HSA 3117: Principles of HSA

Since this is a take-home exam, students are expected to maintain academic honesty and do their own work. Academic honesty also includes refraining from plagiarism. Cutting and pasting answers from lesson notes, or copying answers verbatim from the textbook will result in a deduction of points.

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Multiple Choice (.3 points each)
Please select the choice that most closely answers the question or fits the statement.
Only one answer is correct per question. You need only to give the letter of the
correct answer on your answer sheet. 

1.  Operational planning is characterized by:

   a. short term time frame and middle level management
   b. short term time frame and upper level management
   c. long term time frame and organizational objectives
   d. the organizational mission statement
   

2. An organizational strategy that includes adding new products/services and or entering new markets that are related to the HSO's principal business is:

   a. concentric diversification
   b. conglomerate diversification
   c. divestiture
   d. vertical integration
   

3. Which of the following are characteristics of the "corporatization of healthcare"?

   a. horizontal and vertical integration
   b. increase in for-profit systems
   c. mergers and acquisitions
   d. all of the above
   

4. In relation to the management model, planning forces the manager to focus on __________.

   a. input
   b. resources
   c. output
   d. environmental influences
   

5. What is described as the "foundation of coordinating IORs"?

   a. customs
   b. feedback
   c. negotiation
   d. committees
   

6. ___________ is a type of healthcare organization that has dominated corporate healthcare successfully.

   a. not-for-profit hospitals
   b. private solo practitioner
   c. health maintenance organizations
   d. teaching hospital
   

7. This is a tool used in defining the "real" problem that must be addressed when making decisions. It lists variables to be evaluated in order of importance.

   a. fish-bone diagram
   b. Pareto diagram
   c. cause-and effect diagram
   d. flow chart
   

8. Data collection and standardized comparisons are two major methodological problems when doing comparative health analysis of countries.

   a. true
   b. false
   

9. Which of the following is a the best evaluation tool to use when decisions are linked together over time with various possible outcomes?

   a. payoff table
   b. decision grid
   c. cost-benefit analysis
   d. decision tree
   

10. Coordination in healthcare has traditionally been defined across organizations rather than within organizations.

    a. true
    b. false
    

11. One of the major changes resulting from managed care is the requirement of providers to assume accountability for:

    a. the treatment of the uninsured
    b. the appropriateness of interventions
    c. individual treatment decisions
    d. the health status of defined populations
    

12. A hospital governing board that consists of medical staff and management staff with equal power is an example of which type of healthcare personnel coordination?

    a. autonomous arrangements
    b. heteronomous arrangements
    c. conjoint arrangements
    d. none of the above
    

13. The relationship between a hospital and a patient can be described as which type of IOR?

    a. involuntary
    b. voluntary
    c. market transaction
    d. all of the above
    

14. In the relationship described above, which type of mechanism would be best for coordinating the relationship?

    a. community member on hospital board
    b. strict rules and regulations
    c. direct supervision
    d. programming
    

15. Unfreezing, changing and refreezing are steps in the ____________ phase of the decision making process.

    a. implementation
    b. evaluation
    c. definition
    d. awareness
    

16. The marketing audit is an integral part of strategic planning for health services. What is the role that the marketing audit plays?

    a. it describes the organizational culture
    b. it monitors and evaluates organizational outputs
    c. it provides a link to the informal structure of the organization
    d. if provides a link to the external environment

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Short Answer (1 point each)

These questions require only short answers and should not be more than a few lines long. In some cases, you
need only to list items, do not worry about grammar or spelling for these questions.
Please write the question and answer on the answer sheet.

1. What are the elements of marketing that apply to health services? List and briefly define each.
2. Review the key aspects of coordination in healthcare organizations stressing the importance of each aspect.
3. Describe the five general types of global health care systems. Include the general definition, the position of the physician, the roles of professional associations and ownership of the facilities.
4. List the six steps involved in the basic planning process.
5. In the reading by Starr, he discusses the "corporate ethos" in medical care as one of the most significant consequences of the changing structure of medical care today. What does he mean by "corporate ethos" and why is it so significant?
6. List and define the four characteristics of managerial decision making in healthcare that determine how difficult the process may become when addressing the decision.
7. List and briefly describe outcomes of planning for a health service organization.

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Essay (1.5 points each)
These questions are answered in an essay type format. Be concise and ensure you have
answered the question completely. Proof-read your answer to ensure you have said what you intend.
Answer in complete sentences, do not list. Spelling and grammar will be counted. Please write the
question and answer on the answer sheet.

1. Describe the "evolutionary progress" concept for doing comparative health studies. How does this type of comparative health study help with health care in the United States?
2. What are the characteristics of the United States that differentiate us from other countries when doing comparative health care analysis? Give examples of each characteristic compared to another country.
3. What is health services marketing? What is the difference between contemporary health services marketing and that of two decades ago?
4. Discuss the decomposition of voluntarism and its impact on the not-for-profit organizations.
5. In "Keys to Successful Alliances" on page 200 of your text, what do you feel is the most important key and why?
6. Using a cost-benefit analysis tool what would be the most appropriate action in the following situation? An administrator in the outpatient care clinic of a rehabilitation center is deciding whether to use an automated charting system and become a "paperless office" to cut back on the growing amount of space the chart room is taking up. The current chart room is filled and charts are becoming lost and mismanaged affecting billing and patient satisfaction. The table below outlines some figures the administrator has gathered.
   

   	Costs	Savings
   Automated Charting System	$30,000	$50,000 after 2 years
   Renovate for More Chart Storage	$15,000	$10,000 immediately
   Do Nothing	N/A	N/A

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Bonus Question (2 points)

Japan has one of the lowest rates of health care spending on inpatient services (31.1% of total health care spending) although they have one of the highest rates of hospital bed days (4.0 per person per year). The United States spends 46.1% on inpatient services and only has 1.2 hospital bed days. Generally, inpatient services accounts for the highest expenditures in healthcare due to the cost of equipment, personnel, and hospitality services. Why do you think Japan has such a low cost of inpatient services without a decrease in hospital stays?

1. as an e-mail attachment to kmarino@fgcu.edu

2. fax to FGCU, Department of Interdisciplinary Studies at 941-590-7474 to the attention of Karma D. Marino

3. (snail) mail to: Karma D. Marino, FGCU, College of Health Professions, Department of Interdisciplinary Studies, 10501 FGCU Blvd. S., Ft Myers, Fl. 33965-6565

4. drop off at FGCU, Dept. of Interdisciplinary Studies, copy room in my mailbox or BHG 124.

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