1

1. All of the following are measures of process of health care in a clinic except:

   Proportion of patients in whom blood pressure is measured

   Proportion of patients who have complications of a disease

   Proportion of patients advised to stop smoking

   Proportion of patients whose height and weight are measured

   Proportion of patients whose bill is reduced because of financial need

1 points

QUESTION 2

1. In-Hospital Case-Fatality Rates (CFRs) for 100 Men Not Treated in a Coronary Care Unit (CCU) and for 100 Men Treated in a CCU, According to Three Clinical Grades of Severity of Myocardial Infarction
   	Non-CCU (Number of Patients)	CCU (Number of Patients)
   Clinical Grade	Total	Died	CFR (%)	Total	Died	CFR (%)
   Mild	60	12	20	10	3	30
   Severe	36	18	50	60	18	30
   Shock	4	4	100	30	13	43

   The results shown were based on a comparison of the last 100 patients treated before the CCU was installed and the first 100 patients treated within the CCU. All 200 patients were admitted during the same month.

   You may assume that the CCU was very beneficial for men with severe MI and for those in shock, because the in-hospital CFRs for these categories were much lower in the CCU. This conclusion:

   Is correct

   May be incorrect because CFRs were used rather than mortality rates

   May be incorrect because of a referral bias of patients to this hospital from hospitals in distant towns

   May be incorrect because of differences in the assignment of the clinical severity grade before and after the opening of the CCU

   May be incorrect because of failure to recognize a possible decrease in the annual incidence rate of MI in recent years

1 points

QUESTION 3

1. The extent to which a specific health care treatment, service, procedure, program, or other intervention does what it is intended to do when used in a community-dwelling population is termed its:

   Efficacy

   Effectiveness

   Effect modification

   Efficiency

   None of the above

1 points

QUESTION 4

1. The extent to which a specific health care treatment, service, procedure, program, or other intervention produces a beneficial result under ideal controlled conditions is its:

   Efficacy

   Effectiveness

   Effect modification

   Efficiency

   Efficiency

1 points

QUESTION 5

1. A major problem in using a historical control design for evaluating a health service using case-fatality rate (CFR) as an outcome is that if the CFR is lower after provision of the health service was started, then:

   The lower CFR could be caused by changing prevalence of the disease

   The lower CFR may be a result of decreasing incidence

   The lower CFR may be an indirect effect of the new health service

   The CFR may have been affected by changes in factors that are not related to the new health service

   None of the above