Health policy questions

Question 1

Main public health problems in the Central and Eastern Europe coutry

Answer 1

high mortality rate
high rate of noncommunicable disease morbidity
unfavourable health behaviors
insufficient public health training
low level of interaction between public health professionals and health policy maker

Question 2

Communication between public health professionals and health policy maker

Answer 2

decision making based on solid epidemiology data like planning and organizing health care service
evidence based public health action/intervention
positively discriminative resource allocation
continous health monitoring system

Question 3

Health care financing in Hungary

Answer 3

Dual financing
informal payment
DRG system (inpatient care)
Per capitat (General practician)

Question 4

Meaning of quality in healthcare service

Answer 4

Quality is when the product and services characteristics that meet costumer expectations 
Doing the right thing
For the right person
At the right time
And do them right at the first time

Question 5

Quality focus on

Answer 5

Process of care
Aprropriateness of care
Clinical effectiveness

Question 6

Medical errors

Answer 6

Inappropriate or incomplete diagnosis and treatment
Injury
Behaviour
Syndrome
Infection and other ailment

Question 7

Cause of medical errors

Answer 7

Underuse, overuse of variation in services
Communication problems
Lack of using evidence (EBM)
Dissatified patients

Question 8

Evidence based medicine

Answer 8

is the process of systemically finding, appraising and using contemporaneous research finding as basic for clinical decisions

Question 9

Fundamental principle of EBM

Answer 9

1. EBM posits a hierarchy of evidences to guide clinical decision making
2. Evidence alone is never sufficient to make a clinical decision

Question 10

Steps of EBM

Answer 10

1, Patient

2. Question
3. Resource
4. Evaluation
5. Patient
6. Self-evaluation

Question 11

Possible sources of evidence

Answer 11

Result of primer research, clinical epidemiology study
Systemically review of literature
Result of HTA (health technology assessment)
Guideline recommendations

Question 12

Potential benefits of clinical practice guidelines

Answer 12

Improve the quality of clinical decisions
Support the quality improvement activites
Medical researcher benefits from the spotlight that evidence based guideline shine on gaps in the evidence
Widen the boundary between benefits and harms

Question 13

Classification of evidence

Answer 13

Grade A: Very strong evidence
(from randomized control trials)
Grade B: Fairly strong evidence
(from non-randomized control trial, good observable studies)
Grade C: More limited evidence
(Poor method observable studies, case report)

Question 14

Clinical/Medical Audit

Answer 14

Systemic, critical analysis of the quality of healthcare, including the procedures used for diagnosis and treatment to improve patient outcomes
Effects: decrease the variation of services
Increase the likelihood of desired health outcome

Question 15

Building block of clinical audit

Answer 15

1, Time and resoucres
2, Confidential, link to management
3, Educational, multidisciplinary
4, Standards, Objective measurement, willingness to change

Question 16

Driving force of change

Answer 16

New people
New technology
Competition
Incentives
Managerial pressure
Quality approach

Question 17

Resisting force of change

Answer 17

unwilling for quality thinking
job insecurity
complacency
skill decifits
established work pattern

Question 18

Level of quality

Answer 18

Adequacy to standard
Adequacy to efficient usability
Adequacy to the explicit expectations of the customer
Adequacy to the latent expectations of the customers

Question 19

Quality management

Answer 19

include all the activites (planning, assurance, improvement) that organization use to control, direct, coordinate quality

Question 20

Quality assurance

Answer 20

refers to the planned and systematic activities implemented in a quality system so that quality requirements of a product or service will be fullfilled

Question 21

Total quality management

Answer 21

include all the employees and objectives of continual increase of customer’s satisfaction

Question 22

Components of quality care

Answer 22

Technical quality
Risk management
Economical efficient
Patient/customer satisfaction

Question 23

Why do we need quality management in health care

Answer 23

Ageing population
increasing prevalence of chronic degenerative disease
Increase demands of the patient
Quality problems in healthcare
Development of new technologies
Increase in health expenditures
Patients mobility across borders increases

Question 24

Tools of quality management

Answer 24

Standard (protocol, guideline)
Criteria
Quality indicator

Question 25

Clinical indicators in health care

Answer 25

``` Preventive care Access care Clinical care Appropriate care Safety care Effectiveness care Continuity care Satisfaction care Organizational management ```

Question 26

Health policy

Answer 26

Cover course of actions (and inaction) that affect the set of institutions, organization, services and funding arrangements of the healthcare system

Question 27

Steps of policy process

Answer 27

Identify problems, recognize issues Policy formulation policy implementation Policy evaluation

Question 28

Policy instruments

Answer 28

Legislation and regulations Taxation and financial incentives Information and coordination Provision of direct services

Question 29

Values in health policy

Answer 29

``` Quality Choice Solidarity Equity Efficiency ```

Question 30

Main functions of health system

Answer 30

Service provision Financing Resource generation Stewardship

Question 31

Main goal of healthcare system according to WHO

Answer 31

Good health Responsiveness to the expectation of the population Fair financial contribution

Question 32

Measuring of health needs

Answer 32

Biomedical measures of health status Health status indicators Self-report Geographic variations

Question 33

Demand

Answer 33

The quantity of a good/service per unit time that an individual will purchase and consumpt

Question 34

Needs

Answer 34

The health services level which good medical opinion necessary to meet

Question 35

Utilization

Answer 35

the actual uses of health service and facilities

Question 36

Measuring of healthcare utilization

Answer 36

Inpatient days Outpatient visits Prescription Percentage immunized

Question 37

Individual (behavioral) determinants of health in adults are

Answer 37

BMI smoking physical activity sun exposure

Question 38

Main types of health systems

Answer 38

``` Tax based systems Social health insurance Private health insurance Out of pocket payment Donations ```

Question 39

Gatekeeper in health care

Answer 39

A primary-care provider, often in the setting of a managed-care organization, who coordinates patient care and provides referrals to specialists, hospitals, laboratories, and other medical services

Question 40

Players of medicine

Answer 40

Consumer Healthcare provider Health insurance Health policy

Question 41

HTA

Answer 41

Health Technological Assessment, multidisciplinary activity that systematically examines performance, safety, efficacy, cost, legal and ethical aspects of application of health technology

Question 42

Indicator

Answer 42

tool allowing to assess the performance of the organization | and its functional features

Question 43

quality assessment

Answer 43

assess two similar treatment options in | regard of the better outcome, disregarding price

Question 44

Basic types of health care system

Answer 44

Primary (GP), Secondary | specialist), Tertiary (specialist in a special center

Question 45

Horizontal and vertical equity

Answer 45

Horizontal is allocation of equal or equivalent resources for equal health need; Vertical is allocation of different resources for different levels of health need

Question 46

Regarding needs, demands and price elasticity

Answer 46

rate of elasticity -0.17

Question 47

What are the tools of health policy?

Answer 47

Evidence based health care, health | technology assessment

Question 48

Clinical Effectiveness

Answer 48

the extent to which specific clinical interventions maintain and improve health, and secure the greatest possible health gain from the available resources

Question 49

Medicare

Answer 49

Federal social insurance program for elderly and non-elderly with disabilities (hospital insurance, supplemental insurance, managed care, prescription drugs)