Pharm Care/management Test 3 Set 1

Front 1

2 parts of good health

Back 1

1)goodness
2)fairness

Front 2

WHO objectives of a HC systen (3)

Back 2

1)improve health of a population
2)respond to the ppl's expectations
3)provide financial protection against the cost of ill health

Front 3

Outcomes measured of a HC system (6)

Back 3

1)fair financing
2)access
3)responsiveness
4)equitable
5)good quality
6)affordable

Front 4

Mechanisms to finance HC (4)

Back 4

1)out of pocket
2)individual private insurance
3)employment based
4)gov't financing

Front 5

3 Models of HC systems

Back 5

1)socialized programs
2)decentrailzed nat'l health programs
3)socialist medicine

Front 6

Socialized programs def and 2 types

Back 6

gov't enforces participation in system, but providers are private

1)socialized health insurance
2)socialized medicine

Front 7

Socialist medicine def

Back 7

gov't does everything for the HC system

Front 8

Canada
a)type of HC system
b)how established

Back 8

a)socialized health insurance
b)The Canada Health Act termed it "Medicare"

Front 9

5 main principles of Canada HC

Back 9

1)portability (get it everywhere)
2)comprehensiveness (hospital and MD coverage)
3)universality (everyone covered)
4)accessibility (reasonable acces to HC geographically)
5)public administration

Front 10

Hospitals in Canada (2)

Back 10

a)each different province sets standards for facilities and staffing
b)run @ capacity leading to waiting lists

Front 11

Medicare in Canada covers what hospital services? (4)

Back 11

1)room/meals
2)diagnostic procedures
3)nursing
4)inpatient meds

Front 12

Physicians in Canada (4)

Back 12

1)55% are general/family prac
2)act as gatekeeper
3)pt have free choice of Dr.
4)highest paid professional but still make less than USA MD's

Front 13

Role of private insurance in Canada (2)

Back 13

1)it is supplemental insurance
2)most ppl get it to cover Rx drugs

Front 14

Outpatient Meds will be paid for via Medicare in Canada if... (3)

Back 14

1)senior citizen
2)on welfare
3)pts w/ specific disease states

Front 15

Outpt Med coverage otherwise in Canada (3)

Back 15

1)4 provinces have universal coverage for Rx meds (Pharmacare)
2)only formulary meds covered
3)most rely on private insurance

Front 16

Canada Medicare financing (4)

Back 16

1)12 separates systems
2)paid by payroll taxes
3)$ distributed to provinces accoring to federal and provincal budgets
4)one payer system controls overhead admin costs

Front 17

Canada Medicare financing of:
a)MD's
b)hosptials
c)Rx (3)

Back 17

a)paid on a fee schedule directly from the provincial govt
b)given budget from provincial govt that can NOT be exceeded (= waiting lists)
c1)prices set @ federal level
c2)purchasing @ provincial level
c3)drug spending is 2nd largest HC expenditure

Front 18

Issues facing Canada (6)

Back 18

1)maldistribution of MD's
2)waiting lists
3)decr supply of physicians (b/c MD's migrating to USA)
4)federal recession
5)% of ppl rating system highly is decreasing
6)single payer structure = slow response to local issues

Front 19

Latest considerations to fix Canada issues (3)

Back 19

1)managed care
2)incr pt cost sharing
3)alternative methods for MD compensation

Front 20

UK
a)primary ex of...
b)act that established it

Back 20

a)of SOCIALIZED MEDICINE
b)National Health Service Act

Front 21

3 Innovations of UK system

Back 21

1)universal comprehensive coverage
2)financing thru general taxes w/ little service charge
3)nationalization of hospitals (run by govt)

Front 22

3 components of UK system

Back 22

1)hospitals
2)community services
3)primary medical and dental services

Front 23

UK system availability (2)

Back 23

1)all services available to whole population
2)must have referral for hospital/specialists

Front 24

UK system and physicians (4)

Back 24

1)hospital physicians salaried, office MD's have contracts w/ NHS (national health service)
2)pts have to register w/ GP's but can change
3)reorganized into primary care groups in 1999
4)reorganized into pirmary care trusts in 2002

Front 25

Outpatient Rx's in UK system (4)

Back 25

1)covered by NHS (formulary only)
2)prescribing behavior closely monitored (especially off-label)
3)70% of meds prescribed are generics
4)prices negotiated by NHS and drug manufacturers

Front 26

UK system financing of GP's and hospitals (2)

Back 26

1)hospital lump sum for provided services
2)GP's mix of capitation and fee-for-service

Front 27

What is the UK's FDA? and diff b/w it and FDA

Back 27

NICE, it covers safety and efficacy and cost

Front 28

NHS financed thru and %age (3)

Back 28

1)taxes (80%)
2)nat'l insurance (15%)
3)pt user charges (5%)

Front 29

UK system current status (4)

Back 29

1)underfunded b/c most of the funds are from taxes
2)lack of facilities cause waiting list
3)recent reforms aimed @ improving quality
4)in public opinion polls pts are satisfied

Front 30

UK system recent reforms @ improving quality (2)

Back 30

1)creation of clinical nat'l standards
2)external performance monitoring

Front 31

Germany System overview (3)

Back 31

1)mandatory health insurance (sickness funds)
2)health ins. in conjunction w/ accident, disability, and old-age pension ins
3)once you switch to private ins. you can't go back

Front 32

3 main values of Germany System

Back 32

1)self-governance
2)social partnership
3)social solidarity (all covered)

Front 33

%age of ppl w/ sickness funds and % not

Back 33

90% have sickness funds
10% have private insurance (must meet certain income standards to get private ins.)

Front 34

____ no pay for Germany health ins.

Back 34

police/army/welfare

Front 35

Germany type of HC

Back 35

DECENTRALIZED health insurance

Front 36

Germany recent reform (4)

Back 36

Sickness funds can't discriminate based on...
a)age
b)gender
c)risk factors
d)occupational/geographical limits

Front 37

German hospitals have... (2)

Back 37

1)surplus of hospital beds
2)surplus of MD's

Front 38

Germany MD's (3)

Back 38

1)act as gatekeeper
2)must qualify/apply for accreditation w/ regional assn
3)pts have freedom of choice of MD, but must wait 3months b4 selecting another MD

Front 39

Germany Outpatient meds (3)

Back 39

1)are covered by sickness funds
2)pharmacies must be owned by a pharmacist
3)pharmacist may only own one pharmacy

Front 40

Sickness funds are financed thru..

Back 40

payroll taxes

Front 41

German MD's and hospitals negotiate w/...

Back 41

each sickness fund

Front 42

German Hospital payments (2)

Back 42

1)hospital MD's are salaried
2)hospital payments are prospective cost-per-case payment

Front 43

German financing of office-based MD's

Back 43

paid on a point system

Front 44

German financing of Rx drugs

Back 44

sickness funds provide reimbursement for approved medications

Front 45

Germany has ____ pricing which is.... (2)

Back 45

Medication reference pricing
1)similar drugs are reimbursed @ the same level
2)if you need a costlier med, pt pays difference

Front 46

Germany current status (3)

Back 46

1)reforms being implemented
2)problems integrating E. Germany
3)high unemployment causing revenue problems for sickness funds

Front 47

Current reforms being implemented in Germany (2)

Back 47

1)ceilings on expenditures for office MD's & hospital services
2)budgets for meds prescribed by office MD's

Front 48

Cuba HC is ____

Back 48

SOCIALIST

Front 49

Cuba HC is ruled by 5 principles

Back 49

1)HC is a right
2)HC is the responsibility of the state
3)preventative & curative integrated
4)everyone participates
5)HC activites are integrated w/ economic and social development

Front 50

Cuba HC
a)run by...
b)1970s addition
c)1980s addition
d)Most recent addition

Back 50

a)Cuban Ministry of Health
b)polyclinics provide HC for a geographical region
c)focus changed to primary care
d)incr # of family MD's (The Family Physisican Program)

Front 51

Cuba HC structure (4)

Back 51

1)family MD and nurse assigned to a given community
2)office hrs in the morning
3)follow pts in hospital, make visits, inspect facilities in afternoon
4)in charge of community well-being

Front 52

Cuban polyclinics are now ____ meaning...(3)

Back 52

Ancillary
a)laboratory
b)emergency services
c)residency training

Front 53

Cuban HC has $ alloted towards... (2)

Back 53

1)research and knowledge
2)int'l missions

Front 54

Cuban HC
a)controlled by...
b)financed by...
c)____ is paid for by the govt

Back 54

a)cuban govt
b)100% by the govt
c)medical education

Front 55

National budget for Cuban HC is...

Back 55

most important part of country's budget

Front 56

Current status of Cuban HC (4)

Back 56

1)economic crisis (embargo and fall of Soviets)
2)embargo strengthened in 1992
3)lack of med supplies reduces surgical rates (have to make all supplies themselves)
4)water supply is major problem

Front 57

Confounding problem of Economics and health care (2)

Back 57

1)we want the HC market to respond as any normal/efficient market
2)there are unusual restrictions & forces are placed on the market it distorts reality

Front 58

Unusual restrictions on the HC market? (3)

Back 58

1)barriers to getting HC knowledge
2)barriers to finding out what MD's are good/not
3)hard to make good HC decisions

Front 59

Basic Principles of economics and HC (3)

Back 59

1)premise of scarce resources ($ are scarce)
2)despite unlimited wants by society
3)economic principles allocate resources in most efficient manner

Front 60

Types of resources (3) and used to...

Back 60

1)natural resources
2)labor
3)capital

to produce commodities

Front 61

Commodities?

Back 61

good and services

Front 62

Do pharmacists provide a good or a service

Back 62

both

Front 63

Utility def.

Back 63

term for satisfaction obtained from purchase of a commodity

Front 64

Goal of economics and utility

Back 64

maximize utility, maximize your satisfaction from what you buy given individual budget restraints

Front 65

Cost Constraints? (2)

Back 65

1)limited resources obtained @ certain costs
2)commodities obtained by individuals willing and able to purchase them

Front 66

Marginal cost/utility def.

Back 66

amount of EXTRA benefit (OR EXTRA COST) obtained

Front 67

Opportunity Cost def. (2)

Back 67

a)tradeoff involving purchase of investment decision
b)decision to forego purchase of one good/service for other use of scarce resource ($)

Front 68

Theories of demand and supply are...(2)

Back 68

1)2 most important concepts in economics
2)basis of interaxn b/w the marketplace of suppliers and consumers

Front 69

Demand def.

Back 69

market force exerted by buyers on price/amt of G&S they demand

Front 70

Suppliers exert market force based on...

Back 70

WILLINGNESS AND ABILITY to supply a product for consumption

Front 71

Demand equation

Back 71

Demand = ability AND willingness to pay (want/desire has no part in it)

Front 72

Demand schedule
a)def
b)variables (2)

Back 72

a)various amts of a "commodity" consumers purchase @ each specific price
b)price charged by supplier & quantity demanded @ each given price

Front 73

Changes in demand refers to...

Back 73

SHIFT in entire demand curve

Front 74

Why might change in demand occur? (5)

Back 74

CHANGES IN:
a)prices of related goods
b)consumer income
c)# of consumers in market
d)consumer preferences & attitiudes
e)consumer expectations (future earnings and prices)

Front 75

Shifts in demand curve mean...(2)

Back 75

1)to the RIGHT = INCR DEMAND
2)to the left = decr demand

Front 76

If another product exists (or is created)...

Back 76

that can substitute for the original product, the price of the good & demand for the other become directly related

Front 77

Normal superior goods (and 3ex)

Back 77

demand incr w/ incr in consumer dispoable income

houses, cars, HC (but no change in need)

Front 78

# of consumers in market effects (2)

Back 78

1)more customers increases demand (right shift)
2)# of consumers incr w/ more uses (market expansion for product)

Front 79

Consumer preferences and attitudes can... (4ex)

Back 79

CHANGE IN A SEC

1)minivans
2)dot matrix printers
3)film cameras
4)older generation drugs (prozac)

Front 80

What if I expect future prices to be greater?

Back 80

buy now

Front 81

Causes for incr demand for X: (7)

Back 81

1)decr in price (elasticity)
2)price decr in complementary product Y
3)price incr in substitute product Z
4)incr income (for normal X)
5)decr income (incr demand for an inferior X)
6)incr in consumers/buyers
7)consumer expectations that price for X will incr

Front 82

Supply
a)is a ___
b)def.

Back 82

a)is a schedule
b)# of goods/services supplied @ specific prices

Front 83

Difference b/w supply schedule and demand schedule?

Back 83

Supply sch- price consumer willing to pay

Demand sch- price charged by supplier

Front 84

Supply curve slope is...

Back 84

(+), DEMAND CURVE IS (-)

Front 85

Increases in technology =

Back 85

decr production cost = incr supply

Front 86

Why might changes in supply occur (5)

Back 86

1)production ability and techniques
2)# of sellers in market
3)cost of resources (material/labor)
4)price of related goods
5)sellers expectations

Front 87

Equilibrium occurs @ price where... (2)

Back 87

1)quantity demanded = quantity supplied
2)both buyer and seller are satisfied w/ price

Front 88

Consumer Goal
Seller Goal

Back 88

a)demand more goods @ lower prices
b)want to supply more goods @ higher prices

Front 89

Equilibrium pricing
a)is...
b)determines

Back 89

a)interaxn of supply and demand
b)allocation of economic resources

Front 90

Disequilibrium

Back 90

disruptions in the equilibrium of the market

Front 91

Elasticity of demand (4)

Back 91

1)price incr results in decr demand
2)enough to result in decr in total revenue
3)happens w/ most consumer goods (why retailers standardize prices)
4)quantity demanded is sensitive to the price

Front 92

Inelastic demand (4)

Back 92

1)incr price = incr revenue
2)quantity demanded insensitive to price
3)total revenue increases
4)is reason why drug industry price increases are higher and more freq. than other goods

Front 93

HC & drugs has ___ demand

Back 93

INELASTIC

Front 94

Rx drug pricing structure

Back 94

what the market will bear (see what ppl will pay)

Front 95

_____ results in elasticity (1)

Back 95

1)more availability of substitutes

Front 96

Demand for ____ is elastic (2ex)

Back 96

specific product/brand (specific antihistamine, OTC pain reliever)

Front 97

Differential pricing (3)

Back 97

a)use a formulary/preferred produt list (decr substitutes)
b)get better pricing than independent pharmacies
c)creates market power

Front 98

Price (elasticity/inelasticity) relative to consumer's income (2)

Back 98

1)demand for goods relatively costly for a consumer's income are more elastic
2)small item consumer goods relatively inelastic demand

Front 99

Limited # of alternative uses results on elasticity/inelasticity

Back 99

results in inelasticity

Front 100

Why inelastic demand on Rx drugs? (3)

Back 100

1)Dr writes a specific Rx; consumer cannot authorize substitutes
2)Rx consumes relatively small portion of income
3)some Rx's have few alt. uses (like amoxicillin only used for infections)

Front 101

Other variables to inelastic demand of Rx drugs (4)

Back 101

1)product decision maker is not consumer
2)consumer is not actual payer
3)price not primary consideration
4)health insurance reduces cost relative to income