Essentials of the U. S. Health Care System

by Shi, Leiyu; Singh, Douglas A.

• ISBN13: 9781449683740
• ISBN10: 1449683746
• Edition: 3rd
• Format: Paperback
• Copyright: 2012-07-06
• Publisher: Jones & Bartlett Learning

Summary

Written by best-selling authors Leiyu Shi and Douglas Singh, Essentials of the U.S. Health Care System is the most concise examination of the basic structures and operations of the U.S. health system. An ideal resource for courses in health policy, allied health, health administration and more, the text clarifies the complexities of health care organization and finance and presents a solid overview of how the various components fit together. The Third Edition is a comprehensive update that offers new data, charts, and tables throughout the book, as well as updated ancillary materials. New to the Third Edition: Data updated throughout the book reflected in tables and text Information on Healthy People 2020 initiative New material on U.S. health reform throughout the book New materials on disparities initiatives Updated conceptual framework on determinants of health Mental health services in their historical context Patient centered care The Magnet recognition program of the American Nurses Credentialing Center Critical access hospitals Accountable care organizations Updates on vulnerable populations New information on health centers and safety-net providers Revised perspectives on the future of health care in America

Table of Contents

Preface	p. ix
About the Authors	p. xiii
Acknowledgments	p. xv
List of Exhibits	p. xvii
List of Tables	p. xix
List of Figures	p. xxi
List of Abbreviations	p. xxiii
Major Characteristics of U.S. Health Care Delivery	p. 1
Introduction	p. 1
Subsystems of U.S. Health Care Delivery	p. 3
Characteristics of the U.S. Health Care System	p. 10
Health Care Systems of Other Developed Countries	p. 20
Systems Framework	p. 24
Conclusion	p. 26
Foundation of U.S. Health Care Delivery	p. 29
Introduction	p. 29
What Is Health?	p. 30
Determinants of Health	p. 34
Cultural Beliefs and Values	p. 36
Strategies to Improve Health	p. 37
Conclusion	p. 49
Historical Overview of U.S. Health Care Delivery	p. 53
Introduction	p. 53
Medical Services in Preindustrial America	p. 55
Medical Services in Postindustrial America	p. 59
History of Health Insurance	p. 64
Medical Services in the Corporate Era	p. 73
Conclusion	p. 76
Health Care Providers and Professionals	p. 79
Introduction	p. 79
Physicians	p. 82
Dentists	p. 89
Pharmacists	p. 91
Other Doctoral-Level Health Professionals	p. 92
Nurses	p. 93
Nonphysician Practitioners	p. 95
Allied Health Professionals	p. 98
Public Health Professionals	p. 100
Health Services Administrators	p. 100
Conclusion	p. 101
Technology and its Effects	p. 105
Introduction	p. 105
What Is Medical Technology?	p. 107
Information Technology	p. 107
Utilization of Medical Technology	p. 111
Role of the Government in Technology Diffusion	p. 114
Impact of Medical Technology	p. 118
Assessment of Medical Technology	p. 123
Benefits of Technology Assessment	p. 125
Conclusion	p. 126
Financing and Reimbursement Methods	p. 129
Introduction	p. 129
Effects of Health Care Financing and Insurance	p. 131
Insurance: Its Nature and Purpose	p. 133
Private Insurance	p. 135
Public Insurance	p. 138
The Patient Protection and Affordable Care Act	p. 147
Reimbursement Methods	p. 148
National Health Expenditures	p. 153
Conclusion	p. 155
Outpatient Services and Primary Care	p. 159
Introduction	p. 159
What Is Outpatient Care?	p. 160
Scope of Outpatient Services	p. 161
Outpatient Care Settings and Methods of Delivery	p. 164
Primary Care	p. 170
Conclusion	p. 181
Hospitals	p. 185
Introduction	p. 185
Evolution of the Hospital in the United States	p. 186
Expansion and Downsizing of Hospitals in the United States	p. 188
Access and Utilization Measures	p. 192
Hospital Employment	p. 194
Types of Hospitals	p. 194
Licensure, Certification, and Accreditation	p. 202
The Magnet Recognition Program	p. 203
Hospital Organization	p. 204
Ethics and Public Trust	p. 205
Conclusion	p. 207
Managed Care and Integrated Systems	p. 211
Introduction	p. 211
What Is Managed Care?	p. 212
Evolution and Growth of Managed Care	p. 215
Managed Care Today	p. 218
Utilization Control Methods in Managed Care	p. 219
Types of Managed Care Plans	p. 222
Impact on Cost, Access, and Quality	p. 227
Integrated Systems	p. 229
Types of Integration	p. 230
Conclusion	p. 233
Long-Term Care Services	p. 237
Introduction	p. 237
What Is LTC?	p. 239
Community-Based Long-term Care Services	p. 245
Institutional Long-term Care	p. 249
Licensing and Certification of Nursing Homes	p. 254
Other Long-term Care Services	p. 256
Nursing Home Industry and Expenditures	p. 257
Conclusion	p. 259
Population with Special Health Needs	p. 261
Introduction	p. 261
Framework to Study Vulnerable Populations	p. 262
Predisposing Characteristics	p. 264
Enabling Characteristics	p. 271
Need Characteristics	p. 274
Conclusion	p. 277
Cost, Access, and Quality	p. 281
Introduction	p. 281
Cost of Health Care	p. 282
The High Cost of U.S. Health Care	p. 283
Reasons for High Health Care Costs	p. 284
Cost Containment	p. 291
Unequal in Access	p. 294
Average in Quality	p. 301
Developments in Process Improvement	p. 305
Conclusion	p. 307
Health Policy	p. 311
Introduction	p. 311
What Is Health Policy?	p. 312
Principal Features of U.S. Health Policy	p. 314
Development of Legislative Health Policy	p. 323
Critical Policy Issues	p. 325
International Health Policy: Comparisons	p. 333
Conclusion	p. 334
The Future of Health Services Delivery	p. 337
Introduction	p. 337
Conflicting Realities of Cost and Access	p. 339
The Future of Health Care Reform	p. 341
Future Model of Care Delivery	p. 345
Future Workforce Challenges	p. 346
Global Threats and International Cooperation	p. 347
Bioterrorism and the Transformation of Public Health	p. 349
New Frontiers in Clinical Technology	p. 350
Evidence-Based Health Care	p. 351
Conclusion	p. 353
Index	p. 357
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