readmissions, palliative care access, and care transitions for nursing home residents.
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State and federal policies need to correct imbalances to address facility funding, staffing, and care quality.
US Military and Veterans Administration Health Systems
- Veterans Health Administration (VHA) serves over 8 million military personnel, retirees, families.
- VHA comprises 152 medical centers and 1400 outpatient clinics.
- Policy Issues include PTSD, sexual assault, suicide, and access to care.
- Policy changes within the military health system and VHA are consistently challenged.
- Issues surrounding LGBTQ+ service members, women in combat roles, and healthcare management consolidation also affect VHA.
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Description
This quiz covers key aspects of reproductive health policy, focusing on abortion legislation, Supreme Court cases like Stenberg v. Carhart, and the impact of state policies on access to abortion. Additionally, it examines the factors influencing infant mortality rates and the correlation with Medicaid funding for contraception.
