Delivering Health Care in America : A Systems Approach,9780763731991

Delivering Health Care in America : A Systems Approach

by
Edition: 3rd
ISBN13: 9780763731991
ISBN10: 0763731994
Format: Paperback
Pub. Date: 2003-10-01
Publisher(s): Jones & Bartlett
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Summary

In a clear, cohesive format,Delivering Health Care in Americaprovides a comprehensive overview the basic structures and operations of the US health system-from its historical origins and resources, to its individual services, cost, and quality. Using a unique "systems" approach, it brings together an extraordinary breadth of information into a highly accessible, easy-to-read text that clarifies the complexities of health care organization and finance, while presenting a solid overview of how the various components fit together. Now in its third edition, Delivering Health Care in America has been updated with the latest available data and research findings to provide the most current information on the foundations, structural features, past and current trends, and major issues pertaining to the U.S. health care delivery system.

Table of Contents

Foreword ix
Preface xi
List of Exhibits xiii
List of Figures xv
List of Tables xix
List of Abbreviations/Acronyms xxi
Chapter 1 A Distinctive System of Health Care Delivery 1(34)
Introduction
2(1)
An Overview of the Scope and Size of the System
2(2)
A Broad Description of the System
4(1)
Basic Components of a Health Services Delivery System
5(2)
A Disenfranchised Segment
7(1)
Transition from Traditional Insurance to Managed Care
8(1)
Primary Characteristics of the US Health Care System
9(10)
Trends and Directions
19(1)
Significance for Health Care Practitioners and Policy Makers
19(1)
Significance for Health Care Managers
20(2)
Health Care Systems of Other Countries
22(6)
The Systems Framework
28(2)
Summary
30(1)
Test Your Understanding
31(1)
Review Questions
31(4)
PART I System Foundations 35(80)
Chapter 2 Beliefs, Values, and Health
37(44)
Introduction
38(1)
Significance for Managers and Policy Makers
38(1)
Basic Concepts
39(10)
Determinants of Health
49(5)
Cultural Beliefs and Values
54(2)
A Social Model of Health
56(1)
Equitable Distribution of Health Care
57(4)
Justice in the US Health Delivery System
61(3)
Integration of Individual and Community Health
64(3)
Measures of Health Status
67(6)
Measures of Health Services Utilization
73(1)
Summary
74(1)
Test Your Understanding
74(1)
Review Questions
75(6)
Chapter 3 The Evolution of Health Services in the United States
81(34)
Introduction
82(1)
Medical Services in Preindustrial America
83(4)
Medical Services in Postindustrial America
87(20)
Recent Evolutions and the 21st Century
107(3)
Summary
110(1)
Test Your Understanding
111(1)
Review Questions
111(4)
PART II System Resources 115(120)
Chapter 4 Health Services Professionals
117(38)
Introduction
118(1)
Physicians
119(15)
Dentists
134(2)
Pharmacists
136(1)
Other Doctoral-Level Health Professionals
137(1)
Nurses
137(3)
Nonphysician Practitioners
140(3)
Allied Health Professionals
143(2)
Health Services Administrators
145(2)
Summary
147(1)
Test Your Understanding
147(1)
Review Questions
148(7)
Chapter 5 Medical Technology
155(32)
Introduction
156(1)
What is Medical Technology?
157(1)
Information Technology
157(3)
The Diffusion and Use of Medical Technology
160(4)
Managed Care and Technology Diffusion
164(1)
The Government's Role in Technology Diffusion
164(4)
The Impact of Medical Technology
168(6)
The Assessment of Medical Technology
174(4)
The Role of the Private Sector in Technology Assessment
178(1)
Implications for Policy and Management
179(1)
Some Critical Issues
180(1)
Summary
181(1)
Test Your Understanding
182(1)
Review Questions
182(5)
Chapter 6 Health Services Financing
187(48)
Introduction
188(1)
The Role and Scope of Health Services Financing
188(1)
Financing and Cost Control
189(2)
The Insurance Function
191(1)
Private Financing
191(6)
Public Financing
197(12)
Miscellaneous Private and Public Programs
209(2)
The Payment Function
211(6)
National Health Care Expenditures
217(6)
Problems and Issues in Financing
223(3)
Trends and Directions
226(3)
Summary
229(1)
Test Your Understanding
230(1)
Review Questions
230(5)
PART III System Processes 235(246)
Chapter 7 Outpatient and Primary Care Services
237(44)
Introduction
238(1)
What Is Outpatient Care?
239(1)
The Scope of Outpatient Services
239(2)
Primary Care
241(4)
Community-Oriented Primary Care
245(1)
Primary Care Providers
246(1)
Growth in Outpatient Services
247(2)
Reasons for the Growth in Outpatient Services
249(2)
Types of Outpatient Care Settings and Methods of Delivery
251(20)
Utilization of Outpatient Services
271(2)
Summary
273(3)
Test Your Understanding
276(1)
Review Questions
276(5)
Chapter 8 Inpatient Facilities and Services
281(42)
Introduction
282(1)
Transformation of the Hospital in the United States
283(4)
Expansion of Hospitals in the United States
287(2)
Hospital Downsizing Since 1985
289(2)
Some Key Utilization Measures and Operational Concepts
291(5)
Hospital Employment
296(1)
Types of Hospitals
297(10)
What Makes a Hospital Nonprofit?
307(2)
Some Management Concepts
309(3)
Licensure, Certification, and Accreditation
312(1)
Ethical and Legal Issues in Patient Care
313(2)
Hospitals and Public Trust
315(1)
The Future Outlook for Hospitals
316(1)
Summary
316(2)
Test Your Understanding
318(1)
Review Questions
318(5)
Chapter 9 Managed Care and Integrated Organizations
323(48)
Introduction
324(1)
What is Managed Care?
325(3)
Evolution of Managed Care
328(3)
Growth of Managed Care
331(3)
Cost Control Methods in Managed Care
334(5)
Types of Managed Care Organizations
339(8)
Trends in Managed Care
347(3)
Impact on Cost, Access, and Quality
350(2)
Managed Care Backlash and the Future
352(1)
Managed Care Legislation
353(2)
Consolidation, Expansion, Diversification, and Integration
355(2)
Integrated Delivery Systems
357(1)
Types of Integration
358(4)
Issues Related to Integration
362(2)
Summary
364(1)
Test Your Understanding
365(1)
Review Questions
365(6)
Chapter 10 Long-Term Care
371(52)
Introduction
372(3)
What is Long-Term Care?
375(2)
The Nature of Long-Term Care
377(7)
The Clients of Long-Term Care
384(4)
Types of Community-Based Long-Term Care Services
388(8)
Institutional Long-Term Care
396(6)
Specialized Facilities
402(2)
Institutional Demographics of Long-Term Care Facilities
404(4)
Sources of Financing Nursing Home Care
408(4)
Future Financing of Long-Term Care
412(1)
Prospective Payment System for SNFs
412(1)
Requirements of Participation
413(2)
Summary
415(1)
Test Your Understanding
416(1)
Review Questions
416(7)
Chapter 11 Health Services for Special Populations
423(58)
Introduction
424(1)
Racial/Ethnic Minorities
424(14)
The Uninsured
438(2)
Children
440(3)
Women
443(4)
Rural Health
447(3)
The Homeless
450(3)
Mental Health
453(4)
The Chronically Ill and Disabled
457(2)
HIV/AIDS
459(13)
Summary
472(1)
Test Your Understanding
472(1)
Review Questions
473(8)
PART IV System Outcomes 481(80)
Chapter 12 Cost, Access, and Quality
483(50)
Introduction
484(1)
Cost of Health Care
484(7)
Reasons for Cost Escalation
491(7)
Cost Containment-Regulatory Approaches
498(6)
Cost Containment-Competitive Approaches
504(1)
Access to Care
505(9)
Quality of Care
514(1)
Dimensions of Quality
515(3)
Quality Assurance
518(1)
Quality Assessment
519(5)
Quality Report Cards
524(1)
Summary
525(1)
Test Your Understanding
526(1)
Review Questions
526(7)
Chapter 13 Health Policy
533(28)
Introduction
534(1)
What Is Health Policy?
534(2)
The Principal Features of US Health Policy
536(8)
The Development of Legislative Health Policy
544(4)
Critical Policy Issues
548(7)
The Future of Health Policy
555(3)
Summary
558(1)
Test Your Understanding
559(1)
Review Questions
559(2)
PART V System Outlook 561(34)
Chapter 14 The Future of Health Services Delivery
563(32)
Introduction
564(2)
The Next Stage in Employer-Based Health Insurance
566(2)
Future Challenges for Managed Care
568(1)
Future of Financing and Insurance
569(3)
Comprehensive Reform: If and When It Occurs
572(4)
National and Global Challenges
576(3)
Bioterrorism and the Transformation of Public Health
579(2)
Future of the Health Care Workforce
581(2)
Work Organization
583(1)
Enhanced Focus on Customer Service
584(1)
New Frontiers in Technology
585(2)
Outcome Measurement, Monitoring, and Assessment
587(3)
Summary
590(2)
Test Your Understanding
592(1)
Review Questions
592(3)
Appendix A-Glossary 595(24)
Appendix B-Selected Web Sites 619(4)
Index 623

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