Ch6 Physicians, Healthcare Quality, And Verified Test Bank - Test Bank | Health Disparities 1e Darren Liu by Darren Liu. DOCX document preview.
CHAPTER 6: Physicians, Healthcare Quality, and Health Disparities
Chapter 6 Quiz
- According to the Study Guide PowerPoints: (Level 1)
a. In some respects, the whole of the health care delivery system revolves around hospitals
b. Nurses can be considered as the primary component around which the health system revolves
c. Physicians comprise the “sun” around which the health care delivery system revolves. Therefore, to understand health care quality, we can begin by examining physician to population ratios
d. This point was not discussed in the text nor in the Study Guide PowerPoints
- There are approximately _____ active licensed physicians who serve the U.S. Health care delivery system. (Level 1)
a. 9 million+
b. 950,000+
c. 90,000+
d. 9,000+
- Which country below has the highest physician to population ratio of those listed in the text? (Level 2)
- The U.S.
- Switzerland
- Greece
- Cuba
4. If one accepts the thesis that physicians are key to any country’s care delivery system, one may theorize that the physician to population ratio may play a role in healthcare quality and in healthcare quality disparities. (Level 1)
5. What is the causal pathway by which physicians per 1,000 persons may affect health care quality?: (Level 2)
- Access to medical care can take longer if the physicians per 1,000 is too low
- The panel size may be too long
- Large panel sizes may, according to Dahrouge et al., lead to decreases in quality
- All of the above
- None of the above
Box 6.1: Quality Changes in the American Health Care Delivery System in General |
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Access to health care is necessary in order for health care providers and health care institutions to deliver services. The annual survey uses 20 measures to assess the quality of access.
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Constructed by authors from data found in the U.S. Department of Health and Human Services, Annual National Healthcare Quality and Disparities Report AHRQ Publications No. 17-0001, July 2017. (www. ahrq.gov/research/findings/nhqrdr/index.html)8 |
The 2016 National Healthcare Quality and Disparities Report that was published in 2017 reveals that the following health care disparities as measured by access to health care were observable from 2000 to 2014
- Independently of the racial/ethnic status of Americans, health care access did not improve for impoverished persons from 2000 to 2014
- Health care quality as measured by access did improve from 2000-2014
- While access improved for Native Americans/American Indians and Alaskan Natives relative to White Americans, health care quality did not improve for Native Hawaiians or other Pacific Islanders
- a and b
- b and c
7. According to the text, Americans in general experienced a 75% improvement from 200-2014 in the : (Level 1)
a. Receipt of effective treatment
b. Healthy living
c. Patient-centered care
d. All of the areas listed above
d. None of the area listed above
8. – 10.
Box 6.2: Improvements in Health Care Quality as Documented in the 2016 National Healthcare Quality and Disparities Report from 2000 to 2014 |
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Constructed by authors from data found in the U.S. Department of Health and Human Services, Annual National Healthcare Quality and Disparities Report AHRQ Publications No. 17-0001, July 2017. (www. ahrq.gov/research/findings/nhqrdr/index.html)9 |
8. Overall, improvements occurred in 57.56% of all healthcare measures. This was ___% higher than the 14.28% improvement that occurred in the affordability of care. (Level 3)
a. 4.03% higher
b. 43.28% higher
c. 303.08% higher
d. 3.03% higher
e. None of the above
9. The above finding demonstrates: (Level 3)
a. Based upon an evaluation of the data in 6.2, we may conclude that the American health care system is having difficulty in managing health care costs
b. That medical tourism is causing America’s health care costs to be improve very little
c. a and b
d. None of the above
10. If you were about to have surgery which of the improvements listed would probability give you the greatest comfort? (Level 3)
a. The 83.33% improvement in patient-centered care
b. The 65.63% improvement in patient safety measures
c. The 48.39% improvement in care coordination
d. The 14.28% improvement in the availability of affordable health care
11-12 Use Box 6.3. for these questions.
Box 6.3: Observable Disparities in Health Care Quality by Race/Ethnicity, 2014-2015 |
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Constructed by the authors from data from the 2016 National Healthcare Quality and Disparities Report. Rockville, MD: Agency for Health Care Research and Quality; July, 2017. AHRQ Pub. No. 17-0001; http://www.ahrq.gov/research/findings/nhgrdr/nhgrdr16/index.html9 |
11. Which fact or facts about health care quality disparities listed below do you think would be surprising to the American public? (Level 2)
a. African Americans experienced better quality of care than their counterparts of European descent on 12.64% of quality measures
b. Asian Americans received better quality of care than White Americans on 33.7% of the quality measures
c. American Indians/Alaska Natives received better scores on 12.9% of the quality measured relative to White Americans
d. All of the above would surprise many Americans
e. None of the above would surprise most Americans
12. When the data in Box 6.3. are analytically appraised, which statements below are true: (Level 3)
a. Native Americans had the greatest net negative quality gap of each of the subgroups listed
b. The net negative quality gap was greater for Hispanic/Latino Americans than Native Hawaiians
c. Asian Americans had a net negative quality disparity that was almost as great as that of African Americans
d. No racial/ethnic subgroup had a net positive disparity gap relative to White Americans
13. For this question refer to Box 6.3 and Box 6.4.
Box 6.4: Disparities in Healthcare Quality Outcomes by Income, 2000-2014 |
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13. Relative to healthcare quality disparities, which statement or statements below are true: (Level 3)
a. When data from Box 6.3 and Box 6.4 are compared, low and middle income groups of all races/ethnicities experienced net disparity losses from 2000-2014 that were higher than those experienced by any racial/ethnic subgroup’s losses described in Box 6.3.
b. Middle income groups of all races/ethnicities experienced health care quality losses, but the losses were not very high relative to their higher income counterparts
c. Both a and b
d. None of the above
14. According to the authors, health care administrators, public health personnel, and clinicians are actively and aggressively seeking solutions to the healthcare quality disparities that are affecting poor populations, low-income populations, and middle income populations. (Level 1)
15. When the results of the 2000-2014 health quality outcomes are compared with the outcomes for a previous period, tremendous improvement occurred between middle income and higher income households. Therefore, health disparity researchers have no need to be concerned about these two groups of Americans. (Level 2)
16. In the original research that was carried out to assess whether quality outcomes differed in various states, the analysis was completed by: (Level 1)
a. Comparing the 12 states with the highest overall quality of care and the 9 states with the lowest quality of care
b. Comparing the 9 states with the fewest racial/ethnic disparities in quality of care with the 12 states with the most racial/ethnic disparities in quality of care
c. Researching the mean number of active physicians per 100,000 in each state in both groups
d. Using Census data to identify the percent of the total population who are minority and the 9 percent with incomes below the poverty lie in each state
e. All of the above were steps taken
f. None of the above were steps taken
17 – 25 Please refer to Table 6.1. for these questions.
Table 6.1: Sample Data for Case Study | |||
State Quality of Care | Physicians per 100,000 population | % of total population who are minority | % of the total population in poverty |
States with the Lowest Overall Quality | |||
1. Iowa | 211 | 12.10% | 12.20% |
2. Minnesota | 282.9 | 17.49% | 11.50% |
3. Nebraska | 226 | 18.63% | 12.40% |
4. North Dakota | 237.9 | 17.38% | 11.50% |
5. Wisconsin | 254.9 | 17.00% | 13.20% |
6. Delaware | 266.8 | 35.33% | 12.50% |
7. Maine | 313.8 | 5.21% | 14.10% |
8. Massachusetts | 432.4 | 24.80% | 11.60% |
9. New Hampshire | 300.3 | 7.78% | 9.20% |
10. New Jersey | 290.1 | 42.48% | 11.10% |
11. Pennsylvania | 306.4 | 21.35% | 13.60% |
12. Rhode Island | 346.5 | 24.51% | 14.30% |
| N=12 ∑=3469.0 | N=12 ∑=244.06% | N=12 ∑=147.2% |
| Mean #=289.08 | Mean %=20.33% | Mean %=12.26% |
States with the Fewest Racial and Ethnic Disparities | |||
1. Arkansas | 198.1 | 25.53% | 18.90% |
2. Kentucky | 225.1 | 13.67% | 19.10% |
3. Louisiana | 240.9 | 40.01% | 19.80% |
4. Mississippi | 184.7 | 42.23% | 21.50% |
5. New Mexico | 235.3 | 60.36% | 21.30% |
6. Oklahoma | 201.8 | 29.98% | 16.60% |
7. Texas | 213.3 | 55.70% | 17.20% |
8. West Virginia | 246.7 | 6.54% | 18.30% |
9. Indiana | 222.6 | 18.87% | 15.20% |
| N=9 ∑=1968.5 | N=9 ∑=292.9% | N=9 ∑=167.9% |
| Mean #=218.72 | Mean %=32.54% | Mean %=18.6% |
States with the Fewest Racial and Ethnic Disparities | |||
1. Idaho | 189.6 | 16.16% | 14.80% |
2. Kansas | 214.2 | 22.00% | 13.60% |
3. North Dakota | 237.9 | 12.38% | 11.50% |
4. South Dakota | 231.4 | 15.95% | 14.20% |
5. Utah | 207.5 | 19.52% | 11.70% |
6. Wyoming | 196.7 | 14.89% | 11.20% |
7. Kentucky | 225.1 | 13.67% | 19.10% |
8. Tennessee | 247.1 | 24.46% | 18.30% |
9. Virginia | 255.9 | 35.68% | 11.80% |
| N=9 ∑=2005.4 | N=9 ∑=174.71% | N=9 ∑=126.2% |
| Mean #=222.82 | Mean %=19.41% | Mean %=14.02% |
States with the Most Racial and Ethnic Disparities | |||
1. Massachusetts | 432.4 | 24.80% | 11.60% |
2. New York | 353.8 | 42.75% | 15.90% |
3. Pennsylvania | 306.4 | 21.35% | 13.60% |
4. Illinois | 271.5 | 36.99% | 14.40% |
5. Indiana | 222.6 | 18.87% | 15.20% |
6. Iowa | 211 | 12.10% | 12.20% |
7. Minnesota | 282.9 | 17.49% | 11.50% |
8. Ohio | 279.8 | 18.98% | 15.80% |
9. Wisconsin | 254.9 | 17.00% | 13.20% |
10. North Carolina | 244 | 35.04% | 17.20% |
11. Texas | 213.3 | 55.70% | 17.20% |
12. Arizona | 234 | 42.81% | 18.20% |
| N=12 ∑=3306.60 | N=12 ∑=343.88% | N=12 ∑=176.0% |
| Mean %=275.55 | Mean %=28.66% | Mean %=14.66% |
Source: Constructed from data found on the 2016 National Healthcare Quality and Disparities Report. Rockville, MD: Agency for Healthcare Research and Quality; July 2017. AHRQ Pub. No. 17-00019 | |||
17. The states with the highest overall quality had: (Level 2)
a. A lower number of total active physicians per 100,000 population than the states with the lowest overall quality
b. A higher number of total active physicians per 100,000 population than the states with the lowest overall quality
c. The same number of total active physicians per 100,000 population than the states
d. None of the above
18. The states with the highest overall quality of care had: (Level 2)
a. A lower mean percent of the total population who were minority than the states with the lowest quality
b. A higher mean percent of the total population who were minority than the states with the lowest quality
c. The same mean percent of the total population who were minority as the states with the highest quality
d. None of the above
19. The states with the highest overall quality of care had: (Level 2)
a. A lower mean percent of the total population who were impoverished than the states with the highest quality
b. A higher mean percent of the total population who were impoverished than the states with the highest quality
c. The same mean percent of the total population who were impoverished than the states with the highest quality
d. None of the above
20. States with the fewest racial and ethnic disparities had: (Level 2)
a. A higher mean number of total active physicians per 100,000 than the states with the highest racial and ethnic disparities
b. A lower mean number of total active physicians per 100,000 than the states with the highest racial and ethnic disparities
c. The same mean number of total active physicians per 100,000 than the states with the highest racial and ethnic disparities
d. None of the above
21. States with the fewest racial and ethnic disparities had: (Level 2)
a. A higher mean percent than the population who were minority
b. A lower mean percent than the population who were minority
c. The same mean percent than the population who were minority
d. None of the above
22. States with the fewest racial and ethnic disparities in quality of health care had: (Level 2)
a. A much lower percent of the total population who were in poverty
b. A higher percent of the total population who were in poverty
c. The same proportion of the population who were in poverty
d. None of the above
23. Based upon the findings from this analysis, it becomes imperative that health care disparity researchers investigate: (Level 3)
a. The unexpected positive relationship between number of physicians per 100,000 population and quality of health care
b. The unexpected negative relationship between number of physicians per 100,000 population and high health care disparities
c. The unexpected closeness of the relationship between the percent of the impoverished in both high and low health care disparity states
d. The unexpected inverse relationship between the % of the population who are minorities in high health care quality states
e. a and b
f. b and c
g. c and d
h. a, b c, and d
i. None of the above
24. A panel size is:
a. the total number of patients who see a physician on a regular basis
b. a panel of physicians who are seeking a new treatment
c. a panel of patients who are trying out a new treatment
d. All of the above
e. None of the above
25. At least some findings from the analysis make an original contribution to healthcare disparities research.
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