Delivering health care in America : a systems approach / Leiyu Shi, Douglas A. Singh.

Format:

Book

Author/Creator:

Shi, Leiyu.

Contributor:

Singh, Douglas A., 1946-

Language:

English

Subjects (All):

Medical care--United States.

Medical care.

United States.

Medical policy--United States.

Medical policy.

Delivery of Health Care.

Health Policy.

Medical Subjects:

Delivery of Health Care.

United States.

Health Policy.

Physical Description:

xxv, 652 pages : illustrations ; 26 cm

Edition:

Third edition.

Place of Publication:

Sudbury, MA : Jones and Bartlett, [2004]

Contents:

Chapter 1 A Distinctive System of Health Care Delivery 1

An Overview of the Scope and Size of the System 2

A Broad Description of the System 4

Basic Components of a Health Services Delivery System 5

A Disenfranchised Segment 7

Transition from Traditional Insurance to Managed Care 8

Primary Characteristics of the US Health Care System 9

Trends and Directions 19

Significance for Health Care Practitioners and Policy Makers 19

Significance for Health Care Managers 20

Health Care Systems of Other Countries 22

The Systems Framework 28

Part I System Foundations 35

Chapter 2 Beliefs, Values, and Health 37

Significance for Managers and Policy Makers 38

Determinants of Health 49

Cultural Beliefs and Values 54

A Social Model of Health 56

Equitable Distribution of Health Care 57

Justice in the US Health Delivery System 61

Integration of Individual and Community Health 64

Measures of Health Status 67

Measures of Health Services Utilization 73

Chapter 3 The Evolution of Health Services in the United States 81

Medical Services in Preindustrial America 83

Medical Services in Postindustrial America 87

Recent Evolutions and the 21st Century 107

Part II System Resources 115

Chapter 4 Health Services Professionals 117

Physicians 119

Dentists 134

Pharmacists 136

Other Doctoral-Level Health Professionals 137

Nurses 137

Nonphysician Practitioners 140

Allied Health Professionals 143

Health Services Administrators 145

Chapter 5 Medical Technology 155

Information Technology 157

The Diffusion and Use of Medical Technology 160

Managed Care and Technology Diffusion 164

The Government's Role in Technology Diffusion 164

The Impact of Medical Technology 168

The Assessment of Medical Technology 174

The Role of the Private Sector in Technology Assessment 178

Implications for Policy and Management 179

Chapter 6 Health Services Financing 187

The Role and Scope of Health Services Financing 188

Financing and Cost Control 189

The Insurance Function 191

Private Financing 191

Public Financing 197

Miscellaneous Private and Public Programs 209

The Payment Function 211

National Health Care Expenditures 217

Problems and Issues in Financing 223

Trends and Directions 226

Part III System Processes 235

Chapter 7 Outpatient and Primary Care Services 237

The Scope of Outpatient Services 239

Primary Care 241

Community-Oriented Primary Care 245

Primary Care Providers 246

Growth in Outpatient Services 247

Reasons for the Growth in Outpatient Services 249

Types of Outpatient Care Settings and Methods of Delivery 251

Utilization of Outpatient Services 271

Chapter 8 Inpatient Facilities and Services 281

Transformation of the Hospital in the United States 283

Expansion of Hospitals in the United States 287

Hospital Downsizing Since 1985 289

Some Key Utilization Measures and Operational Concepts 291

Hospital Employment 296

Types of Hospitals 297

What Makes a Hospital Nonprofit? 307

Some Management Concepts 309

Licensure, Certification, and Accreditation 312

Ethical and Legal Issues in Patient Care 313

Hospitals and Public Trust 315

The Future Outlook for Hospitals 316

Chapter 9 Managed Care and Integrated Organizations 323

Evolution of Managed Care 328

Growth of Managed Care 331

Cost Control Methods in Managed Care 334

Types of Managed Care Organizations 339

Trends in Managed Care 347

Impact on Cost, Access, and Quality 350

Managed Care Backlash and the Future 352

Managed Care Legislation 353

Consolidation, Expansion, Diversification, and Integration 355

Integrated Delivery Systems 357

Types of Integration 358

Issues Related to Integration 362

Chapter 10 Long-Term Care 371

The Nature of Long-Term Care 377

The Clients of Long-Term Care 384

Types of Community-Based Long-Term Care Services 388

Institutional Long-Term Care 396

Specialized Facilities 402

Institutional Demographics of Long-Term Care Facilities 404

Sources of Financing Nursing Home Care 408

Future Financing of Long-Term Care 412

Prospective Payment System for SNFs 412

Requirements of Participation 413

Chapter 11 Health Services for Special Populations 423

Racial/Ethnic Minorities 424

The Uninsured 438

Children 440

Women 443

Rural Health 447

The Homeless 450

Mental Health 453

The Chronically Ill and Disabled 457

HIV/AIDS 459

Part IV System Outcomes 481

Chapter 12 Cost, Access, and Quality 483

Cost of Health Care 484

Reasons for Cost Escalation 491

Cost Containment

Regulatory Approaches 498

Competitive Approaches 504

Access to Care 505

Quality of Care 514

Dimensions of Quality 515

Quality Assurance 518

Quality Assessment 519

Quality Report Cards 524

Chapter 13 Health Policy 533

The Principal Features of US Health Policy 536

The Development of Legislative Health Policy 544

Critical Policy Issues 548

The Future of Health Policy 555

Part V System Outlook 561

Chapter 14 The Future of Health Services Delivery 563

The Next Stage in Employer-Based Health Insurance 566

Future Challenges for Managed Care 568

Future of Financing and Insurance 569

Comprehensive Reform: If and When It Occurs 572

National and Global Challenges 576

Bioterrorism and the Transformation of Public Health 579

Future of the Health Care Workforce 581

Work Organization 583

Enhanced Focus on Customer Service 584

New Frontiers in Technology 585

Outcome Measurement, Monitoring, and Assessment 587.

Notes:

Includes bibliographical references and index.

ISBN:

0763731994

OCLC:

52494322