Major changes that have occurred in IV infusion devices as a result of the growth of home care.
the size and weight of infusion devices have decreased dramatically
Manufacturers have introduced disposable infusion devices
Pharmacists can only administer them
A & B
All of the above
The advent of Medicare Part D coverage in 2008 provided partial or full coverage of home care medications.
Factors influencing prescriber behavior include:
Education (e.g., Training in pharmacotherapeutics; Preceptors' prescribing habits)
Control and regulatory mechanisms
Demands by consumers and society
Promotional activities by drug manufacturers
Researchers test an experimental drug or treatment in a small group of healthy people (20-80) for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase I
Phase II
Phase III
Phase IV
Drug Labeling:
All printed information accompanying a drug, label, wrapping & package insert
FDA Division of Marketing, Advertising & Communication seeks balanced, not misleading, scientifically accurate information for health care practitioners
Label claim (indication) is particularly important to sponsor because of its connection to reimbursement
A & B only
Select the true statement:
From 2008 to 2014, there is a projected 6.6% annual decrease in spending for mental health and substance use services in the US.
From 2008 to 2014, there is a projected 6.6% annual increase in spending for mental health and substance use services in the US.
There will not be a % change in spending for mental health during this period in the US.
These groups/cultures are “at-risk” populations and more likely to delay or not seek mental health care/treatment
Cultural and linguistic minorities
Rural populations
Women and children in lower socio-economics
A & C only
In 1915, Abraham Flexner declared pharmacy
Shouldn’t receive War Dept. commissions
Was not a profession
Should share physicians education systems
Had achieved doctoral status
None of the above
The Health Insurance Portability and Accountability Act is best known for:
Portability of insurance coverage
Patient privacy rules
Portability of patient records
The Hyde Amendment
The Flexner Amendment
Horizontal Integration is
the term used to describe an affiliation between hospitals
the term used to describe an affiliation between inpatient surgery centers
the term used to describe a commensalistic relationship between local public health unit
none of the above
Approx what % of hospitals utilize “UD” drug distribution?
25%
40%
80%
95%
Which is least likely to be offered by pharmacists in US hospitals?
Pharmacokinetic Consultations
Drug Use Evaluation (DUE)
Participation on medical rounds
Adverse Drug Reaction management
In-service Education
For pharmacists, Mental Health patients often present….
increase risk of drug interaction issues
increased risk of medication adherence problems
increased difficulty in communication
the same need for compassionate care
The average charge for Assisted Living in the US is…
higher than skilled nursing care
approximately $200/bed/day (2010 data)
approximately $3300/month (2010 data)
covered by Medicare
Activities of Daily Living are the basic measurement for determining…
quality of nursing home care
appropriateness of LTC setting selection
patient age
all of the above
All of the following contribute to increased competition EXCEPT:
open information
available substitute goods
lower barriers to entry
many market participants
a strong patent and copyright system
An extremely small percentage of Americans (<1%) are estimated to have a mental disorder in their lifetime.
Professional Pharmacy Organizations provide service to
pharmacists and related individuals
society & community
the pharmacy profession
Hospitals are often categorized by
ownership
bed count
length of stay
A, B, & C
A patient is likely not a good fit for ambulatory care if they:
have no obvious symptoms
have no insurance
have only Medicare, Medicaid, or SCHIP coverage
need assistance with activities of daily living
need a specialty, international travel-related immunization
Demand quantity generally always decreases as price increases because
replacement products lower prices
utility is often elastic as prices increase
fewer buyers have ability or willingness to pay the higher price
complementary products become available as substitutes
the number of consumers in the market increases
Phase one clinical trials focus on
long term safety and effectiveness
efficacy and dose ranging
safety, side effects, and preliminary dosing
comparison to other therapy
Which market most closely resembles a monopsony?
A rural community with one grocery store and many residents
A farming community with one cotton mill and many cotton farms
An urban neighborhood with several "bodega" style food markets and many residents
An urban area with two oil refineries and many automobiles
A farmer's market in a suburban community
Factors which might make a patient a good "fit" for home care include
treatment need is relatively long term
home care services available in the area
available of family members to assist
Elasticity refers to change in demanded quantity due to change in
number of consumers
availability of substitutes
price
supply
Pharmacy educational outcome(s) set forth by CAPE (Center for Advancement in Pharmaceutical Education) in 2004 include:
Pharmaceutical Care
Systems Management
Public Health
A prescribed legend drug indicated for a chronic disease (e.g., diabetes) is an example of….
Primary prevention
Secondary prevention
Tertiary prevention
The iron triangle of health care include(s):
Cost, Access, Quality
Assessment, Monitor, Assurance
Disease, Diagnosis, Prognosis
Primary, Secondary, and Tertiary Prevention
Which statement is true?
The HMO Act of 1973 mandated exclusion of a prepaid, fixed-fee option for some employers.
The HMO Act of 1973 mandated inclusion of a prepaid, fixed-fee option for some employers.
The HMO Act of 1973 mandated inclusion of a cost-plus option for some employers.
Select the true statement.
In 2006, the average number of prescription drug purchases is lesser by the poor than for the middle income or high income.
In 2006, the average number of prescription drug purchases is greater by the poor than for the middle income or high income.
In 2006, the average number of prescription drug purchases is equal by the poor, middle income, and high income.
Until the mid-1980s, hospitals were reimbursed for their expenses for the prior year on a retrospective basis. Now they are paid a certain amount for each patient’s care on a prospective basis. The amount they are paid is based on:
prospective patient categories (PPCs)
epidemiology
diagnosis related groups (DRGs)
Specialty pharmacies:
are projected not to exist within the next 10 years.
are only found in rural areas.
are the most prevalent of all community pharmacies.
usually specialize in the medication management of one or two disease states.
A law that compels hospital to treat patients who present in the emergency room regardless of ability to pay or insurance status. The law also intends to prevent “patient dumping.”
Emergency Medical Treatment and Association Labor Act
Emergency Medical Treatment and Active Law Act
Emergency Medical Treatment and Active Legal Act
Emergency Medical Treatment and Active Labor Act
The federal government operates a number of hospitals for specific populations, including:
Veterans
Military personnel
Native Americans
Hospital mergers or acquisitions often take advantage of:
Finance of Scale
Scale of Economy
Scale of Justice
Economies of Scale
The patient Protection Affordable Care Act has:
Disincentives for preventive health services
Incentives and requirements for preventive health services
Incentives and requirements for tertiary prevention
B & C
An example of adjudication in healthcare is
defaulting on a pharmacy claim
processing a pharmacy claim
Neither A or B is an example
Both A and B
Which of the following is a type of Pharmacoeconomics?
Cost minimization
Cost effectiveness
Cost utility
Cost perspective
Activities of Daily Living (ADL) are the basic measurement for determining…
appropriateness of Long-Term Care (LTC) setting selection
Home care pharmacy standards are developed by:
American Association of Colleges of Pharmacy
American Society of Health-System Pharmacists
American Colleges of Pharmaceutical Education
Hospice services cannot legally be provided in a patient's home in most states.
Which federal program always had a higher reimbursement prior to ACA?
Medicaid
Medicare
Similar to property and casualty insurance, health insurance applies the theory of risk pooling to manage unanticipated risk.
Group policies are usually less expensive than individual policies because:
Group policies are most often negotiated by large companies with skilled negotiators
Insurance companies pay significantly greater sales commissions for individual policies than group policies
Individual policies are most often purchased by those less healthy in need of coverage but groups policies include everyone in the group
Insurance companies selling individual policies cannot legally restrict policyholders to specific (discounted) hospital/physicians
Skilled Nursing Facilities are highly regulated by state and federal agencies.
The biggest difference in health care between developing and developed countries is:
Communicable diseases are more prevalent than chronic diseases in developing countries.
Chronic diseases are more prevalent than communicable diseases in developing countries.
Developing countries all have portability of benefits.
Developing countries all have a socialized medicine system of health care.
Continuing challenges of applying technology in a healthcare environment include
systems integration
transactional integrity
barcode specificity
Adherence implies a patient choice in making the decision to follow a health professional's recommendations.
The FDA's roles in drug development include all of the following EXCEPT:
premarketing clearance
regulation of labeling
manufacturing regulation
development of bioequivalent compounds
conducting postmarketing surveillance
Typical Home Care services include all EXCEPT
homemaker services
wound care
parental nutrition
minor home surgery
hospice care
Health insurance is not a strong "fit" with the criteria for insurable risk and prescription coverage is an even worse "fit".
The Durham-Humphrey amendment created
hospital funding
the FDA
the category of Legend drugs
pharmacists' license requirements
Every substance can be toxic and some can be therapeutic depending on the concentration.
