Chapter 10 Complete Test Bank Hospitals And Healthcare

CHAPTER 10: Hospitals and Healthcare

Chapter 10 Quiz

1. Based upon the text, the number of registered hospitals in the United States is: (Level 1)

a. Increasing

b. Decreasing

c. Constant in numbers

d. None of the above

1. In order for a hospital to meet the criteria of a registered facility it must: (Level 2)

a. Be accredited by CMS

b. Be accredited under titles 18 and 19 of the Medicare and Medicaid Act

c. Have at least 16 beds

d. Be invited by the American Hospital Association to be listed

e. All of the above

g. None of the above

1. More than 87% of all hospitals are. (Level 1)

a. Owned by the federal government

b. Long-term care or continual care hospitals

c. Prison hospitals

d. All of the above

e. None of the above

4. Several factors have impacted the change in the number of hospitals in the health care system. These factors include: (Level 2)

a. The shift from a retrospective to a prospective payment system

b. The shift from a prospective to a retrospective payment system

c. Both a and b

d. Neither a nor b

5. DRG stands for: (Level 1)

1. Drugs-Related Guidelines
2. Diagnosis Related Groups
3. Both of the above70.1%
4. None of the above

6. Patient care at acute hospitals decreased as a result of: (Level 2)

1. The growth in medical technology
2. Preferences for outpatient care
3. Changes in reimbursement
4. a and b
5. b and c
6. a, b, and c
7. None of the above

7. Based upon a comprehensive analysis of the discussion on hospital disparities, one may conclude that disparities in health care outcomes are: (Level 2)

a. Most often sourced in implicit bias

b. Most often sourced in explicit bias

c. Often sourced in differences in patient characteristics

d. a and b

e. b and c

f. a, b, and c

g. None of the above

8. Worster et al. (2018: (Level s)

1. Confirmed that hospitals provide disparate care in childbirth
2. Confirmed that hospitals provide differential surgical care
3. Confirmed that no differences existed in palliative care for the hospitals studied
4. Confirmed that the use of certain clinical protocols leaves fewer points in the care cycle for implicit bias
5. a, b, and c
6. None of the above are true

9. Based on Box 10.1, approximately what percent of the 50 states plus the District of Columbia had no hospitals with 1 or 2 stars in 2015? (Level 3)

a. 8%

b. 15.7%

c. 16.0%

d. None of the above

10. The states (including the District of Columbia) in the country with the largest % of hospitals with 1 or 2 star ratings in 2015 were: (Level 3)

a. Nevada, Florida and California

b. District of Columbia, Nevada, New York

c. District of Columbia, New Jersey, Nevada

d. None of the above

11. The group of states (plus D.C.) with the highest percent of minority populations in 2015 were: (Level 3)

a. District of Columbia, Hawaii, and California

b. Mississippi, Maryland, Louisiana

c. New Mexico, Texas, Nevada

d. Florida, Texas, Georgia

12. The group of states (including D.C.) with the highest poverty rates in 2015 were: (Level 3)

a. Louisiana, Mississippi, Arkansas

b. Kentucky, Georgia, District of Columbia

c. New Mexico, New York, North Carolina

d. Oklahoma, Oregon, Texas

13. The group of states (including D.C.) with the lowest percent of college graduates in 2015 were: (Level 3)

a. Mississippi, West Virginia, Kentucky

b. District of Columbia, Massachusetts, Colorado

c. Georgia, Mississippi, Arkansas

d. Florida, Georgia, and Hawaii

14. The null hypothesis, “H0: There is no relationship between the percentage of poorly performing hospitals and key socioeconomic and variables” was tested using: (Level 1)

a. A correlation coefficient calculator

b. A “t-test” calculator

c. A single regression calculator

d. A multiple regression calculator

e. A p-value calculator

f. None of the above

15. In order to interpret the Summary Output Table, definitions are needed for each component. Which definitions listed below are correctly matched? (Level 3)

a. Multiple R – Described the degree to which changes in the independent variables “predict” changes in the dependent variable

b. The Multiple R of 0.64072 tells us that the relationship between the percent of hospitals with 1 or 2 stars in each state and the listed independent variable is moderately strong.

c. The p-values inform us that while the percent of “low quality” hospitals in a state is significantly related to the % of minorities in each state and the % of persons with 4 years or more of college, there is no significant relationship between the percent of impoverished persons in the state and the % of hospitals in that state with low quality ratings

d. a and b

e. b and c

f. a, b, and c

g. None of the above

16. One of the most interesting findings when the data in the Summary Output Table is interpreted is the fact that:

a. The percent of 1 or 2 star hospitals is higher in states that have a higher proportion of the population with four years or more of education

b. There is an inverse relationship between the percent of persons with 4 years of more of college and the percent of 1 or 2 star hospitals in each state

c. There is no significant relationship between the percent of persons with 4 years of more of college and the percent of 1 or 2 star hospitals

d. The relationship between the proportion of persons who are impoverished and the % of 1 or 2 star hospitals is significantly stronger than the relationship between college education and the percent of 1 or 2 star hospitals

17. The term “multicollinearity” is a measure of whether the independent variables are themselves related. (Level 1)

18. In order to check this original case study for multicollinearity, we calculated: (Level 3)

a. The degrees of freedom

b. Variance inflation factor

c. The coefficients of the intercept

d. The standard error

e. The residual

f. All of the above check for multicollinearity

g. None of the above check for multicollinearity

19. A qualitative case study was introduced using data for one low performing hospital in one state. The community served by this hospital was: (Level 2)

a. Very demographically diverse

b. Has a far lower proportion of college graduates than the country as a whole

c. Was located in a community with a higher proportion of persons with disability than the country as a whole

d. Had a much higher poverty rate than the country as a whole

e. a and b

f. c and d

g. All of the above

h. None of the above

20. The authors recommended that it is critical for hospitals with low ratings to compare the patient characteristics of those whom they service in order to determine whether a % of their ratings reflect a demographic and/or socioeconomic group who enter a hospital with: (Level 2)

a. More morbidity

b. Different types of morbidities that may affect readmission rates and other clinical outcomes

c. Fewer morbidities

d. a and b

e. b and c

f. a, b, and c

g. None of the above

21. According to the authors, Urban Medical Center X also received worse ratings based upon: (Level 1)

a. The 10% of persons who contacted MRSA

b. The % of persons who contracted VME

c. Neither a nor b

d. Both a and b

22. However, the authors advance the argument in using Box 10.3. that: (Level 1)

a. Urban Medical Center X served a greater percent of certain types of patients, it would increase their vulnerabilities to hospitals acquired infections. Which groups below are more vulnerable to hospital-acquired infections.

b. Premature babies

c. Persons age 65+

d. Persons with diabetes

e. b and c

f. a, b, and c

g. None of the above

23. According to the authors, in addition to the patient-based conditions that enhance risks of hospital-acquired infections, treatment=related conditions also increase vulnerability to hospital-acquired infections. Thus, hospitals with lower ratings may want to analyze their files to determine whether the patients in the higher risk category also:

a. Spent time in high risk care units

b. Were tested for wounds that made them more vulnerable to hospital-acquired infections

c. Were tested with certain antibiotics that are associated with greater vulnerability to hospital acquired infections

d. Had longer lengths of stays since this increases vulnerability to hospital-acquired infections

e. a and b

f. b and c

g. c and d

h. a, b, c, and d

i. None of the above

24. Urban Hospital X will also need to: (Level 2)

a. Assess adherence to medical guidelines by clinical and other staff

b. Compare social media ratings with Hospital Compare data

c. Assess customer service

d. Conduct a performance rating flow process analysis using strategies learned in their qualitative management class

e. a and b

f. b and c

g, c and d

h. a, b, c, and d

i. None of the above

a. Barish, et al. (2012)

b. Chen, et al. (2015)

c. Both a and b

d. Neither a nor b

26. According to the authors, EMTALA’s passage in 1986: (Level 2)

a. Increased use of emergency departments

b. Decreased use of emergency departments

c. Had no effect on emergency departments

d. Did not relate to emergency departments

27. Throughout the text, the authors emphasize the importance of examining the Disparity Chain that leads to or has led to a current day disparity. Because emergency use for nonemergency conditions is income related, research was introduced which revealed preterm birth can generate a Disparity Chain that lead to nonemergency emergency department use. Which listings below most accurately reflect this chain of circumstance? (Level 3)

a. Preterm birth ⇨academic problems in school⇨failure to complete a college degree as adults⇨ lower income or joblessness⇨an absence of health care insurance ⇨emergency room use

b. Preterm birth ⇨health problems⇨high school dropout

c. Preterm birth⇨better health care⇨high income⇨emergency room use

d. a and b

e. b and c

f. a, b, and c

g. None of the above

28. Barnett and Berchick (2017) found that as of 2016, which group below was less likely to have healthcare insurance: (Level 1)

a. Hispanic Americans

b. White Americans

c. African Americans

d. Asian Americans

29. Hospital healthcare disparities across subgroups are only a problem in the United States according to: (Level 3)

a. Wang, et al. (2015)

b. Zhang, et al. (2016)

c. Both a and b

d. None of the above

30. Every hospital administrator should have access to data to determine if disparities exist.. (Level 1)

31. The Qualis Report found that a crisis may currently exist in terms of higher rates of hospital readmission for _______ among Medicare patients in the State of Washington. (Level 2)

a. White Americans

b. Native Americans

c. African Americans

d. Asian Americans

32. Brooks-Carthan et al. (2016) research on racial/ethnic disparities in 253 hospitals in California, New Jersey, and Pennsylvania discovered that disparities in hospital readmission rates between older African American patients and other groups occurred because of: (Level 3)

a. Explicit bias among physicians

b. Implicit bias among physicians

c. Differential care by nurses

d. a and b

e. b and c

f. a, b, and c

g. None of the above

h. This was not the focus of the researchers

33. The employment of new nurses in hospitals is: (Level 2)

a. Increasing

b. Decreasing

c. Remaining constant

d. Fluctuating

34. According to the authors, explicit bias based on subtribalism can occur at 3 affective levels. Which levels below are correctly defined. (Level 2)

a. Affective Level 1 is an adverse response to the individuals’ personality

b. Affective Level 2 is the operations of an ontology that ranks some subgroups as inferior

c. Affective Level 1 occurs as a response to ranking learned behaviors of selected groups

d. a, b and c are correctly defined

e. None of the above are correctly defined

35. Hospitals remain the primary employers of nurses. (Level 1)