Module 15: Making Smart Health Care Choices

Question 1

define self-care

Answer 1

• knowing your body, paying attention to its signals, and taking appropriate actions to stop the progression of illness or injury
• useful for minor illness or injury

Question 2

define malpractice

Answer 2

• improper or negligent treatment by a health practitioner that results in loss, injury, or harm to the patient

Question 3

what is the third leading cause of preventable death in america

Answer 3

• preventable medical error

Question 4

what are your rights as a paitent

Answer 4

• informed consent
• knowing whether treatment is standard or experimental
• make decisions on your health care
• confidentiality
• receive adequate health care and refuse treatment
• access to all your medical records
• continuity of care
• seek opinions of other health care professionals
• courtesy, respect, dignity, responsiveness, and timely attention

Question 5

define informed consent

Answer 5

• acknowledgement that you have been told of the potential risks and benefits of a recommended test or treatment, understand what you have been told, and agree to the care

Question 6

define placebo

Answer 6

• inactive substance used as a control in a clinical test to determine the effectiveness of a particular drug
• placebo effect occurs when patients are given a placebo drug and experience an improved state of health because of belief that they are receiving something that will be beneficial

Question 7

define allopathic medicine

Answer 7

• conventional health care, mainstream medicine, western medical practice
• dominant type of health care in developed world
• says illness is a result of exposure to harmful environmental agents or organic changes in the body

Question 8

define evidence-based medicine

Answer 8

• decisions regarding patient care based on clinical expertise, patient values, and current best scientific evidence

Question 9

define primary care practitioner (PCP)

Answer 9

• medical practitioner who provides preventative care and treats routine ailments, gives medical advice, and makes appropriate referrals when necessary

Question 10

define osteopath

Answer 10

• general practitioner who receives training similar to a medical doctor’s but with an emphasis on the skeletal and muscular systems
• may use spinal manipulation as part of treatment

Question 11

define ophthalmologist

Answer 11

• physicians who specializes in the medical and surgical care of the eyes, including prescriptions for lenses

Question 12

define optometrist

Answer 12

• eye specialist whose practice is limited to prescribing and fitting lenses to correct vision problems

Question 13

define dentist

Answer 13

• physicians who diagnoses and treats diseases of the teeth, gums, and oral cavity

Question 14

define nurse

Answer 14

• health professional who provides patient care in a variety of settings

Question 15

define nurse practitioner (NP)

Answer 15

• nurse with advanced training obtained through either a master’s degree program or a specialized nurse practitioner program

Question 16

define physician assistant (PA)

Answer 16

• health care practitioner trained to handle most routine care under the supervision of a physician

Question 17

define premium

Answer 17

• payment made to an insurance carrier
• usually in monthly installments
• covers the cost of an insurance policy

Question 18

define deductible

Answer 18

• payments made for health care before insurance coverage kicks in
• ranges from $500 to $5000 annually

Question 19

define copayments

Answer 19

• set amounts you pay per service or product received, regardless of total cost
• ex: $20 per doctor visit

Question 20

define coinsurance

Answer 20

• percentage of costs that you must pay based on the terms of the policy
• ex: you pay 20% of total bill and insurance company pays 80%

Question 21

define managed care

Answer 21

• type of health insurance plan based on coordination of care and cost-reduction strategies
• emphasizes health education and preventative care
• includes HMOs, PPOs, and POSs

Question 22

define capitation

Answer 22

• prepayment of a fixed monthly amount for each patient without regard to the type or number of services provided

Question 23

define health maintenance organizations (HMOs)

Answer 23

• usually least expensive
• most restrictive: patient required to use physicians in network, must get referral from PCP to specialist
• low or no deductible, coinsurance, and copayments

Question 24

define preferred provider organizations (PPOs)

Answer 24

• networks of independent doctors and hospitals
• more choices of providers than HMOs
• less likely to coordinate patient’s care

Question 25

define point of service

Answer 25

- hybrid of HMO and PPO - members select in network PCP - can go to nonnetwork providers for care without a referral and must pay extra cost

Question 26

define independent practice association

Answer 26

- independent physicians who maintain their own offices - enroll members or organization for negotiated fee

Question 27

define exclusive provider organizations

Answer 27

- no coverage provided for services outside of the EPO

Question 28

define medicare

Answer 28

- federal insurance program - covers people over the age of 65, permanently disabled people, and people with end-stage kidney failure

Question 29

define medicare

Answer 29

- federal-state matching funds program - provides health insurance to low income people

Question 30

issues facing today's health care system

Answer 30

- access to providers and health insurance - cost - quality