Essentials of the U. S. Health Care System

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

Prefacep. ix
About the Authorsp. xiii
Acknowledgmentsp. xv
List of Exhibitsp. xvii
List of Tablesp. xix
List of Figuresp. xxi
List of Abbreviationsp. xxiii
Major Characteristics of U.S. Health Care Deliveryp. 1
Introductionp. 1
Subsystems of U.S. Health Care Deliveryp. 3
Characteristics of the U.S. Health Care Systemp. 10
Health Care Systems of Other Developed Countriesp. 20
Systems Frameworkp. 24
Conclusionp. 26
Foundation of U.S. Health Care Deliveryp. 29
Introductionp. 29
What Is Health?p. 30
Determinants of Healthp. 34
Cultural Beliefs and Valuesp. 36
Strategies to Improve Healthp. 37
Conclusionp. 49
Historical Overview of U.S. Health Care Deliveryp. 53
Introductionp. 53
Medical Services in Preindustrial Americap. 55
Medical Services in Postindustrial Americap. 59
History of Health Insurancep. 64
Medical Services in the Corporate Erap. 73
Conclusionp. 76
Health Care Providers and Professionalsp. 79
Introductionp. 79
Physiciansp. 82
Dentistsp. 89
Pharmacistsp. 91
Other Doctoral-Level Health Professionalsp. 92
Nursesp. 93
Nonphysician Practitionersp. 95
Allied Health Professionalsp. 98
Public Health Professionalsp. 100
Health Services Administratorsp. 100
Conclusionp. 101
Technology and its Effectsp. 105
Introductionp. 105
What Is Medical Technology?p. 107
Information Technologyp. 107
Utilization of Medical Technologyp. 111
Role of the Government in Technology Diffusionp. 114
Impact of Medical Technologyp. 118
Assessment of Medical Technologyp. 123
Benefits of Technology Assessmentp. 125
Conclusionp. 126
Financing and Reimbursement Methodsp. 129
Introductionp. 129
Effects of Health Care Financing and Insurancep. 131
Insurance: Its Nature and Purposep. 133
Private Insurancep. 135
Public Insurancep. 138
The Patient Protection and Affordable Care Actp. 147
Reimbursement Methodsp. 148
National Health Expendituresp. 153
Conclusionp. 155
Outpatient Services and Primary Carep. 159
Introductionp. 159
What Is Outpatient Care?p. 160
Scope of Outpatient Servicesp. 161
Outpatient Care Settings and Methods of Deliveryp. 164
Primary Carep. 170
Conclusionp. 181
Hospitalsp. 185
Introductionp. 185
Evolution of the Hospital in the United Statesp. 186
Expansion and Downsizing of Hospitals in the United Statesp. 188
Access and Utilization Measuresp. 192
Hospital Employmentp. 194
Types of Hospitalsp. 194
Licensure, Certification, and Accreditationp. 202
The Magnet Recognition Programp. 203
Hospital Organizationp. 204
Ethics and Public Trustp. 205
Conclusionp. 207
Managed Care and Integrated Systemsp. 211
Introductionp. 211
What Is Managed Care?p. 212
Evolution and Growth of Managed Carep. 215
Managed Care Todayp. 218
Utilization Control Methods in Managed Carep. 219
Types of Managed Care Plansp. 222
Impact on Cost, Access, and Qualityp. 227
Integrated Systemsp. 229
Types of Integrationp. 230
Conclusionp. 233
Long-Term Care Servicesp. 237
Introductionp. 237
What Is LTC?p. 239
Community-Based Long-term Care Servicesp. 245
Institutional Long-term Carep. 249
Licensing and Certification of Nursing Homesp. 254
Other Long-term Care Servicesp. 256
Nursing Home Industry and Expendituresp. 257
Conclusionp. 259
Population with Special Health Needsp. 261
Introductionp. 261
Framework to Study Vulnerable Populationsp. 262
Predisposing Characteristicsp. 264
Enabling Characteristicsp. 271
Need Characteristicsp. 274
Conclusionp. 277
Cost, Access, and Qualityp. 281
Introductionp. 281
Cost of Health Carep. 282
The High Cost of U.S. Health Carep. 283
Reasons for High Health Care Costsp. 284
Cost Containmentp. 291
Unequal in Accessp. 294
Average in Qualityp. 301
Developments in Process Improvementp. 305
Conclusionp. 307
Health Policyp. 311
Introductionp. 311
What Is Health Policy?p. 312
Principal Features of U.S. Health Policyp. 314
Development of Legislative Health Policyp. 323
Critical Policy Issuesp. 325
International Health Policy: Comparisonsp. 333
Conclusionp. 334
The Future of Health Services Deliveryp. 337
Introductionp. 337
Conflicting Realities of Cost and Accessp. 339
The Future of Health Care Reformp. 341
Future Model of Care Deliveryp. 345
Future Workforce Challengesp. 346
Global Threats and International Cooperationp. 347
Bioterrorism and the Transformation of Public Healthp. 349
New Frontiers in Clinical Technologyp. 350
Evidence-Based Health Carep. 351
Conclusionp. 353
Indexp. 357
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