Health Care U. S. A. : Understanding Its Organization and Delivery,9780834208414

Health Care U. S. A. : Understanding Its Organization and Delivery

by Harry A. Sultz; Kristina M. Young

ISBN13: 9780834208414

ISBN10: 0834208415

Format: Hardcover

Pub. Date: 1997-04-01

Publisher(s): Wolters Kluwer

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Summary

This book is the first survey reference of the US health care system with a sharply defined population-based perspective. In this timely text, you'll learn how today's health care system workshow it got that way, and where it's likely to go. An ideal teaching tool, Health Care USA is organized in a succession of chapters that both stand alone and, when read in sequence, complete the reader's understanding of the total health care system. it features a student-friendly format, with easy-to-understand language, and includes a faculty guide with discussion questions, class assignments, and examination suggestions. An instructor's manual is available upon request.

Table of Contents

Foreword	p. xi
Acknowledgments	p. xiii
Introduction	p. xv
Overview of Health Care: A Population Perspective	p. 1
Problems of Health Care	p. 2
Understanding Health Care	p. 3
Why Patients and Providers Behave the Way They Do	p. 4
Indexes of Health and Disease	p. 5
Natural Histories of Disease and the Levels of Prevention	p. 6
Major Stakeholders in the U.S. Health Care Industry	p. 9
Long-Term Care	p. 15
Development of Managed Care	p. 17
Rural Health Networks	p. 19
Priorities of Health Care	p. 20
Social Choices of Health Care	p. 23
The Aging Population	p. 23
Access to Health Care	p. 26
Quality of Care	p. 28
Conflicts of Interest	p. 28
Health Care's Ethical Dilemmas	p. 29
Benchmark Developments in U.S. Health Care	p. 31
The Great Depression and the Birth of Blue Cross	p. 33
The Dominant Influence of Government	p. 34
Health Maintenance Organizations	p. 38
The Reagan Administration	p. 39
Biomedical Advances: Evolution of High-Technology Medicine	p. 40
Roles of Medical Education and Specialization	p. 42
Influence of Interest Groups	p. 44
Public Health Focus on Prevention	p. 49
Economic Influences: Rising Costs	p. 50
The Uninsured and Problems of Access to Medical Care	p. 50
The Aging of America	p. 51
Values and Assumptions That Guide Priorities	p. 52
Oregon Death with Dignity Act	p. 54
Provisions of the Oregon Death with Dignity Act	p. 55
The Internet and Health Care	p. 55
The Basic Issues	p. 56
Hospitals: Origin, Organization, and Performance	p. 60
Historical Perspective	p. 60
Sources That Shaped the Hospital Industry	p. 63
Growth and Decline in Numbers of Hospitals	p. 65
Types of Hospitals	p. 65
Financial Condition of Hospitals	p. 67
Academic Health Centers, Medical Education, and Specialization	p. 68
The Balanced Budget Act and Academic Medical Centers	p. 69
The Hospital System of the Department of Veterans Affairs	p. 69
Structure and Organization of Hospitals	p. 70
Types and Roles of Patients	p. 77
Rights and Responsibilities of Hospitalized Patients	p. 78
Important Decisions, Informed Consent, and Second Opinions	p. 81
Diagnosis-Related Group Hospital Reimbursement System	p. 83
Discharge Planning	p. 84
Subacute Care	p. 85
Market-Driven Reforms Affecting Hospitals	p. 86
Integrated Health Systems	p. 91
Market Responses to Managed Care	p. 95
The Quality of Hospital Care	p. 97
Variations in Medical Care	p. 99
Hazards of Hospitalization	p. 100
Current Research Efforts in Quality Improvement	p. 102
Responsibility of Governing Boards for Quality of Care	p. 103
Incremental Quality Improvement	p. 105
Forces of Reform: Cost, Quality, and Access	p. 106
Ambulatory Care	p. 110
Overview and Trends	p. 110
Private Medical Office Practice	p. 113
Other Ambulatory Care Practitioners	p. 116
Ambulatory Care Services of Hospitals: History and Trends	p. 116
Hospital Emergency Services	p. 121
Free-Standing Services	p. 123
Community Health Centers	p. 129
Public Health Services	p. 131
Voluntary Agencies	p. 133
Conclusion	p. 134
Medical Education and the Changing Practice of Medicine	p. 137
The Flexner Report and Medical School Reforms	p. 139
Academic Medical Centers	p. 140
Graduate Medical Education Consortia	p. 143
Delineation and Growth of Medical Specialties	p. 145
Specialty Boards and Residency Performance	p. 146
Funding of Graduate Medical Education	p. 149
Physician Surplus and U.S. Medical Schools	p. 149
The Generalist/Specialist Imbalance	p. 151
Primary Care Physicians--Gatekeepers of the System	p. 152
Preventive Medicine	p. 153
Changing Physician/Hospital Relationships	p. 154
Cost Containment and the Restructuring of Medical Practice	p. 155
Hold Harmless Clauses	p. 157
Clinical Practice Guidelines	p. 157
Physician Report Cards	p. 159
Growing Concern about Ethical Issues	p. 160
Physicians and the Internet	p. 161
Provider Network Contracting	p. 162
The Future of Medical Practice	p. 163
Health Care Personnel	p. 169
Health Professions	p. 170
Health Care Personnel and Health Care Reforms	p. 171
Credentialing and Regulating Health Professionals	p. 171
Health Care Occupations	p. 173
Alternative Therapists	p. 194
Factors That Influence Demand for Health Personnel	p. 197
Health Care Work Force Issues	p. 200
Conclusion	p. 200
Financing Health Care	p. 207
Health Care Expenditures in Perspective	p. 207
New Diagnostic and Treatment Technology	p. 209
The Aging of America	p. 210
The Growth of Specialized Medicine	p. 212
The Uninsured and Underinsured	p. 212
A Labor-Intensive Industry	p. 214
Economic Incentives That Fuel Rising Costs	p. 214
Components of Health Care Expenditures	p. 214
Sources of Health Care Payment	p. 215
Evolution of Health Insurance: Third-Party Payment	p. 217
Self-Funded Insurance Programs	p. 221
Government as a Source of Payment	p. 222
The Future: Continuing Change	p. 250
Managed Care	p. 257
Historical Perspective	p. 257
Managed Care Fundamentals	p. 260
HMO Act of 1973	p. 262
The Evolution of Managed Care	p. 264
Emerging Developments in Managed Care	p. 268
Medicare and Medicaid Managed Care	p. 270
Managed Care Organizations and Quality	p. 272
The Future of Managed Care	p. 275
Long-Term Care	p. 279
Long-Term Care and the Continuum of Care	p. 279
Development of Long-Term Care Services	p. 281
Modes of Long-Term Care Service Delivery	p. 284
Innovations in Long-Term Care	p. 305
Long-Term Care Insurance	p. 308
The Future of Long-Term Care	p. 309
Mental Health Services	p. 316
Historical Perspective	p. 316
Recipients of Mental Health Services	p. 320
Special Populations	p. 326
The Organization and Financing of Mental Health Services	p. 328
Health Insurance Coverage and Managed Behavioral Health Care	p. 331
Barriers to Accessing Services	p. 338
Priorities for Mental Health Services	p. 339
Need for Further Research	p. 341
Public Health and the Role of Government in Health Care	p. 348
Historical Perspective	p. 348
Decline in Influence of the Public Health Service	p. 358
Responsibilities of the Public Health Sector	p. 359
Relationships of Public Health and Private Medicine	p. 362
Resource Priorities Favor Curative Medicine	p. 364
Health Care Reform and the Public Health/Medicine Relationship	p. 365
Hospital-Sponsored Public Health Activities	p. 366
Public Health Services of Voluntary Agencies	p. 367
Changing Roles of Government in Public Health	p. 368
Public Health in an Era of Privatization and Managed Care	p. 369
Federal Support To Address Emerging Health Issues	p. 371
Future Role of Government in Promoting the Public's Health	p. 372
Research: How Health Care Advances	p. 376
The Focus of Different Types of Research	p. 377
Research in Health and Disease	p. 377
Epidemiology	p. 378
Health Services Research	p. 380
Agency for Healthcare Research and Quality (Formerly the Agency for Health Care Policy and Research)	p. 380
Health Services Research and Health Policy	p. 383
Quality Improvement	p. 384
Outcomes Research	p. 390
Patient Satisfaction	p. 391
Research Ethics	p. 392
Future Challenges	p. 393
The Future of Health Care	p. 398
The Paradox of U.S. Health Care	p. 399
Organizations and Facilities	p. 400
Corporate Growth in Health Care	p. 402
Corporate Alliances	p. 404
Future of Managed Care	p. 405
Growth of Home, Outpatient, and Ambulatory Care	p. 407
Technology	p. 408
Personnel	p. 409
Physicians	p. 410
Academic Health Centers	p. 413
Health Professions	p. 414
Nurses	p. 416
Nurse Practitioners	p. 417
Physician Assistants	p. 417
Future Role of the Federal Government	p. 417
Conclusion	p. 419
Abbreviations and Acronyms	p. 428
Web Sites	p. 439
Index	p. 442
About the Authors	p. 461
Table of Contents provided by Syndetics. All Rights Reserved.