Note: Supplemental materials are not guaranteed with Rental or Used book purchases.
Purchase Benefits
What is included with this book?
Foreword | p. ix |
Preface | p. xi |
List of Exhibits | p. xv |
List of Figures | p. xvii |
List of Tables | p. xxi |
List of Abbreviations/Acronyms | p. xxiii |
A Distinctive System of Health Care Delivery | p. 1 |
Introduction | p. 2 |
An Overview of the Scope and Size of the System | p. 2 |
A Broad Description of the System | p. 4 |
Basic Components of a Health Services Delivery System | p. 5 |
A Disenfranchised Segment | p. 7 |
Transition from Traditional Insurance to Managed Care | p. 8 |
Primary Characteristics of the US Health Care System | p. 9 |
Trends and Directions | p. 19 |
Significance for Health Care Practitioners and Policymakers | p. 19 |
Significance for Health Care Managers | p. 20 |
Health Care Systems of Other Countries | p. 21 |
The Systems Framework | p. 28 |
Summary | p. 31 |
Test Your Understanding | p. 32 |
Review Questions | p. 32 |
System Foundations | |
Beliefs, Values, and Health | p. 37 |
Introduction | p. 38 |
Significance for Managers and Policymakers | p. 38 |
Basic Concepts | p. 39 |
Health Promotion and Disease Prevention | p. 44 |
Developmental Health | p. 45 |
Public Health | p. 45 |
Health Protection | p. 46 |
Quality of Life | p. 48 |
Determinants of Health | p. 49 |
Overarching Factors and Implications for Health Care Delivery | p. 53 |
A Social Model of Health | p. 56 |
Equitable Distribution of Health Care | p. 56 |
Justice in the US Health Delivery System | p. 60 |
Equality in the US Health Care Delivery System | p. 61 |
Integration of Individual and Community Health | p. 64 |
Measures of Health Status | p. 68 |
Evaluation of Health Status | p. 68 |
Demographic Change | p. 71 |
Measures of Mental Health | p. 72 |
Measures of Social Health | p. 72 |
Measures of Spiritual Health | p. 73 |
Measures of Health Services Utilization | p. 73 |
Summary | p. 74 |
Test Your Understanding | p. 74 |
Review Questions | p. 75 |
The Evolution of Health Services in the United States | p. 83 |
Introduction | p. 84 |
Medical Services in Preindustrial America | p. 85 |
Medical Services in Postindustrial America | p. 89 |
Medical Care in the Corporate Era | p. 109 |
Summary | p. 113 |
Test Your Understanding | p. 114 |
Review Questions | p. 115 |
System Resources | |
Health Services Professionals | p. 119 |
Introduction | p. 120 |
Physicians | p. 122 |
Some Key Issues in Medical Practice Involvement in the Development of Clinical Practice Guidelines | p. 128 |
International Medical Graduates | p. 136 |
Dentists | p. 137 |
Pharmacists | p. 138 |
Other Doctoral-Level Health Professionals | p. 139 |
Nurses | p. 140 |
Nonphysician Practitioners | p. 142 |
Allied Health Professionals | p. 146 |
Health Services Administrators | p. 148 |
Summary | p. 150 |
Test Your Understanding | p. 150 |
Review Questions | p. 151 |
List of Professional Associations | p. 152 |
Medical Technology | p. 161 |
Introduction | p. 162 |
What Is Medical Technology? | p. 163 |
Information Technology and Informatics | p. 163 |
Innovation, Diffusion, and Utilization of Medical Technology | p. 168 |
Managed Care and Technology Diffusion | p. 173 |
The Government's Role in Technology Diffusion | p. 173 |
The Impact of Medical Technology | p. 177 |
The Assessment of Medical Technology | p. 182 |
Current and Future Directions in Health Technology Assessment | p. 186 |
Summary | p. 189 |
Test Your Understanding | p. 190 |
Review Questions | p. 190 |
Health Services Financing | p. 197 |
Introduction | p. 198 |
The Role and Scope of Health Services Financing | p. 198 |
Financing and Cost Control | p. 199 |
The Insurance Function | p. 201 |
Private Financing | p. 202 |
Public Financing | p. 207 |
Miscellaneous Private and Public Programs | p. 222 |
The Payment Function | p. 224 |
National Health Care Expenditures | p. 229 |
Trends, Problems, and Issues in Insurance and Financing | p. 233 |
Summary | p. 237 |
Test Your Understanding | p. 238 |
Review Questions | p. 238 |
System Processes | |
Outpatient and Primary Care Services | p. 243 |
Introduction | p. 244 |
What Is Outpatient Care? | p. 244 |
The Scope of Outpatient Services | p. 245 |
Primary Care | p. 245 |
Community-Oriented Primary Care | p. 251 |
Primary Care Providers | p. 251 |
Growth in Outpatient Services | p. 253 |
Reasons for the Growth in Outpatient Services | p. 255 |
Types of Outpatient Care Settings and Methods of Delivery | p. 257 |
Utilization of Outpatient Services | p. 275 |
Summary | p. 281 |
Test Your Understanding | p. 282 |
Review Questions | p. 283 |
Inpatient Facilities and Services | p. 289 |
Introduction | p. 290 |
Transformation of the Hospital in the United States | p. 290 |
The Expansion Phase: Late 1800s to Mid-1980s | p. 294 |
The Downsizing Phase: Mid-1980s Onward | p. 297 |
Some Key Utilization Measures and Operational Concepts | p. 299 |
Hospital Employment | p. 304 |
Types of Hospitals | p. 305 |
What Makes a Hospital Nonprofit? | p. 315 |
Some Management Concepts | p. 317 |
Licensure, Certification, and Accreditation | p. 319 |
Ethical and Legal Issues in Patient Care | p. 321 |
Hospitals and Public Trust | p. 323 |
Summary | p. 324 |
Test Your Understanding | p. 325 |
Review Questions | p. 326 |
Managed Care and Integrated Organizations | p. 333 |
Introduction | p. 334 |
What Is Managed Care? | p. 336 |
Evolution of Managed Care | p. 338 |
Growth of Managed Care | p. 341 |
Efficiencies and Inefficiencies in Managed Care | p. 343 |
Cost Control Methods in Managed Care | p. 344 |
Types of Managed Care Organizations | p. 349 |
Trends in Managed Care | p. 355 |
Impact on Cost, Access, and Quality | p. 358 |
Managed Care Backlash, Regulation, and the Aftermath | p. 360 |
Consolidation, Expansion, Diversification, and Integration | p. 362 |
Integrated Delivery Systems | p. 363 |
Types of Integration | p. 364 |
Issues Related to Integration | p. 368 |
Summary | p. 370 |
Test Your Understanding | p. 371 |
Review Questions | p. 371 |
Long-Term Care | p. 379 |
Introduction | p. 380 |
The Nature of Long-Term Care | p. 383 |
Long-Term Care Services | p. 385 |
The Clients of Long-Term Care | p. 392 |
Types of Community-Based Long-Term Care Services | p. 396 |
Institutional Long-Term Care | p. 403 |
Specialized Facilities | p. 408 |
Nursing Home Industry and Patient Demographics | p. 409 |
Patient Assessment and Prospective Payment for SNFs | p. 418 |
Requirements of Participation | p. 418 |
Summary | p. 420 |
Test Your Understanding | p. 421 |
Review Questions | p. 421 |
Health Services for Special Populations | p. 427 |
Introduction | p. 428 |
Racial/Ethnic Minorities | p. 428 |
The Uninsured | p. 441 |
Children | p. 443 |
Women | p. 446 |
Rural Health | p. 450 |
The Homeless | p. 453 |
Mental Health | p. 456 |
The Chronically Ill and Disabled | p. 460 |
HIV/AIDS | p. 462 |
Summary | p. 474 |
Test Your Understanding | p. 474 |
Review Questions | p. 475 |
System Outcomes | |
Cost, Access, and Quality | p. 483 |
Introduction | p. 484 |
Cost of Health Care | p. 484 |
Reasons for Cost Escalation | p. 491 |
Cost Containment-Regulatory Approaches | p. 498 |
Cost Containment-Competitive Approaches | p. 504 |
Access to Care | p. 505 |
Quality of Care | p. 514 |
Dimensions of Quality | p. 515 |
Quality Assurance | p. 518 |
Quality Assessment | p. 519 |
Quality Report Cards | p. 524 |
Summary | p. 525 |
Test Your Understanding | p. 526 |
Review Questions | p. 526 |
Health Policy | p. 533 |
Introduction | p. 534 |
What Is Health Policy? | p. 534 |
The Principal Features of US Health Policy | p. 536 |
The Development of Legislative Health Policy | p. 544 |
Critical Policy Issues | p. 548 |
The Future of Health Policy | p. 555 |
Summary | p. 558 |
Test Your Understanding | p. 559 |
Review Questions | p. 559 |
System Outlook | |
The Future of Health Services Delivery | p. 561 |
Introduction | p. 562 |
Trends in Private and Public Health Insurance | p. 563 |
Future Options in Financing and Insurance | p. 566 |
Future Challenges for Managed Care | p. 569 |
Comprehensive Reform: If and When It Occurs | p. 570 |
National and Global Challenges | p. 574 |
Bioterrorism and the Transformation of Public Health | p. 579 |
The Future Outlook for US Hospitals | p. 580 |
Future of the Health Care Workforce | p. 581 |
Work Organization | p. 584 |
Enhanced Focus on Customer Service | p. 585 |
New Frontiers in Clinical Technology | p. 586 |
The Era of Evidence-Based Health Care | p. 587 |
Summary | p. 589 |
Test Your Understanding | p. 590 |
Review Questions | p. 590 |
Glossary | p. 595 |
Selected Web Sites | p. 621 |
Index | p. 625 |
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The New copy of this book will include any supplemental materials advertised. Please check the title of the book to determine if it should include any access cards, study guides, lab manuals, CDs, etc.
The Used, Rental and eBook copies of this book are not guaranteed to include any supplemental materials. Typically, only the book itself is included. This is true even if the title states it includes any access cards, study guides, lab manuals, CDs, etc.