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:

xxviii, 649 pages : illustrations ; 26 cm

Edition:

Fourth edition.

Place of Publication:

Sudbury, Mass. : Jones and Bartlett, [2008]

Summary:

In a clear, cohesive format, Delivering Health Care in America provides a comprehensive overview of the basic structures and operations of the U.S. health system-from its historical origins and resources to its individual services, cost, and quality. Using the unique "systems" approach, it brings together an extraordinary breadth of information into a highly accessible, easy-to-read text that clarifies the complexities of healthcare organization and finance, while presenting a solid overview of how the various components fit together.

The Fourth Edition has been thoroughly updated with the most current information on trends and issues in health care, including: Mandates of recent legislation such as the Medicare Prescription Drug Act and the Deficit Reduction Act, The global threat of avian influenza, Health policy agenda of the Bush administration, Progress toward Healthy People 2010 goals, The effects of corporatization, information revolution, and globalization on healthcare delivery, Pay-for-performance initiatives, Updated information on health services for special populations, State Children's Health Insurance Plan reauthorization issues, The President's Emergency Plan for AIDS Relief, Insurance restructuring in Massachusetts, Challenges in long-term care and trends in home healthcare services, The era of evidence-based medicine.

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 Policymakers 19

Significance for Health Care Managers 20

Health Care Systems of Other Countries 21

The Systems Framework 28

Part I System Foundations

Chapter 2 Beliefs, Values, and Health 37

Significance for Managers and Policymakers 38

Health Promotion and Disease Prevention 44

Developmental Health 45

Public Health 45

Health Protection 46

Quality of Life 48

Determinants of Health 49

Overarching Factors and Implications for Health Care Delivery 53

A Social Model of Health 56

Equitable Distribution of Health Care 56

Justice in the US Health Delivery System 60

Equality in the US Health Care Delivery System 61

Integration of Individual and Community Health 64

Measures of Health Status 68

Evaluation of Health Status 68

Demographic Change 71

Measures of Mental Health 72

Measures of Social Health 72

Measures of Spiritual Health 73

Measures of Health Services Utilization 73

Chapter 3 The Evolution of Health Services in the United States 83

Medical Services in Preindustrial America 85

Medical Services in Postindustrial America 89

Medical Care in the Corporate Era 109

Part II System Resources

Chapter 4 Health Services Professionals 119

Physicians 122

Some Key Issues in Medical Practice Involvement in the Development of Clinical Practice Guidelines 128

International Medical Graduates 136

Dentists 137

Pharmacists 138

Other Doctoral-Level Health Professionals 139

Nurses 140

Nonphysician Practitioners 142

Allied Health Professionals 146

Health Services Administrators 148

Appendix 4-A List of Professional Associations 152

Chapter 5 Medical Technology 161

What Is Medical Technology? 163

Information Technology and Informatics 163

Innovation, Diffusion, and Utilization of Medical Technology 168

Managed Care and Technology Diffusion 173

The Government's Role in Technology Diffusion 173

The Impact of Medical Technology 177

The Assessment of Medical Technology 182

Current and Future Directions in Health Technology Assessment 186

Chapter 6 Health Services Financing 197

The Role and Scope of Health Services Financing 198

Financing and Cost Control 199

The Insurance Function 201

Private Financing 202

Public Financing 207

Miscellaneous Private and Public Programs 222

The Payment Function 224

National Health Care Expenditures 229

Trends, Problems, and Issues in Insurance and Financing 233

Part III System Processes

Chapter 7 Outpatient and Primary Care Services 243

What Is Outpatient Care? 244

The Scope of Outpatient Services 245

Primary Care 245

Community-Oriented Primary Care 251

Primary Care Providers 251

Growth in Outpatient Services 253

Reasons for the Growth in Outpatient Services 255

Types of Outpatient Care Settings and Methods of Delivery 257

Utilization of Outpatient Services 275

Chapter 8 Inpatient Facilities and Services 289

Transformation of the Hospital in the United States 290

The Expansion Phase: Late 1800s to Mid-1980s 294

The Downsizing Phase: Mid-1980s Onward 297

Some Key Utilization Measures and Operational Concepts 299

Hospital Employment 304

Types of Hospitals 305

What Makes a Hospital Nonprofit? 315

Some Management Concepts 317

Licensure, Certification, and Accreditation 319

Ethical and Legal Issues in Patient Care 321

Hospitals and Public Trust 323

Chapter 9 Managed Care and Integrated Organizations 333

What Is Managed Care? 336

Evolution of Managed Care 338

Growth of Managed Care 341

Efficiencies and Inefficiencies in Managed Care 343

Cost Control Methods in Managed Care 344

Types of Managed Care Organizations 349

Trends in Managed Care 355

Impact on Cost, Access, and Quality 358

Managed Care Backlash, Regulation, and the Aftermath 360

Consolidation, Expansion, Diversification, and Integration 362

Integrated Delivery Systems 363

Types of Integration 364

Issues Related to Integration 368

Chapter 10 Long-Term Care 379

The Nature of Long-Term Care 383

Long-Term Care Services 385

The Clients of Long-Term Care 392

Types of Community-Based Long-Term Care Services 396

Institutional Long-Term Care 403

Specialized Facilities 408

Nursing Home Industry and Patient Demographics 409

Patient Assessment and Prospective Payment for SNFs 418

Requirements of Participation 418

Chapter 11 Health Services for Special Populations 427

Racial/Ethnic Minorities 428

The Uninsured 441

Children 443

Women 446

Rural Health 450

The Homeless 453

Mental Health 456

The Chronically Ill and Disabled 460

HIV/AIDS 462

Part IV System Outcomes

Chapter 12 Cost, Access, and Quality 483

Cost of Health Care 484

Reasons for Cost Escalation 491

Cost Containment-Regulatory Approaches 498

Cost Containment-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

What Is Health Policy? 534

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

Chapter 14 The Future of Health Services Delivery 561

Trends in Private and Public Health Insurance 563

Future Options in Financing and Insurance 566

Future Challenges for Managed Care 569

Comprehensive Reform: If and When It Occurs 570

National and Global Challenges 574

Bioterrorism and the Transformation of Public Health 579

The Future Outlook for US Hospitals 580

Future of the Health Care Workforce 581

Work Organization 584

Enhanced Focus on Customer Service 585

New Frontiers in Clinical Technology 586

The Era of Evidence-Based Health Care 587

Appendix B Selected Web Sites 621.

Notes:

Includes bibliographical references and index.

ISBN:

076374512X

9780763745127

OCLC:

85885364