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Health Services: Policy and Systems for Therapists prepares readers for the rapid and continual developments in private and public health policy that have changed - and continue to change - the work environment for occupational therapists and physical therapists. Written from the therapist's perspective, it explains the principles and major structures of health services, provides an overview of how policies and systems affect the ability to serve patients, and details ways to be an effective advocate during private and public policy change. Discussions include such issues as access, cost, and quality, as well as regulation basics including public health, licensure, informed consent, and medical liability. FEATURES: Direct applications to physical therapy, occupational therapy and disablement throughout. FREE integrated website - www.prenhall.com/sandstrom - serves readers with updates as well as self-study exercises. Exploration of various settings and professions across the health care continuum with a specific emphasis on public health and mental health. Chapter objectives and overview streamline studies. Chapter summaries and review questions provide convenient review, self-assessment, and critical-thinking aids. Tables and figures illustrate and supplement chapter content.
Table of Contents
I. FUNDAMENTALS OF POLICY.
1. Disablement, Policy and Systems. 2. Access to Health Care Services. 3. Economics/Cost of Health Care. 4. Quality of Health Care. 5. Public Policy and Disability.
II. REIMBURSEMENT POLICY: FINANCING THERAPY SERVICES.
6. Insurance. 7. Managed Care. 8. Medicare. 9. Medicaid, SCHIP and Military/Veterans Medical Insurance.
III. THERAPISTS AND THE HEALTH CARE SYSTEM.
10. The Acute Health Care System. 11. The Post-Acute Health Care System. 12. Healthcare Manpower. 13. Mental Health Practice and Public Policy. 14. Public Health.
IV. THERAPIST AS ADVOCATE.
15. Affecting Policy Change.
Policy makes a difference. Each day, occupational therapists and physical therapists alleviate pain, prevent and treat conditions, and improve the functioning of people with temporary or permanent disabilities. Therapists examine, evaluate, diagnose, establish goals, plan, and implement interventions to improve the lives of those they serve. All of this professional activity is supported by policies and systems that define what therapists do and provide the resources to get the job done.This book is about policy and practice. Policy is not only for administrators and politicians. Policy is for all therapists. If you are a new practitioner, a measure of your effectiveness will be your understanding of the system in which you work and how you professionally socialize yourself within it. As an experienced therapist, one measure of your effectiveness will be your understanding of how you can help your patients receive affordable, necessary services when they need them. As an expert practitioner or administrator, one measure of your effectiveness is to anticipate policy change and proactively make effective choices to advance the quality of care in your work group.The changes in health care during the 1990s were enormous. Managed care contracting, consolidation and mergers of health care providers, slow growth of government spending on health care, growing disparities between the health of different segments of the population, and the large number of uninsured or underinsured persons reflect some of these momentous events in American health care. For occupational therapists and physical therapists, the 1990s brought significant change, including weakened demand for therapists in traditional settings, the closing and restructuring of outpatient and long-term care businesses, increasing documentation requirements, and increased attention to therapist fraud and abuse of insurance programs. The working environment of therapists is significantly different in 2002 than it was in 1992. But for all of the turmoil and change, we believe that the outlook for the professions of physical therapy and occupational therapy remains positive. The population of Americans who will be retiring and experiencing disablement and need for rehabilitation services will mushroom in the next decade. Advances in medical research (e.g., gene therapy) promise new treatments for conditions that today are fatal. With these new treatments that extend life will come a new demand for improved quality of life for a growing population of persons with disabilities. The development of new practice opportunities in fitness centers and wellness clinics provides new growth potential for the rehabilitation professions. While these changes and others bode well for the long-term future of the rehabilitation professions, the achievement of success will require hard work and an understanding of policy, systems, and advocacy.This book is about helping therapists to understand the forces and policies that shape the future of health care for people with disabilities. In order to survive and excel in the future health care environment, occupational therapists and physical therapists will need to understand the effect of policy on their work and advocate for the changes necessary to reduce or eliminate their disabling conditions of their patients/clients. Physical therapy and occupational therapy exist for a social purpose: namely, to address the problems created by disablement and to assist patients/clients to self-directed and more complete independence and participation in society. We believe that it is imperative for occupational therapists and physical therapists to understand the policies that support their professions so that they can effectively advocate for their patients and clients to reduce disablement and fulfill the societal purpose of their professions.The idea for this book originated in courses for physical therapists and occupational t