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CPH Exam Policy
| Question | Answer |
|---|---|
| Infectious Disease Control Era (pre 1850) | limited ph and med. practice; little effective treatment; ph focused on protection from infectious disease from traveler's thru ship inspections and quarantine; Marine Hospital System created in 1798 |
| Building Infrastructure (after 1850) | Great sanitary awakening shifted focus to social/environ; life expectancy doubled; 1870-states involved in ph; 1906-FDA; 1918-fed gives grants to states for ph |
| Flexnor Report | 1910; evaluated quality of medical education; recommended a science based curriculum at least 4 yrs long w/ high admission standards |
| Hill-Burton Act | 1946; provides federal matching funds for community and state hospitals; those built w/ those funds must provide care regardless of ability to pay |
| US Health Care Spending | $2.3 trillion spent-more than any other developed country; 2.8% of health expenditures went to public health |
| Employer Sponsored Insurance | Established during WWII to lure workers in response to wage controls; 2008-60% of US have ESI (which is paid pre-tax) |
| Medicare (Title XIX in Social Security Act) | Provides healthcare for elderly and disabled; funded with payroll tax; benefits same across country; covers 45 mil and 14% of fed budget |
| Eligibility for Medicare | Individual or spouse must have contributed for 10yrs (or one can pay buy-in premium), 65 yrs or older, disabled and entitled to Social Security |
| Medicare Part A | Hospital insurance for inpatient, skilled nursing and hospice care; financed thru mandatory payroll tax |
| Medicare Part B | Supplemental medical insurance (SMI) for outpatient services; is voluntary and paid thru premiums/tax revenue |
| Medicare Part C | aka Medicare Advantage; multiple plans provide additional benefits not paid by traditional Medicare; requires an additional premium |
| Medicare Part D | Prescription drug coverage; established in 2003 as part of Medicare Prescription Drug and Improvement Act; voluntary |
| Medicaid (Title XVIII) | Federal and state program for low-income; 59 million and $269 billion per yr; administered by state w/ fed matching funds; feds set broad service criteria and states choose optional service |
| Medicaid Eligibility | Initially focused on those already receiving welfare; 1996-Personal Responsibility and Work Opportunity Reconciliation Act separated from welfare criteria to parents w/ kids, pregnant, and the low-income aged, blind or disabled |
| State Children's Health Insurance Program (SCHIP-Title XXI) | 1997; gives broad fed guidelines w/ state flexibility for eligibility; covered 6.6 million low-income kids; funded by discretionary spending |
| General Welfare Clause (Article 1, Sec 8, Clause 1) | In the Constitution; has been interpreted as giving fed govt authority to use tax revenue for public health service |
| Police Powers | Where states derive their public health authority; comes from the Constitution |
| Common Functions for State Public Health | Collecting and analyzing health statistics, providing education to public, state laboratories, licensing of health professionals |
| Funding for State Public Health | 1/2 from state govt; 1/3 from fed govt; rest from sources such as licensing fees |
| Local Public Health Agencies | Unit of local govt responsible for health w/in area smaller than the state; six basic functions-vital stats, control of communicable disease, sanitation, lab services, MCH, health education |
| Health Policy | Aggregate decisions by govt and stakeholders that determine allocation of health resources and services; reflects the principles, priorities and values of decision makers |
| Determinants of Health | Social (SES), behavorial (habits), environmental (air/water quality), biological (genetics, age) |
| Policy Analysis | Systematic investigation of policy alternatives based on evidence; includes problem analysis and solution analysis |
| Problem Analysis | Identifying and understanding the problem with quantitative and qualitative info from various perspectives; criteria for analysis established prior to. |
| Solution Analysis | Considers the technical, economic, and political feasibility of policy implementation strategies and predicted outcomes |
| Policy Development | Occurs in 6 stages-agenda setting, policy formulation, policy adoption, implementation, administration, consequences, evaluation; Kingdon (85) said window open for new policy when political forces and problem align |
| Agenda Setting | political influence (or mass media) gets item on agenda; need someone with sufficient power and influence |
| Policy Formulation | Solutions to the problem generated by political staffers or special interest groups |
| Policy Adoption | Policies are enacted; the highest profile stage with lots of media and scrutiny |
| Implementation | Development of rules/regulations based on how policy will work in reality; exec branch leads; complex and technical w/ results sometimes at odds with original policy; can take years |
| Administration | Running the policy's programs as detailed in policy rules, which continue to be refined |
| Consequences | The policy's effect on the population arise |
| Evaluation | Assessing if the goal of the policy was achieved; often ignored stage; political influence can prevent dissemination of results |
| Management | The process of coordinating and organizing people and resources to achieve organizational goals; functions include planning, organizing, leading, and controlling |
| Planning | The ongoing process of developing the organization's mission, vision, goals, and how to accomplish them |
| Strategic Planning | Determining where the organization wants to be in the future and how to get there; is active and ongoing; includes vision, mission, and values; process is environ scan, strategy forming, implementing and evaluation |
| Vision | The desired future state |
| Mission | The enduring statement of the organization's purpose |
| Values | The organization's culture |
| Strategic Planning Environmental Scan | A responsibility of senior management; analyzes internal strengths and weaknesses, and external opportunities and threats |
| Strategic Planning Strategy Formulation | Formulation of objectives based on vision, mission, values and results of environ scan; objectives analyzed in terms of probability of success; must be clear, focused and doable |
| Strategic Planning Strategy Implementation | Development of a tactical plan and implementation plan |
| Tactical Plan | Breaks down the strategic plan into short-term actions and assigns responsibility |
| Implementation Plan | Outlines how to communicate the strategic plan to employees and get employees on board |
| Strategic Planning Evaluation | Ensures organization is following the plan and identifies areas to adjust; defines parameters, establishes target values, and who is responsible for evaluation |
| Effective Marketing Plan | Composed to a product tailored to consumer needs, that is appropriately priced, distributed conveniently and adequately promoted |
| Effective Communication Planning | Focuses on developing plan and identifying goals, describing objectives, identifying audience, learning about audience, and writing plan to outline activities, partnerships and evaluation criteria |
| Effective Communication Development | Focuses on developing the message by brainstorming messages, identifying channels, best time to reach audience, pretesting message w/ audience and revising based on feedback |
| Effective Communication Implementation | Focuses on implementing by executing plan, communicating with partners and beginning evaluation |
| Effective Communication Assessment | Focuses on assessing and refining plan by seeing if objectives were achieved |
| Organizing | Ensuring resources are available and configured to meet the organization's mission/vision |
| Systems Theory | Views organizations as complex systems functioning in the broader environment; provides a useful approach for understanding organization function |
| Inputs for Public Health Organizations | Health resources, funding, scientific evidence and facilities |
| 10 Essential Functions of Public Health | Monitoring, diagnosing/investigating, informing/educating, mobilizing, developing policies, enforcement, creating linkage, assurance, evaluation, and research |
| Human Resources | Responsible for implementing strategies and policies related to the management of individuals; handle staff management, training, compensation, employee/labor relations |
| Staff Management | Identifying, recruiting, and retaining employees needed to support activities |
| Training and Development | Improving the performance of individuals and groups |
| Compensation and Benefits | Combination of direct and indirect payment to attract, recognize, and retain employees; includes wages/salaries; benefits are either mandated (Social Sec, unemployment) or voluntary (pensions, health insurance) |
| Employee Relations | Concerned with employer-employee relationship, employee performance and resolving workplace disputes |
| Labor Relations | Concerned with terms and conditions of employment such as unfair labor or management practices, union activities and collective bargaining |
| Leading | Involves setting a direction and influencing people to follow |
| Transactional Leadership | Most common style; assumes employees work for the money; focuses on task/reward structure to encourage productivity; doesn't make for a motivating environment |
| Autocratic Leadership | Extreme form of transactional; exerts absolute power over employees; leads to high turnover and absenteeism; can be effective in routine/unskilled jobs |
| Bureaucratic Leadership | Style insists rules must be followed precisely; appropriate for work involving safety risks |
| Charismatic Leadership | Generates enthusiasm/inspiration; no commitment to company/shared vision and is troublesome if leader leaves the organization |
| Democratic/Participative Leadership | Style involves employees in decisions w/ leader having final say; great job satisfaction and motivation; takes longer to make decisions |
| Laissez-Faire Leadership | Style leaves employees to work on their own; effective w/ good monitoring and communication; appropriate with experienced self-starter employees |
| Relationship-Oriented Leadership | Style focuses on organizing, supporting and developing employees; often used in combo w/ task-oriented |
| Servant Leadership | Informal leader meets need of the team and involves others in decision making; effective where values are important |
| Transformational Leadership | Style inspires employees to share in vision; encourages enthusiasm; may require others to manage details |
| Motivation | Act of influencing individual to take desired action |
| Intrinsic Motivation | Arises from rewards inherent in accomplishing the task; more effective but harder to influence |
| Extrinsic Motivation | Arises from external rewards of the task, such as money |
| Maslow's Hierarchy of Needs | Motivation from needs progressing from subsistence to self-actualization; five levels-physiological, safety, belonging, esteem, and self-actualization |
| Alderfer's Existence, Relatedness and Growth Theory | Believes motivation can be backward/forward thru levels; three levels-existence (physiological and safety), relatedness (social need), growth (self-esteem and actualization) |
| Herzberg's Two Factor Theory | Job satisfaction from motivators (challenge, responsibility, opportunity for growth) and dissatisfaction from hygiene factors (salary, job security, company policy) |
| McClelland's Acquired Needs Theory | Needs are learned from life experiences; three types- need for achievement, need for affiliation, need for power |
| Skinner's Reinforcement Theory | Believes there are four types of reinforcement that influence motivation (positive, negative, punishment, extinction); doesn't account for higher level cognition in humans |
| Positive Reinforcement | Influences desirable behavior by providing rewards for that behavior |
| Negative Reinforcement | Influences desirable behavior by providing rewards for avoiding negative behavior |
| Punishment Reinforcement | Influences desirable behavior by providing negative consequences for undesirable behavior |
| Extinction Reinforcement | Influences desirable behavior by removing positive rewards for undesirable behavior |
| Adam's Equity Theory | Argues that motivation is determined by the employee's perception of treatment equity |
| Expectancy Theory | Motivation is a function of belief that more effort into a job will result in better performance, which will be rewarded with something valuable |
| Locke's Goal Setting Theory | Individuals are motivated to improve when given specific and challenging goals |
| McGregor's XY Theory | Theory X assumes employees dislike work, avoid responsibility and must be compelled to perform. Theory Y assumes employees are naturally motivated and managers help them achieve full potential |
| Attribution Theory | Our perceptions influence whether we attribute someone's behavior to their personality or to outside circumstances; can cause issues if behavior is attributed to wrong factor |
| Control | Systematic process of measuring performance and taking corrective action to achieve goals; must determine appropriate performance areas and satisfactory performance through financial management and quality assurance |
| Financial Management | day-to-day and long range financial goals; functions are accounting and financial management |
| Accounting | Reporting financial transactions; either managerial or financial |
| Managerial Accounting | Financial data is provided concurrently or prospectively to internal uses such as managers, execs, governing boards |
| Financial Accounting | Provides data retrospectively to external users such as stakeholders, lenders, insurers |
| Incremental Budgeting | Begins with prior info which is then adjusted based on assumptions about the future; appropriate when environment hasn't changed much |
| Zero-Based Budgeting | Starts with predictions about needs and assumptions of the future; appropriate for new entities |
| Retrospective Reimbursement | Amount is determined after the service is delivered; aka fee for service |
| Prospective Reimbursement | Amount is determined before the service is provided and is based on arrangement between provider and payer; aka managed care |
| Unit of Service Reimbursement | Provider is reimbursed pre-determined fee for each unit (such as a visit, procedure) |
| Bundled Payments | A fix amount is paid to treat patient and is shared by the providers |
| Capitation | Plan pays provider a fixed amount per employee in exchange for specified set of services (whether or not they are used) |
| Medicare Reimbursement | Prospective method; based on Diagnosis Related Group-hosp, Resource Utilization Group-SNF, Home Health Resource Group-home health, Outpt Prospect Pay System-Outpt, Resource-Based Relative Value System (flat fee)-Phys office |
| Medicaid Reimbursement | Varies by state but is usually lower than other providers |
| Quality Assurance | Focuses on eliminating errors and sets acceptable threshold levels |
| Quality Improvement | aka Continuous Quality Improvement; investigates the causes and solutions to errors, implements improvement and evaluates results |
| Total Quality Management | A philosophy with three principles: customer focus, continuous improvement and teamwork |
Created by:
epijoy