Health Services Research
Final Exam
Course Introduction
Health Services Research is an interdisciplinary course that explores the organization, delivery, and effectiveness of health care services. Students will examine methodologies for evaluating health care interventions, policies, and systems, focusing on issues such as access, quality, cost, and outcomes. The course covers quantitative and qualitative research methods, data sources, and analytical strategies used to assess health services, with an emphasis on how research findings inform health policy and improve patient care. Through case studies and real-world applications, students will develop critical skills in designing and conducting research to address current challenges in health care systems.
Recommended Textbook
Health Care Economics 7th Edition by Paul
J. Feldstein
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18 Chapters
357 Verified Questions
357 Flashcards
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Chapter 1: An Introduction to the Economics of Medical Care
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Sample Questions
Q1) Demand curves are downward sloping because of
A)Increasing marginal cost
B)Diminishing marginal cost
C)Increasing marginal benefit
D)Diminishing marginal benefit
Answer: D
Q2) Suppose the government institutes new regulations on physicians requiring physicians to take additional years of training before practicing medicine.What will happen to the wages and quantity of physicians?
A)Wages decrease;number of physicians increases
B)Wages increase;number of physicians increases
C)Wages decrease;number of physicians decreases
D)Wages increase;number of physicians decreases
Answer: D
Q3) Supply curves are upward sloping because of
A)Law of increasing marginal cost
B)Law of diminishing marginal cost
C)Law of increasing marginal returns
D)Law of diminishing marginal returns
Answer: D
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Chapter 2: The Role of Government in Health and Medical Care
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Sample Questions
Q1) Each inpatient day at the teaching hospital helps train medical residents to become better physicians.This has a social external benefit MEB to society of $200 per inpatient day.Graph the MEB curve and find the socially optimal price and quantity.
Answer: In this case,the socially optimum quantity is found where the MPC = MPB+MEB. 200=1200-4Q
4Q=1000
Q=250
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Q2) Which of the following is an example of an externality in the cigarette market?
A)firsthand smoke
B)secondhand smoke
C)Increase in the price of tobacco
D)Increase in the price of a competitors' cigarettes
Answer: B
Q3) Graph the Marginal Private Cost (MPC)and the Marginal Private Benefit.
Answer: 11ea48be_8914_81ef_b057_a5da371a5ee7_TB2105_00
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Page 4
Chapter 3: Health Policy and the Legislative Marketplace
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Sample Questions
Q1) Which of the following is an example of a regressive tax?
A)Sales tax
B)Federal income tax
C)Federal estate tax
D)Federal gift tax
Answer: A
Q2) Explain why the AMA supports a requirement of employer sponsored health insurance,but not a public health insurance option?
Answer: A large public health insurance company can impose monopsony power and force medical providers to accept lower prices for services than those that can be negotiated with smaller private firms.
Q3) Dental hygienists are considered compliments to dentist.Therefore,dentists would support legislation
A)Allowing dental hygienists to independently open dental offices.
B)Limiting the expansion of dental hygienists.
C)Requiring additional education to become a dental hygienist.
D)None of the above
Answer: D
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5
Chapter 4: The Production of Health: the Impact of Medical
Services on Health
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Sample Questions
Q1) Compare cost-utility analysis to cost-effective analysis.
Q2) A process that determines how many dollars will be returned for dollars invested in a health promotion program is called
A)cost-benefit analysis
B)cost-revenue analysis
C)cost-utility analysis
D)cost-effectiveness analysis
Q3) Between 1968 and 1976,medical intervention accounted for
A)More than 60% of the decline in ischemic heart disease mortality
B)Between 40 and 60% of the decline in ischemic heart disease mortality
C)Less than 40% of the decline in ischemic heart disease mortality
Q4) The QALYs (quality adjusted life years)measure of health captures the idea that people may be willing to accept
A)Longer life with better health.
B)Shorter life with better health.
C)Longer life with worse health.
D)Shorter life with worse health.
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Chapter 5: An Overview of the Medical Care Sector
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Sample Questions
Q1) What are the prices and quantities in each of the three markets of the medical sector?
Q2) Currently,the federal government subsidizes medical education in the form of reimbursement for direct medical education (DME)and indirect medical education (IME)expenditures.These expenditures are reimbursed via Medicaid and Medicare.How would the three markets react to an elimination of this federal subsidy?
Q3) Which type of market is not present in the medical care sector?
A)Institutional
B)Management
C)Manpower
D)Educational
Q4) The Balance Budget Act of 1997 for Medicare and Medicaid decreased the reimbursement rate for hospitals by the number of beds they had available.Hospitals responded by
A)Expanding the number of beds
B)Increasing their demand for input
C)Both a and b
D)Neither a nor b
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Chapter 6: The Demand for Medical Care
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Sample Questions
Q1) According to Michael Grossman,consumers have a demand for health because
A)It is a consumption commodity
B)It is an investment commodity
C)Both a and b
D)Neither a nor b
Q2) Determining the quantity of medical services based on need instead of the market can lead to
A)An over provision of medical services
B)An under provision of medical services
C)Both a and b
D)Neither a nor b
Q3) Discuss the results of the RAND Health Insurance Experiment.Specifically,did the generosity of the health insurance plan affect the level of medical care use? Did the generosity of the health insurance plan affect overall health,on average?
Q4) Discuss the role of physicians on patients' demand for medical services.
Q5) Assume that the patient's out-of-pocket price for visiting a physician is $30 and that the time costs are equal to $50.Assume the elasticity of the medical service,with respect to the total price,was -2.0.If the out-of-pocket price dropped 50 percent,by what percent does the number of visits change?
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Chapter 7: The Demand for Health Insurance
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Sample Questions
Q1) Purchasing additional medical services because you are covered by health insurance is an illustration of
A)The adverse selection problem
B)The moral hazard problem
C)A failure of the market for externalities
D)The existence of spillover benefits
Q2) It is flu season,and you are trying to decide if you should get a flu shot.When you are healthy,you earn $144 a day,but if you become ill,you will only earn $100 a day.There is a 25% chance you will get the flu without a flu shot.If you do receive the flu shot,then you definitely will not get the flu.What is the actuarially fair price for the flu shot given this information?
A)$44
B)$33
C)$22
D)$11
Q3) Suppose the inverse demand for physician office visits is P = 1000 - 20Q.Now suppose an insurance policy provides a co-insurance rate of 50%.Graph the new demand function with health insurance.
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Chapter 8: The Supply of Medical Care: an Overview
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Sample Questions
Q1) If a hospital displays decreasing average costs on output,should the hospital be regulated even though it is more efficient?
Q2) If a hospital is experiencing economies of scale,
A)Its average cost curve is positively sloped as output increases.
B)Its average cost curve is negatively sloped as output increases.
C)It should reduce its output level to lower costs.
D)Quality is falling as output is rising.
E)Both b and c are true.
Q3) Which market structure is characterized by a large number of differentiated firms?
A)Monopolistic competition
B)Monopoly
C)Oligopoly
D)Perfect competition
Q4) The average fixed cost curve is
A)U shaped with output
B)Always increasing with output
C)Always decreasing with output
D)None of the above
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10
Chapter 9: Market Competition in Medical Care
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Sample Questions
Q1) Explain how the lack of information to patients about plans and physicians leads to more market distortions.
Q2) Explain how the new payment system for hospitals instituted by the National Health Services of Britain affected hospital stay length,expenditures,and mortality.
Q3) Tax exemption of health insurance leads to _________ market distortion._________ health insurance choices leads to _________ market distortion.
A)More;More;more
B)More;More;less
C)Less;Less;less
D)More;More;more.
E)None of the above
Q4) Compare the quality difference in care between HMOs and traditional health insurance.
Q5) Health insurance providers in order of increasing management are
A)FFS,PPO,HMO
B)PPO,FFS,HMO
C)FFS,HMO,PPO
D)PPO,HMO,FFS
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Chapter 10: The Market for Health Insurance: Its
Performance and Structure
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Sample Questions
Q1) Premiums based on experience ratings
A)Are uniform across age groups.
B)Are based on the loss experience of the insured.
C)Vary depending on the income of the insured.
D)Are illegal in most states in the United States
E)Are only used in property-casualty insurance underwriting.
Q2) Assume the health insurance market is perfectly competitive.If the benefit/premium ratio is 0.90 and the premium is $1,000,how much are administrative cost?
Q3) Blue Cross and Blue Shield uses
A)Experience rating premiums
B)Community rating premiums
C)Uniform rating premiums
Q4) Explain why the use of community-rated premiums leads to economic inefficiencies.
Q5) A movement of the medical loss ratio from .6 to .8 indicates an
A)Increase in administrative cost per enrollee
B)Decrease in administrative cost per enrollee
C)No difference in administrative cost per enrollee
Page 12
Q6) Do high concentration ratios have an effect on input prices?
Q7) Explain why insurance companies may be hesitant to increase relative premiums.
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Chapter 11: The Physician Services Market
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Sample Questions
Q1) A specific opportunity cost of attending medical school is:
A)The tuition fee
B)The foregone income
C)The sleep deprivation and fatigue during arduous internships
D)All of the above
Q2) Which of the following statements about the distribution of physicians among specialties is true in the United States?
A)The majority of physicians specialize in general/family practice
B)There are twice as many generalists as there are specialists
C)There are twice as many specialists as there are generalists
D)The specialty distribution in the United States is similar to that of the rest of the world
E)None of the above
Q3) What are the reasons why both the size of medical groups and their numbers have Explain.
Q4) On average,the training costs (both money and time)for a physician are felt to explain
A)Virtually not at all the high income of physicians
B)Partially the high income of physicians
C)Completely the high income of physicians
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Chapter 12: The Market for Hospital Services
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Sample Questions
Q1) The quality of hospitals used by HMOs is on average
A)Greater than non-HMO hospitals
B)Equal to non-HMO hospitals
C)Less than non-HMO hospitals
Q2) You are a consultant and have been employed by a large inner-city hospital called City Hospital to estimate the demand for its services.Your research indicates that the income elasticity of demand for the target market is +0.50;the price elasticity of demand is -0.15;and the cross-price elasticity of demand with respect to the price of services at Rural Hospital,a near-by hospital,is +0.35.Answer the following questions.
The price of services at Rural Hospital falls by 10%.What happens to the quantity of services demanded at City Hospital?
A)Quantity demanded rises by 35.0%
B)Quantity demanded falls by 3.5%
C)Quantity demanded falls by 1.5%
D)Quantity demanded rises by 5.0%
E)Quantity demanded stays the same
Q3) Explain why a hospital can be considered a multiproduct firm.
Q4) What are the advantages of using the Herfindahl-Hirschman Index versus a concentration ratio?
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Chapter 13: The Pharmaceutical Industry
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Sample Questions
Q1) Which drug type is expected to have a higher markup over cost?
A)Innovation drugs
B)"Me-too" drugs
C)Both have about the same markup
Q2) If the demand for Lipitor is P = 1000 - 10Q (MR = 1000 -20Q)in the United States and P = 500 -20Q (MR = 500 - 40Q)in Canada,at what price would Lipitor sell at in each country? Assume marginal cost is equal to $100.
Q3) The economic rationale for patent protection for prescription drugs is the
A)Creation of a monopoly that will maximize consumer surplus
B)Redistribution of income to wealthy corporations
C)Privatization of a public good to make it excludable
D)Incentive it provides for medical drug innovation
Q4) Pharmaceutical firms charge different prices in different countries after because
A)Government regulations are different between countries
B)Demand elasticities are different between countries
C)Both a and b
D)Neither a nor b
Q5) Describe methods used by brand-name pharmaceutical companies to delay the entry of generic drugs.
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Chapter 14: Health Manpower Shortages and Surpluses:
Definitions, measurement, and Policies
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Sample Questions
Q1) Suppose the demand for labor is w = 300 - 2Q and the supply of labor is w = Q.If a price floor is set at $200,then the equilibrium
A)Wage is $100 and quantity is 100
B)Wage is $100 and quantity is 50
C)Wage is $200 and quantity is 100
D)Wage is $200 and quantity is 50
Q2) Which of the following is true?
A)Dynamic shortages are resolved over time
B)Static shortages are resolved overtime
C)Both a and b
D)Neither a nor b
Q3) What are the potential pitfalls of using the ratio technique to determine shortages/surpluses?
Q4) Regulators and advocates argue that licensure is appropriate because it:
A)Ensures that patients get high-quality care
B)Increases remuneration to those with the licenses
C)Reduces the incidence of deficient care
D)Both a and c
Page 16
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Chapter 15: The Market for Physician Manpower
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Q1) If a physician cannot charge every patient a different price but can group patients by type and charge each group a different price,this is called
A)First-degree price discrimination
B)Second-degree price discrimination
C)Third-degree price discrimination
D)Fourth-degree price discrimination
Q2) If a physician can charge every patient a different price according to their willingness to pay,this is called
A)First-degree price discrimination
B)Second-degree price discrimination
C)Third-degree price discrimination
D)Fourth-degree price discrimination
Q3) Which action caused a barrier to entry into dentistry?
A)Flexner Report
B)Removal of antitrust protection
C)Gies Report
D)P4P
Q4) Describe how physicians can use price-discrimination to serve both high- and low-income patients.
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Chapter 16: The Market for Medical Education: Equity and Efficiency
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Q1) What are some of the concerns associated with medical school tuition that reflect the true cost of a medical education?
Q2) If medical schools are not using tuition to ration students,what mechanism is being used to ration students and to what end?
Q3) What would be an economic justification for subsidizing a medical education?
Q4) The net effect of the externality on welfare is equal to
A)d + f
B)i
C)h
D)i + d + f + h
Q5) Income Contingent Loan Repayment Plans (ICLRP)have been proposed to encourage medical school graduates to
A)Locate to a rural area
B)Work with underserved populations
C)Locate to an urban area
D)None of the above
Q6) How do we determine economic efficiency in the supply of medical schools?
Page 18
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Chapter 17: The Market for Registered Nurses
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Q1) What are the benefits and cost of a comparable worth-based wage determination system.
Q2) Explain why prior to 1966,the nursing market was experiencing a static shortage.
Q3) Which of the following items has the smallest effect on the wage differential between men and women?
A)Years of experience
B)Years of tenure
C)Sex discrimination
D)Each of the above have the same effect on the wage differential
Q4) Hospital can keep nurses' wages artificially low through
A)Monopoly power
B)Oligopoly power
C)Monospony power
D)Oligospony power
Q5) The vacancy rate of nurses within hospitals was highest during A)1958
B)1962
C)1967
D)1968
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Chapter 18: National Health Insurance: an Approach to the
Redistribution of Medical Care
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Q1) Health Savings Accounts were established by
A)HIPAA
B)CHIP
C)Medicare Prescription Drug Act of 2003
D)PPACA
Q2) Medicaid is financed using a
A)Progressive tax
B)Regressive tax
C)Flat tax
D)None of the above
Q3) Medicare expenditures can be reduced by
A)Reducing payments to the suppliers of Medicare services
B)Increasing the Medicare payroll tax
C)Making Medicare a defined contribution program
D)All of the above
Q4) Life expectancy is higher in Canada than in the United States.
A)True
B)False
Q5) Why is deficit financing politically appealing?
Q6) Explain how a comparative effectiveness board could reduce health care cost. Page 20
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Page 21