Dee PT works at an outpatient orthopedic physical therapy practice that has a Biodex System 4 Isokinetic Dynamometer.
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Dee PT works at an outpatient orthopedic physical therapy practice that has a Biodex System 4 Isokinetic Dynamometer. This machine can be used for advanced muscle testing and training for multiple patient types. This technology is an example of what health care system element:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
2. Dee PT works at an outpatient orthopedic physical therapy practice that accepts out-of-pocket payments and multiple types insurance plans. These methods of payments and reimbursement in this setting are components of what health care system element:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
3. In the city where Dee PT’s clinic is, there are three hospitals that have large orthopedic surgery departments. There are 3 major sports teams. The population is primarily made of young active people, heavy labor type workers, and a “baby boomer” group of people in their early 70s.
In response, multiple PT practices have opened to try to address this outpatient physical therapy need. This is an example of what health care system element dictating business development:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
4. Dee PT is not the owner of the practice. The practice is one of many in a large chain of physical therapy clinics owned by the same company. Dee has a manager who reports to a regional director, who reports to a Board of Directors. The Board of Directors establishes annual clinical, organizational, and financial goals and targets which are then carried out by the directors, managers, and staff therapists.
This structure is an example of what health care system element:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
5. Although Dee PT is a direct access provider, Dee gets most of his patients referred to him by multiple physician specialists. During the course of therapy, PTAs and PT Aides are involved in carrying out the treatment plan that is developed by Dee PT. Periodic re-evaluations are completed with updates regularly sent to the referring physician.
This method of how care is carried out and coordinated is a component of what health care system element:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
6. Joelle PT works for a small outpatient practice with a limited expense budget. Joelle evaluates a patient following a stroke who is demonstrating a right foot slap during gait. Joelle’s practice does not have an electric stimulation device, sample or “off the shelf” training orthoses, and does not have the materials to create a temporary orthoses. The closest orthotist is more than 2 hours away and they do not make house calls. Joelle improvises using ace wraps and theraband to facilitate a static right ankle dorsiflexion posture during gait. As a result, gait training is ineffective, and the patient never achieves much dorsiflexion control on the right side.
What element of the health care system has interfered with the achievement of an optimal patient outcome:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
7. Mike PT works for an outpatient physical therapy practice in a large city. In Mike’s area, there are about 7 outpatient PT practices that compete for outpatient therapy business. To differentiate itself and remain competitive, Mike’s company offers free transportation to and from therapy sessions to patient’s unable to get to therapy.
Mike evaluates an patient with lumbar spine compression fractures who was brought to the evaluation by the patient’s daughter. His treatment plan includes a frequency of 2x/week for 8 weeks. His patient’s daughter cannot take off more time from work to bring the patient to therapy. So the company arranges for transportation and the patient successfully achieves her goals.
In this example, what element of the health care system was underlying factor was the cause that provided a way for the patient to access PT services:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
8. Irene M. Pain is a patient in an acute care teaching hospital. She was admitted to the ICU following a car accident. Every morning rounds are completed led by the Attending Critical Care Physician and includes residents, nurses, PT, OT, SLP, Case Managers and Social workers. Following rounds each team member focuses on their responsibilities to support the care for the patient. The rehab therapists (PT, OT, SLP) coordinate their schedules to maximize their effective treatment time and Irene’s clinical outcomes. The nurses carry through rehab instructions for positioning and out of bed activity to support the therapists goals. The case managers work with the insurance company to update progress and get extension approvals. The team members then come back each day for rounds to report on patient progress and outcomes leading to timely and safe discharge for Irene.
This division of responsibility and collaboration of efforts to support Irene’s outcomes is a component of what element of the health care system:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
9. Pennsylvania State Board of Physical Therapy requires every PT to complete 30 hours of Continuing Education credits every 2 years. The owner of the practice that Sally PT works for supports this requirement by providing continuing education money as a benefit to her employees. Sally PT uses this money to take a continuing education course on advanced treatment for cervical spine dysfunction.
Following the course, Sally evaluates a patient with cervical spine radiculopathy. Sally is able to develop a plan of care based on the techniques taught at the course she attended that was paid for by her employer. Sally’s patient achieves pain free ROM and can perform all ADLs without limitation within 4 weeks.
In this example, what element of the health care system facilitated Sally’s ability to provide effective care for her patient and the patient’s optimal functional outcomes:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
10. Dee PT’s clinic is in an urban area. There are 4 other outpatient orthopedic clinics within 10 miles of Dee’s clinic. One is a private practice, two are associated with a hospital network, and the other is part of another chain of outpatient clinics.
These 5 practices located within 10 miles of each other compete with each other for outpatient PT patients. This competition is a component of what element of the health care system:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
11. Dee PT is treating a patient with a vestibular disorder, Eileen M Dizzy. Dee does not have access to balance training equipment and has not developed a suitable alternative to create an soft and unstable surface. Balance training on unstable surfaces is a typical intervention strategy for patients with vestibular disorders. Without this equipment, Eileen’s episode of care is prolonged by 4 weeks and she gets discharged prior to meeting her balance goals.
This is an example of what element of the health care system impacting the patient’s potential for a maximal outcome.
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
12. Emily PT works in the inpatient rehabilitation department of a large health system. Although the hospital system is a for-profit entrepreneurial structure, the Board of Trustees who manage the system has mandated that funding is allocated in the operating budget each year to cover the cost of care for patients who are uninsured and underinsured. Emily is working with a patient who recently had a stroke and also exhausted his inpatient rehabilitation benefits. The patient is not yet safe to be discharged to home. The patient is able to access the funding mandated by the Board of Trustees to continue treatment. Emily is able to adjust her plan of care and the patient is discharged 4 weeks later and is safe to transition to home care.
In this example, what element of the health care system has supported Emily’s ability to provide care for her patient and facilitated a more optimal patient outcome:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
13. Ash PT has worked for 10 years in a hospital in a rural setting with a large elderly population. As a result, most of Ash’s patient cases are over 60 years old. Ash has developed expertise for working with a geriatric population. And the PT department has focused their resources on program development for a geriatric population.
Ash evaluates a 6 year old boy after he gets his cast removed following a tibia fracture. The closest pediatric hospital PT department is 2 hours away. Ash treats the boy but because the area in which she lives and works is mostly a geriatric population she is not very skilled with pediatric patients. Ash’s treatment plan is not very effective and efficient and the boy is discharged without returning to full functional ability.
What is the underlying element that contributed to a lack of resources for the boy to achieve his optimal functional outcomes:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
14. Joe PT works in a skilled nursing facility (SNF). The rehabilitation department has PTs, PTAs, OTs, COTAs, SLPs, patient transporters, volunteers, students, administrative support personnel, a director and assistant director of rehabilitation.
All of this personnel is a component of what element of the health care system:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
15. In Joe PTs SNF Rehabilitation department:
PTs complete evaluations, re-evaluations and discharge summaries and write functional goals related to standing balance, trunk control and lower extremity function.
PTAs carry out the plans of care established by the PTs.
OTs complete evaluations, re-evaluations and discharge summaries and write functional goals related to sitting balance, trunk control and upper extremity function.
COTAs carry out the plans of care established by the OTs.
SLPs complete evaluations, re-evaluations and discharge summaries and write functional goals related to communication and feeding.
Patient transporters are given patient schedules to bring patients to and from the gym to save the therapists from wasting time getting patients to therapy.
Admin support staff remind all therapists when paperwork is due to update patient progress.
The director and assistant director of rehab coordinate case reviews to monitor patient progress and discharge status.
This coordination of care and the way the department operates is a component of what element of the health care system:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
16. Joe PT works in a skilled nursing facility (SNF) who’s patient population is mostly covered by Medicare insurance plans. As a result, the SNF follows the specific guidelines, rules and regulations established by Medicare for patient management.
Joe has a patient that recently had a total hip replacement. Following his initial examination, Joe established goals for the patient using functional outcome measures. He completes his weekly progress notes required by Medicare guidelines which keeps Joe’s treatment plan on track, and his patient meeting his goals in a timely way.
In this example, what element of the health care system is facilitating the patient achieving his goals and outcomes:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
17. Mary PT works for a large entrepreneurial health system that has state of the art facilities including a full gait lab, a large therapy gym with body weight supported gait training equipment, and an aquatic therapy pool with a patient lift.
Mary evaluates a 12 year old boy with cerebral palsy. Mary is able to do a thorough gait analysis in the gait lab, implement a treatment plan which includes aquatic therapy for some maximal total body resistance exercise, and gait training with progressive body weight support and loading. In 12 weeks the patient improves his GMFM score, shows an reduced Energy Expenditure Index, and an improved PedsQL Quality of Life outcome measure.
The facilities and technology available to support this plan of care are an example of what element of the health care system
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
18. Out-of-pocket payments, private insurance, employer-funded insurance, and government funded insurance are the primary methods of health care reimbursement in the US.
These sources of funding are a component of what element of the health care system:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
19. Gerry PT works for a for-profit health system. The executive management of the system expects that they will be reimbursed for the care provided by it’s staff either from insurance or patient out-of-pocket payments.
Gerry PT has a patient who has exhausted her PT insurance benefits but is not achieved the goals Gerry has set for her. Gerry’s explains the case to her supervisor and modifies her plan of care for the patient to achieve goals established for safety within two weeks. Her supervisor then presents this case to the Director of Rehabilitation who approves the two week plan and Gerry continues to see the patient. Because of the director’s approval, the patient will not be charged for the additional services.
In this example, what element of the health care system is supporting Gerry’s ability to provide care for this patient:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
20. A target patient population is a component of what element of the health care system:
Group of answer choices
A. Resources
B. Delivery System
C. Market
D. Governance and Management
21. Government financing is one mode of payment for healthcare in the US. This model includes which of the following programs:
Group of answer choices
A. Medicare
B. Medicaid
C. SCHIP
D. All of the Above
22. Two modes of paying for healthcare specifically involve financing through a private or commercial insurance company. These modes are:
Group of answer choices
A. out of pocket payment and government financed
B. individual purchased and employer purchased
C. individual purchased and out of pocket payment
D. employer purchased and government financed
23. Bodenheimer describes “out of pocket payment” as one of the four primary modes of paying for healthcare in the US in which a patient pays a provider directly the full cost of the care provided. However, the other three methods of paying for healthcare include out of pocket costs for patients by which the patient pays a provider directly for part of the cost of a specific service provided. These out of pocket costs are in the form of:
Group of answer choices
A. deductibles
B. copays/coinsurance
C. premiums
D. A and B
24. Bodenheimer describes financial and nonfinancial barriers as the two major categories impacting access to care. From a financial perspective, what is likely a most important key factor impacting access to care:
Group of answer choices
A. Income level
B. Having or not having health insurance coverage
C. Socioeconomic status
D. Employment status
25. Which of the following statements is true?
Group of answer choices
A. Income status does not correlate with health status
B. Health status does not vary among different races
C. Multiple studies have demonstrated that a greater percentage of whites have higher morbitiy and mortality rates for complex or chronic medical conditions compared to Hispanic or African American patients
D. Female physicians are more likely to refer female patients for women’s health diagnostic testing than male physicians
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