Acknowledgments |
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xiii | |
Foreword |
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xv | |
Introduction |
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xvii | |
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Overview of Health Care: A Population Perspective |
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1 | (32) |
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1 | (1) |
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2 | (1) |
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Understanding Health Care |
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3 | (2) |
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Why Patients and Providers Behave the Way They Do |
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5 | (1) |
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Indexes of Health and Disease |
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6 | (1) |
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Natural Histories of Disease and the Levels of Prevention |
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7 | (7) |
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Major Stakeholders in the U.S. Health Care Industry |
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14 | (1) |
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15 | (1) |
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Managed Care Organizations and Other Insurers |
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16 | (1) |
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17 | (1) |
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17 | (1) |
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Voluntary Facilities and Agencies |
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17 | (1) |
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Health Professions Education and Training Institutions |
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17 | (1) |
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Professional Associations |
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18 | (1) |
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Other Health Industry Organizations |
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18 | (1) |
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18 | (1) |
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Development of Managed Care |
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19 | (1) |
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20 | (2) |
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Priorities of Health Care |
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22 | (1) |
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The Tyranny of Technology |
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23 | (2) |
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Social Choices of Health Care |
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25 | (1) |
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25 | (3) |
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28 | (2) |
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30 | (1) |
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30 | (1) |
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Health Care's Ethical Dilemmas |
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31 | (2) |
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Benchmark Developments in U.S. Health Care |
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33 | (28) |
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33 | (2) |
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The Great Depression and the Birth of Blue Cross |
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35 | (2) |
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The Dominant Influence of Government |
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37 | (2) |
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Efforts at Planning and Quality Control |
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39 | (2) |
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The Reagan Administration |
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41 | (1) |
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Biomedical Advances: Evolution of High-Technology Medicine |
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42 | (2) |
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Roles of Medical Education and Specialization |
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44 | (2) |
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Influence of Interest Groups |
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46 | (5) |
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Influences of Business and Labor |
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51 | (1) |
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Public Health Focus on Prevention |
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52 | (1) |
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Economic Influences: Rising Costs |
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52 | (1) |
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The Uninsured and Problems of Access to Medical Care |
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53 | (1) |
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54 | (1) |
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Values and Assumptions That Guide Priorities |
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55 | (1) |
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Oregon Death with Dignity Act |
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56 | (1) |
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57 | (4) |
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Hospitals: Origin, Organization, and Operation |
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61 | (23) |
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61 | (1) |
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62 | (2) |
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Types and Roles of Patients |
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64 | (1) |
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65 | (1) |
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66 | (1) |
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Structure and Organization of Hospitals |
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67 | (7) |
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74 | (1) |
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Rights and Responsibilities of Hospitalized Patients |
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74 | (4) |
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Important Decisions, Informed Consent, and Second Opinions |
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78 | (2) |
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Diagnosis-Related Group Hospital Reimbursement System |
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80 | (2) |
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82 | (2) |
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Hospitals: Reengineered for the Future |
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84 | (29) |
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84 | (1) |
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Forces That Shaped the Hospital Industry |
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85 | (6) |
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The Quality of Hospital Care |
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91 | (2) |
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Landmark Studies of Quality of Hospital Care |
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93 | (4) |
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Market Forces: Managed Care |
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97 | (7) |
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104 | (1) |
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Integrated Care Arrangements |
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105 | (1) |
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Market Responses to Managed Care |
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106 | (2) |
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Forces of Reform: Cost, Quality, and Access |
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108 | (1) |
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The Rise of For-Profit Hospital Systems |
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109 | (4) |
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113 | (29) |
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113 | (1) |
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113 | (3) |
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Private Medical Office Practice |
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116 | (4) |
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Other Ambulatory Care Practitioners |
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120 | (1) |
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Ambulatory Care Services of Hospitals: History and Trends |
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120 | (13) |
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133 | (1) |
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134 | (2) |
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136 | (2) |
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138 | (2) |
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140 | (2) |
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Medical Education and the Changing Practice of Medicine |
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142 | (27) |
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142 | (2) |
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The Flexner Report and Medical School Reforms |
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144 | (2) |
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146 | (2) |
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Graduate Medical Education Consortia |
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148 | (1) |
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Delineation and Growth of Medical Specialities |
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149 | (2) |
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Specialty Boards and Residency Performance |
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151 | (3) |
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Funding of Graduate Medical Education |
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154 | (1) |
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The Generalist/Specialist Imbalance |
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155 | (1) |
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156 | (1) |
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Changing Physician/Hospital Relationships |
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157 | (2) |
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Cost Containment and the Restructuring of Medical Practice |
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159 | (1) |
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160 | (1) |
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Clinical Practice Guidelines |
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161 | (2) |
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Provider Network Contracting |
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163 | (2) |
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The Future of Medical Practice |
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165 | (4) |
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169 | (37) |
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169 | (1) |
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170 | (1) |
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Health Care Personnel and Health Care Reforms |
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171 | (1) |
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Credentialing and Regulating Health Professionals |
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172 | (2) |
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174 | (21) |
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195 | (1) |
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Factors That Influence Demand for Health Personnel |
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196 | (3) |
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Health Care Work Force Issues |
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199 | (1) |
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200 | (6) |
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206 | (47) |
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206 | (1) |
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Health Care Expenditures in Perspective |
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207 | (2) |
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New Diagnostic and Treatment Technology |
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209 | (1) |
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210 | (1) |
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The Growth of Specialized Medicine |
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210 | (1) |
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The Uninsured and Underinsured |
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211 | (1) |
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A Labor-Intensive Industry |
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211 | (1) |
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Economic Incentives That Fuel Rising Costs |
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212 | (1) |
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Components of Health Care Expenditures |
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212 | (1) |
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Sources of Health Care Payment |
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213 | (1) |
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Evolution of Health Insurance: Third-Party Payment |
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214 | (4) |
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Self-Funded Insurance Programs |
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218 | (1) |
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Government as a Source of Payment |
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219 | (29) |
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248 | (1) |
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The Future: Continuing Change |
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248 | (5) |
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253 | (18) |
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253 | (1) |
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253 | (2) |
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Managed Care Fundamentals |
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255 | (3) |
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258 | (5) |
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Managed Care Organizations and Quality |
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263 | (4) |
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Medicare and Medicaid Managed Care |
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267 | (1) |
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The Future of Managed Care |
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268 | (3) |
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271 | (35) |
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271 | (1) |
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Long-Term Care and the Continuum of Care |
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271 | (2) |
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Development of Long-Term Care Services |
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273 | (5) |
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Delivery of Long-Term Care Services |
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278 | (4) |
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Institutional versus Home-Based Services |
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282 | (8) |
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290 | (7) |
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Innovations in Long-Term Care |
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297 | (4) |
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The Future of Long-Term Care |
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301 | (5) |
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306 | (28) |
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306 | (1) |
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307 | (4) |
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Need for Further Research |
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311 | (1) |
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Recipients of Mental Health Services |
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311 | (7) |
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318 | (1) |
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Resource Allocation and the Provision of Mental Health Services |
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319 | (1) |
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Current Availability of Treatments for Mental Disorders |
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320 | (1) |
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Barriers to Accessing Services |
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320 | (5) |
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Priorities for Mental Health Services |
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325 | (9) |
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Public Health and the Role of Government in Health Care |
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334 | (21) |
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334 | (1) |
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334 | (7) |
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Decline in Influence of the Public Health Service |
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341 | (1) |
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Responsibilities of the Public Health Sector |
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342 | (2) |
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Relationships of Public Health and Private Medicine |
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344 | (1) |
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Resource Priorities Favor Curative Medicine |
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345 | (2) |
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Health Care Reform and the Public Health/Medicine Relationship |
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347 | (1) |
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Hospital-Sponsored Public Health Activities |
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347 | (1) |
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Public Health Services of Voluntary Agencies |
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348 | (1) |
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Changing Roles of Government in Public Health |
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349 | (2) |
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Public Health in an Era of Privatization and Managed Care |
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351 | (1) |
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Future Role of Government in Promoting the Public's Health |
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352 | (3) |
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Research: How Health Care Advances |
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355 | (22) |
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355 | (1) |
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The Focus of Different Types of Research |
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356 | (1) |
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Research in Health and Disease |
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357 | (1) |
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358 | (1) |
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359 | (1) |
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Agency for Health Care Policy and Research |
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360 | (2) |
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Health Services Research and Health Policy |
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362 | (1) |
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363 | (6) |
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369 | (2) |
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371 | (1) |
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372 | (5) |
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The Future of Health Care |
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377 | (30) |
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377 | (1) |
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The Paradox of U.S. Health Care |
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378 | (3) |
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Organizations and Facilities |
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381 | (2) |
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Corporate Growth in Health Care |
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383 | (2) |
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385 | (1) |
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386 | (2) |
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Growth of Home, Outpatient, and Ambulatory Care |
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388 | (1) |
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389 | (1) |
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390 | (1) |
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391 | (1) |
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392 | (1) |
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393 | (2) |
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395 | (1) |
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395 | (1) |
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Future Role of the Federal Government |
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396 | (2) |
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398 | (9) |
Appendix A---Abbreviations |
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407 | (10) |
Index |
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417 | (22) |
About the Authors |
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439 | |