Introduction to Health Services Research : A Self-Study Course
Module 2: Brief History of Health Services Research (Page 39 of 40)
Use these questions to review for the quiz for this module. After successfully taking the quiz and passing it with 80% accuracy, you can choose to get a Certificate of Success for the module.
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1. In the early 1990s health care reform was heavily debated. Many health services research issues such as universal coverage, equity, financing, and the cost of health care services were discussed. Which of these are still being debated today?
A. universal coverage
B. equity of access
C. financing and insurance
D. the cost of health care services
E. none of these
F. all of these
Most health services research issues such as universal coverage, equity, financing, and the cost of health care services are still being discussed today.
2. Health services research embraces the socioeconomic milieu of _______ and asks broader questions than the health status of an individual. (Fill in the missing word).
Health services research embraces the socioeconomic milieu of populations and does ask broader questions than about the health status of an individual.
3. Health services research encompasses a single | multiple discipline(s). (Select the correct answer).
The field of health services research encompasses multiple disciplines far removed from the familiar territory of clinical medicine with its well-defined, concrete subject areas of etiology, prevention, diagnosis, pathophysiology, and treatment.
4. Health care reform raises many issues and will continue to provide health services researchers with interesting hypotheses to test. True | False
As health care reform makes changes to the American health care system health services researchers will find problems and issues to research.
5. The European and American health care systems are identical. True | False
American ideology emphasizes individual responsibility while many European countries and the former socialist states have adopted social welfare policies for health and medical care.
6. Political and labor unrest in Germany and England led to the development of medical insurance in the late 19th Century and early 20th Century. True | False
In the late 19th Century and early 20th Century, amidst political and labor unrest, the German and English governments adopted medical insurance as a way to secure the allegiance of the working class.
7. In what year was the Public Health Service established?
The Public Health Service was established by the Federal government in 1912.
8. Political upheaval forced social change in the area of health insurance in the early part of the 20th Century in the United States. True | False
A similar level of political upheaval did not exist in the United States at this time as it did in Europe. Labor organizations developed under a more conservative leadership during the early 20th Century and were less involved in issues of social reform, such as health insurance.
9. Florence Nightingale was a nurse who proposed to work with William Farr in 19th Century London to create a uniform reporting system for London hospitals that would determine their relative 'life-risks'. True | False
Florence Nightingale, a nurse, proposed to work with William Farr on a uniform reporting system for London hospitals so that their relative "life-risks" could be rigorously determined.
10. William Petty was remarkable for his attempt to apply _______________ to assess the benefits of physician practice and hospital care. (fill in the correct words)
A. socioeconomic factors
B. a reporting system
C. effectiveness research
D. quantitative reasoning
William Petty was remarkable for his attempt to apply quantitative reasoning to assess the benefits of physician practice and hospital care.
11. Health services research conducted before World War I described the impact of disease on society. True | False
Researchers pre-WWI described the impact of disease on society.
12.The birth record survey to document the role of midwifery in childbirth was a joint project between which two groups?
A. Chicago Medical Society and Metropolitan Life Insurance Company
B. Metropolitan Life Insurance Company and Hull House
C. American Medical Association and Hull House
D. Hull House and the Chicago Medical Society
The Chicago Medical Society and Hull House sponsored a birth record survey to document the role of midwifery in childbirth.
13. Abraham Flexner's Report increased the number of medical schools and black and women physicians in the United States. True | False
In fact, higher costs of enrollment and explicit discrimination by the medical schools caused a severe decline in the number of black and women physicians, leading to scarce medical services for rural and poor people.
14. Richard C. Cabot and Dr. E.A. Codman are primarily remembered for their work in which area?
A. social work
C. quality of care and patient outcomes
D. statistical inference
Both were pioneers in the area of outcomes research (quality of care and patient outcomes).
15. Alice Hamilton was (select her occupation)
A. a midwife
B. a surgeon
C. a labor agitator
D. an occupational health advocate and researcher
Alice Hamilton was a respected occupational health advocate and researcher in that field.
16. The Committee on the Costs of Medical Care (select the correct answer)
A. lead to the stock market crash of 1929
B. documented that health care costs were negligeable - only US$85.00 per person in 1929
C. published 27 important research reports on health services costs and distribution
D. issued a relatively unimportant set of reports on medical care costs
E. all of the above
F. none of the above
The Committee on the Costs of Medical Care published 27 important research reports on health services costs and distribution that had important implications for health care during the 1920s and 1930s.
17. During the Great Depression there was an increase | decrease in utilization of hospital and physician services.
Use of hospitals and physicians decreased during the Great Depression. No one had any money to pay for services.
18. The Great Depression, a time of severe economic conditions and social unrest and militancy, was characterized by social change. True | False
Social change occurred as a result of the severe economic conditions of the Great Depression.
19. The Social Security Act was passed in (which year)?
The Social Security Act was enacted into law in 1935 amid much fanfare.
20. APHA early on determined that core public health services such as vital statistics, communicable disease control, environmental sanitation, maternal child health, and public health education should be endorsed by APHA. True | False
The Association conducted a needs assessment and endorsed the core public health services of vital statistics, communicable disease control, environmental sanitation, maternal child health, and public health education.
21. The core public health services for public health were determined to be: vital statistics, communicable disease control, environmental sanitation, maternal child health, and public health education. Are these still core public health services? Yes | No
Although the list of services has expanded and has been rewritten, these five services along with those not mentioned, are still important.
22. The failure of the working class and poorer families to access health care after WWII was caused by (select the best answer).
A. a disinterest in health care overall due to war weariness
B. prepaid health care plans already covered everyone who needed health care
C. the US had a National Health Care Plan in place
D. the cost of health care coverage was too burdensome
While the middle class had access to care through private health insurance and HMOs, the poor could not afford to seek care due to the high cost of medical care after WWII.
23. Which organization defines health as 'a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.'
D. RWJ Foundation
WHO defines health as 'a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
24. The Hill-Burton Act was passed in (which year)?
Congress passed the Hospital Survey and Construction (Hill-Burton) Act of 1946 which legislated the funding and conditions for expanded hospital construction throughout the U.S.
25. Hill-Burton is an important law. It legislated funding for (what activity)?
A. expanded hospital construction
B. increased numbers of hospital beds
C. improving the health of the public
D. increased funding for research against major diseases
E. all of the above
F. none of the above
Hill-Burton expanded the number of beds and hospitals, expecially in underserved areas, improved the health of the public through improved access to hospitals and to clinics, and increased the funding for research against major diseases, especially infectious diseases like measles and polio.
26. The Activities of Daily Living (ADL) scale, the Quality of Well-Being Scale, the SF-36 Health Survey, the Sickness Impact Profile are all examples of (select the best answer).
A. validated instruments
B. health status indicators
C. computerized assessment tools
D. high quality research
E. All of the above
F. None of the above
The instruments listed in the question contain validated questions about health status indicators. They are created by and used in high quality research and are often computerized for easier data collection and analysis.
27. Medicare is required to provide health care to the ________ while Medicaid provides services to ________. (select the best pair).
A. middle class | very rich
B. elderly | poor and disabled
C. children | Mothers
D. men | women
Medicare provides care to the elderly while Medicaid provides services to the poor and disabled.
28. One group of social science researchers was mentioned as being important to describing health manpower during the 1960s and later. Name this group.
A. Health educators
Sociologists have been important in doing research into health manpower issues for many years.
29. In 1966, what key health services journal was started by the Hospital Research and Education Trust (HRET)?
A. Health Services Research
B. New England Journal of Medicine
C. Journal of Health Politics, Policy and Law
D. Journal of Public Health Management and Practice
Health Services Research was first published in 1966 through the efforts of the Hospital Research and Education Trust, an affiliate of the American Hospital Association.
30. The Health Services Research Study Section under the leadership of ___________ , set out to accelerate the development of the field of health services research in the United States between 1963-1965. (name the person).
A. Florence Nightingale
B. J. Allison Glover
C. John Adams
D. Kerr White
Dr. Kerr White, chairman of the Health Services Research Study Section from 1963-1965, and with the support of top NIH officials set out to accelerate the development of the field in the United States.
31. NCHSR grew out of the work done by a specific health services research group (which group)?
B. NIH Health Services Research Study Section
D. NIH Nursing Research Study Section
Dr. Paul Sanazaro had been a member of the NIH Health Services Research Study Section and had succeeded White as chair in 1966. He was one of the guiding forces in bringing about the creation of NCHSR.
32. Health status instruments were relatively unimportant instruments in health services research. True | False
Instruments that measure the health of the public were and are very important in the field. The early instruments such as the Sickness Impact Profile and SF-36 and related documents are still in use today. Other instruments are constantly being developed to measure the many aspects of health and illness.
33. The 'crisis in health care' after the Vietnam War was said to be caused by (name two main reasons).
A. excessive surgery and hospitalization
B. expensive procedures | increased manpower utilization
C. overspending by states | and overspending by the federal government
D. inadequate numbers of physicians | oversupply of allied health manpower
Excessive surgery and hospitalizations after the Vietnam War lead to what was called the 'crisis in health care.'
34. Per capita health care expenditures increased | declined between 1970 and 1997 in the United States.
Per capita health care expenditures increased from $357 to $4,095 per person between 1970 and 1997.
35. What was the old name for CMS, the federal agency in whose interest it is to maintain program quality and effectiveness in the Medicare and Medicaid programs?
The Health Care Financing Administration (HCFA), established in 1974, managed the Medicare and Medicaid programs and generated research on their effectiveness and quality. Many documents still bear the old name as part of their citations.
36. The Urban Institute was established by which president in 1968 to evaluate the programs of the Great Society by studying America's cities and urban populations?
The Urban Institute was established by the Johnson Administration in 1968 to evaluate the programs of the Great Society.
37. In 1971 a great social experiment was begun in California that lasted 15 years. The findings from the project had an enormous impact on the organization of both public and private health programs and on the fields of health economics and health services research. The name of the project was (select the correct name of the project)?
A. Urban Institute
B. Office of Economic Opportunity
D. Rand Health Insurance Experiment (HIE)
The Rand Health Insurance Experiment has had a huge impact on the organization of both public and private health programs.
38. HIE is the acronym for what famous health services research project?
A. Health Insurance Experiment (Rand)
B. Health Insurance Exclusionary Project
C. Health Insurance Economics Project
D. Health Information Excitement Project
HIE is the acronym for the Rand Health Insurance Experiment, 'the most important health insurance study ever conducted' according to the Rand Web site.
39. 'DRG creep,' the use of more profitable diagnoses when coding for reimbursement, was one response to PPS. Other responses include changing hospital behavior through financial incentives that encourage more cost-efficient management of medical care, an increase in ambulatory medical and surgical procedures that replaced many in-hospital services and __________. (fill in the blank with the correct item from the list below).
A. decreased data
B. increased data
C. cost cutting
D. reduction in development of new drugs due to hospital's inability to pay for them
In an effort to remain profitable hospital administrators looked for ways they could cut costs. This led to a reduction in the length of stay and to more efficiencies in providing care.
40. JCAH changed its name in 1987 to better reflect its purpose. The new acronym was (what)?
JCAH, the Joint Commission on Accreditation of Hospitals, changed its name to JCAHO - Commission on Accreditation of Health Care Organizations - to better reflect its mission and wider purpose of accrediting many kinds of health care organizations.
41. AHSR and AHCPR were important in improving knowledge about the field of health services research. True | False
AHCPR promoted research through grants and through reporting results in their publications and AHSR provided a venue through which researchers could publish their research (through the journal Health Services Research) and through the Association's annual meeting.
42. In 1996 Leiyu Shi published one of the first compilations of health services research methods in his book titled, Health Services Research Methods. True | False
Shi's book is still an important resource for students planning on becoming health services researchers. It draws together health services research methods into one book.
43. NICHSR provides quality information in the following areas. (Select the best answer).
A. practice guidelines
B. health services research
C. public health
D. training for practitioners and librarians
E. all of the above
F. none of the above
NICHSR provides high quality information on many important topics, and training to librarians, health services researchers and public health practitioners.
44. The Agency at NLM with the primary responsibility for '...the collection, storage, analysis, retrieval, and dissemination of information on health services research, clinical practice guidelines, and on health care technology, including the assessment of such technology' is _____________?
A. History of Medicine
C.National Network of Libraries of Medicine
NICHSR's primary responsibility is '...the collection, storage, analysis, retrieval, and dissemination of information on health services research, clinical practice guidelines, and on health care technology, including the assessment of such technology' and it does this extremely well.
45. Health care costs in the USA have meant that car manufacturers are very competitive | not very competitive in world markets. (select the correct answer).
High health care costs add $700-$1,400 to the cost of a US-built car. (The amount varies with the source giving the figure). This reduces American automakers' ability to stay competitive with other car makers especially against countries that have national health insurance.
46. Which organization was formed as the result of a merger between the Association for Health Services Research (AHSR) and the Alpha Center?
B. Robert Wood Johnson Foundation
D. Henry J. Kaiser Family Foundation
The Association for Health Services Research (AHSR) and the Alpha Center merged in 2001 to form AcademyHealth.
47. Health care issues such as elder care, women's health, and the rising cost of health care are no longer | continue to be a problem in the 21st century. (Select the correct answer).
Many health care issues of the 20th century are still a problem in the 21st century. The high cost of health care, mental health services accessibility, medically underserved areas and other issues continue to be a problem.
48. In the 20th century, large insurance companies successfully | unsuccessfully opposed universal, tax-based health care coverage.
Large insurance companies successfully opposed universal, tax-based coverage and organized themselves into managed care structures to provide health care.
49. In a managed care environment in the late 20th century, some HMOs reduced costs by (select the best answer).
A. buying pharmaceuticals from Canada and other countries
B. hiring more physicians
C. restricting members' access to specialists and supervising the extent of care offered
D. reducing the salaries of management
In an effort to cut costs some HMOs restricted members' access to specialists and supervised the extent of care offered.
50. The health care system is no longer changing. All major problems related to the provision of health care were solved in the late 20th century. True | False
There are still numerous problems with the health care system that are still being worked on such as the high cost of health care, what to do with a rapidly aging population, unequal access to health care and the like.
51. What is the name of the management process that measures a physician's use of medical resources compared to similar physicians? (Select correct name from list below).
A. physician reassignment
B. resource sharing
C. healthcare under-resourcing
D. physician credentialing
Comparing one physician's use of resources with another's or a group of physicians is called physician credentialing.
52. Health services researchers contributed to the definition of the data elements incorporated into HEDIS, including measures of consumer satisfaction and physician performance. True | False
Health services researchers, especially those like Avedis Donabedian whose work in the area of quality of care helped HEDIS with defining their classification of structure, process, and outcomes of care.
53. Health care report cards were developed independently and without the help of health services researchers. True | False
Health services researchers like Avedis Donabedian provided relevant information on structure, process and outcomes of health care.
54. Financial crises in states have no effect | have a big effect on funding access to care for the uninsured and indigent populations through Medicaid.
The loss of Medicaid funds from public health agencies can leave the uninsured and indigent populations without the health care the health departments provided with federal funding as state and local public health departments shifted Medicaid recipients into managed care arrangements to save dollars and to provide access to care.
55. Quality in some managed care organizations was | was not perceived as a problem by patients and consumer groups in the early 1990s.
Some patient and consumer groups were concerned about losing continuity of care with their personal physician as health plans added and deleted doctors from their networks.
56. It is important that health services researchers document the problems and successes in the health care arena. True | False
It is important for policy makers and for the health of the public that health services researchers document the problems and successes in the health care arena.
57. The number of those who are under- and uninsured in today's economy has risen | dropped since 1990.
The number of without coverage rose by 1.4 million to 45.0 million - or one out of every six members of the U.S. population. The percentage of the nation’s population without coverage grew from 15.2 percent in 2002 to 15.6 percent in 2003.
58. Concern for the health of children lead to the the Balanced Budget Act of 1997. This act included a provision titled, the 'Children's Health Insurance Program (CHIP).' The Agency with the responsibility for the SCHIP (State CHIP) is called the __________, (select the correct name from the list below)
A. National Information Center for Health Services Research
B. Bureau of Indian Affairs
C. National Center for Health Statistics
D. Centers for Medicare and Medicaid Services (CMS)
CMS has the responsibility for administering SCHIP. More information can be found on its Web site http://www.cms.hhs.gov/schip/.
59. Insurance benefits for both mental illness and substance abuse treatment continues to lag behind those for traditional physical illness. True | False
True | False
Insurance benefits continue to lag behind medical care for those suffering from substance abuse and/or mental illness.
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