HEALTHCARE DELIVERY SYSTEMS

Question 1

A term used to describe how a national, regional, or local health care system is organized, administered, provided, and paid for, sometimes to a circumscribed system such as that under the auspices of a specific medical and hospital insurance carrier or health maintenance organization

Answer 1

healthcare delivery systems

Question 2

all organizations, people and actions whose primary intent is to promote, restore or maintain health (WHO, 2000)

Answer 2

healthcare delivery systems

Question 3

organization of people, institutions, and resources to deliver health care services to meet the health needs of a target population, whether a single-provider practice or a large health care system

Answer 3

healthcare delivery systems

Question 4

private funding by fee-for-service and private initiative and ownership, and has very little state or third-party intervention

Answer 4

free-market medicine system

Question 5

characterized by a two-track system of financing and of healthcare delivery

Answer 5

free-market medicine system

Question 6

Free market medicine system: identify what track system is this.

Based on individual purchasing power

Answer 6

Private track

Question 7

Free market medicine system: identify what track system is this.

Based on welfare provision

Answer 7

Public track

Question 8

Provides healthcare delivery in the form of a state- supported consumer service financed by taxation

Answer 8

socialized-medicine system/beveridge

Question 9

healthcare is purchased, but the buyer is the government

Answer 9

socialized-medicine system / beveridge

Question 10

services available at little or no additional cost to the consumer

Answer 10

socialized-medicine system

Question 11

Free at the point of delivery and funded by general tax

Answer 11

beveridge model

Question 12

Most hospitals are government owned; healthcare workers are employed by the government; salaries are fixed and costs of treatments are standardized

Answer 12

beveridge model

Question 13

In private hospitals that provide a service free at the point of delivery, the hospitals get paid by the government

Answer 13

beveridge model

Question 14

Gov’t can control what the doctor can do and what the hospital can charge

Answer 14

beveridge model

Question 15

These ff. Countries adheres to what model?

Great Britain, Scandinavian countries, New Zealand and Spain

Answer 15

beveridge model

Question 16

indirect government control and management of healthcare delivery

Answer 16

Decentralized National Healthcare System

Question 17

government acts primarily to regulate the system

Answer 17

Decentralized National Healthcare System

Question 18

Model in Germany

Answer 18

Bismarck model

Question 19

funded by an insurance system

Answer 19

Bismarck model

Question 20

Financing is provided by employers and employees through payroll deductions and covers the entire population

Answer 20

Bismarck model

Question 21

tight regulatory control by the Government, there is much better control over costs

Answer 21

Bismarck model

Question 22

Employed people will get additional private insurance to cover the top up reimbursement costs

Answer 22

Bismarck model

Question 23

Unemployed: supported by the government to get complete coverage

Answer 23

Bismarck model

Question 24

healthcare is a state-provided public service

Answer 24

Socialist Medicine System

Question 25

state controls, organizes, finances, and allocates healthcare directly to all citizens, free of charge

Answer 25

Socialist Medicine System

Question 26

No third-party organizations or insurance companies are interposed between healthcare providers and patients

Answer 26

Socialist Medicine System

Question 27

The state owns all facilities and pays a salary to all healthcare workers

Answer 27

Socialist Medicine System

Question 28

healthcare is financed through government-mandated contributions by employers and employees, and healthcare is delivered by private providers

Answer 28

Socialized insurance system

Question 29

The government subsidizes voluntary mutual-aid societies that insure their members for medical care, death benefits, and, occasionally, some form of old-age assistance, operating entirely independently

Answer 29

Socialized insurance system

Question 30

governments create public health insurance programmes that citizens are required to join

Answer 30

National Health Insurance

Question 31

government provides finance, but actual care is delivered by private providers

Answer 31

National Health Insurance

Question 32

Every citizen pays into a government sponsored insurance program and healthcare is provided in the private sector

Answer 32

National Health Insurance Model

Question 33

These ff. countries are part of what model?

Answer 33

National Health Insurance Model

Question 34

no need for marketing or any incentives to deny any claims

Answer 34

National Health Insurance Model

Question 35

- drive down costs through negotiations with vendors - may not cover every condition; wait longer to be seen or treated

Answer 35

National Health Insurance Model

Question 36

financing a tax-supported NHI programme, the government also manages the infrastructure for the delivery of medical care

Answer 36

Public contracting

Question 37

-healthcare providers are basically public employees -non-profit, publicly funded and delivered service

Answer 37

Public contracting

Question 38

state involvement is more limited but still substantial

Answer 38

Pluralistic

Question 39

providing coverage only for certain population groups and giving way for the rest of the population to largely private finance, provision and ownership of facilities

Answer 39

Pluralistic

Question 40

-Developing countries -those with adequate finances can avail of the numerous private hospitals for their healthcare; those who can’t afford: die

Answer 40

Private insurance/ out of pocket

Question 41

Corporate social responsibility: big corporate organizations have by law to set aside a sum of money for infrastructure projects such as healthcare

Answer 41

Private insurance/ out of pocket

Question 42

-private insurers are for profit: decide to refuse coverage for preexisting conditions or other conditions with a view to minimizing claims and maximizing profit. -doctors may over investigate or prescribe for insured patients on the assumption that the insurer will pay for it

Answer 42

Private insurance/ out of pocket

Question 43

Characteristics: A range of health services is provided, appropriate to the needs of the target population, including preventative, curative, palliative and rehabilitative services and health promotion activities

Answer 43

Comprehensiveness

Question 44

Characteristics: no undue barriers of cost, language, culture, or geography.

Answer 44

Accessibility

Question 45

Characteristics: close to the people, with a routine point of entry to the service network at primary care level (not at the specialist or hospital level)

Answer 45

Accessibility

Question 46

Characteristics: may be provided in the home, the community, the workplace, or health facilities as appropriate.

Answer 46

Accessibility

Question 47

Characteristics: all people in a defined target population are covered, i.e. the sick and the healthy, all income groups and all social groups

Answer 47

Coverage

Question 48

Characteristics: Service delivery is organized to provide an individual with continuity of care across the network of services, health conditions, levels of care, and over the life-cycle

Answer 48

Continuity

Question 49

Characteristics: effective, safe, centered on the patient’s needs and given in a timely fashion.

Answer 49

Quality

Question 50

Characteristics: Services are organized around the person, not the disease or the financing

Answer 50

Person-centeredness

Question 51

Characteristics: Users perceive health services to be responsive and acceptable to them

Answer 51

Person-centeredness

Question 52

Characteristics: -participation from the target population in service delivery design and assessment -people are partners in their own health care

Answer 52

Person-centeredness

Question 53

Characteristics: Local area health service networks are actively coordinated, across types of provider, types of care, levels of service delivery, and for both routine and emergency preparedness

Answer 53

Coordination

Question 54

Characteristics: The patient’s primary care provider facilitates the route through the needed services, and works in collaboration with other levels and types of provider

Answer 54

Coordination

Question 55

Characteristics: Coordination also takes place with other sectors (e.g. social services) and partners (e.g. community organizations).

Answer 55

Coordination

Question 56

Characteristics: Health services are well managed so as to achieve the core elements described above with a minimum wastage of resources

Answer 56

Accountability and efficiency

Question 57

Characteristics: Managers are allocated the necessary authority to achieve planned objectives and held accountable for overall performance and results

Answer 57

Accountability and efficiency

Question 58

Characteristics: Assessment includes appropriate mechanisms for the participation of the target population and civil society

Answer 58

Accountability and efficiency