Organizational Frameworks and Structure

Every question here, with the answer

1. A nurse is helping an underinsured patient plan follow-up care after an emergency department visit. The patient asks which type of hospital is expected to function as a safety-net facility regardless of ability to pay. Which response is most accurate?

   1. Independent physician practice
   2. Single-specialty group practice
   3. State and local government hospital
   4. For-profit hospital

   Answer: State and local government hospital

   State and local government hospitals are described as safety-net facilities that provide care for uninsured or underinsured patients regardless of ability to pay. For-profit hospitals rarely function as safety-net hospitals, and independent or single-specialty practices are provider practice types rather than the hospital delivery system described here.

2. A community health nurse is referring a family to services commonly provided by state and local health departments. Which services should the nurse include? Select all that apply.

   1. Returning profits to shareholders
   2. Monitoring communicable diseases
   3. WIC support for women, infants, and children
   4. Setting hospital profit expectations for investors
   5. Testing and reporting of communicable diseases

   Answer: Monitoring communicable diseases, WIC support for women, infants, and children, Testing and reporting of communicable diseases

   State and local health departments administer WIC, monitor communicable diseases, and manage communicable disease testing and reporting. Returning profits to shareholders and setting investor profit expectations are associated with for-profit organizations, not local public health departments.

3. A nursing student is comparing international healthcare models. In one model, employed people have insurance paid by both the employee and employer, prices are controlled by the government, and medical facilities are private. Which model is the student describing?

   1. Out-of-pocket model
   2. Beveridge model
   3. Bismarck model
   4. National health insurance model

   Answer: Bismarck model

   The Bismarck model is described as social health insurance in which employed people have insurance paid by themselves and their employer, with government-controlled prices and private facilities. The other models differ in payer structure, facility ownership, or reliance on patients paying for their own care.

4. A nurse manager is evaluating whether a proposed partnership among a clinic, hospital, and community agency reflects the goals of an integrated delivery system. Which goals should the nurse manager identify? Select all that apply.

   1. Sharing resources to support care
   2. Sharing information among participating providers and agencies
   3. Limiting care to only one level of need
   4. Keeping each organization separate so providers do not collaborate
   5. Sharing responsibility for care

   Answer: Sharing resources to support care, Sharing information among participating providers and agencies, Sharing responsibility for care

   Integrated delivery systems are intended to share information, responsibility, and resources to provide the best care. Keeping organizations separate or limiting care to one level conflicts with the collaborative and integrated purpose described in the section.

5. A hospital board is considering whether to continue services that are needed by the community but have poor profitability, such as burn care or obstetrics. Which hospital type is more likely to offer these services because it serves the community and does not answer to shareholders?

   1. Not-for-profit hospital
   2. Independent practice
   3. For-profit hospital
   4. Out-of-pocket model facility

   Answer: Not-for-profit hospital

   Not-for-profit hospitals are more likely to provide services with poor profitability because they have a mandate to serve the community and do not answer to shareholders. For-profit hospitals are under pressure to earn profit, while an out-of-pocket model and independent practice do not describe this hospital obligation in the section.

6. A patient is referred to a multispecialty group practice. Which services or specialties would be consistent with the example of this type of practice in the section? Select all that apply.

   1. Physical therapy
   2. Primary care
   3. General surgery
   4. A single physician operating a solo independent practice
   5. Pulmonology

   Answer: Physical therapy, Primary care, General surgery, Pulmonology

   A multispecialty group may include primary care, pulmonology, general surgery, and physical therapy in one location or related locations. A single physician operating a solo practice describes an independent practice, not a multispecialty group.