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Health Care USA / Edition 7

Health Care USA / Edition 7

1.6 3
by Harry A. Sultz

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ISBN-10: 0763784583

ISBN-13: 2900763784583

Pub. Date: 07/08/2010

Publisher: Jones & Bartlett Learning

Health Care USA: Understanding Its Organization and Delivery, Second Edition reflects recent major legislative changes that have occurred in Medicare, Medicaid and public health. The growing concern about mental health services will be covered by taking a close look at emerging behavioral health managed care organizations. The new edition will also reflect the


Health Care USA: Understanding Its Organization and Delivery, Second Edition reflects recent major legislative changes that have occurred in Medicare, Medicaid and public health. The growing concern about mental health services will be covered by taking a close look at emerging behavioral health managed care organizations. The new edition will also reflect the increased penetration of managed care across the country and its effect on not only the health care industry, but also on consumers. Current benchmarks in all areas of health care will be thoroughly updated. Also, an Instructor's Manual is available to support this book.

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Jones & Bartlett Learning
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Table of Contents

Chapter 1Overview of Health Care: A Population Perspective1
Problems of Health Care2
Understanding Health Care3
Why Patients and Providers Behave the Way They Do4
Indexes of Health and Disease5
Natural Histories of Disease and the Levels of Prevention6
Major Stakeholders in the U.S. Health Care Industry9
Long-Term Care15
Development of Managed Care17
Rural Health Networks19
Priorities of Health Care20
Social Choices of Health Care23
The Aging Population23
Access to Health Care26
Quality of Care28
Conflicts of Interest28
Health Care's Ethical Dilemmas29
Chapter 2Benchmark Developments in U.S. Health Care31
The Great Depression and the Birth of Blue Cross33
The Dominant Influence of Government34
Health Maintenance Organizations38
The Reagan Administration39
Biomedical Advances: Evolution of High-Technology Medicine40
Roles of Medical Education and Specialization42
Influence of Interest Groups44
Public Health Focus on Prevention49
Economic Influences: Rising Costs50
The Uninsured and Problems of Access to Medical Care50
The Aging of America51
Values and Assumptions That Guide Priorities52
Oregon Death with Dignity Act54
Provisions of the Oregon Death with Dignity Act55
The Internet and Health Care55
The Basic Issues56
Chapter 3Hospitals: Origin, Organization, and Performance60
Historical Perspective60
Sources That Shaped the Hospital Industry63
Growth and Decline in Numbers of Hospitals65
Types of Hospitals65
Financial Condition of Hospitals67
Academic Health Centers, Medical Education, and Specialization68
The Balanced Budget Act and Academic Medical Centers69
The Hospital System of the Department of Veterans Affairs69
Structure and Organization of Hospitals70
Types and Roles of Patients77
Rights and Responsibilities of Hospitalized Patients78
Important Decisions, Informed Consent, and Second Opinions81
Diagnosis-Related Group Hospital Reimbursement System83
Discharge Planning84
Subacute Care85
Market-Driven Reforms Affecting Hospitals86
Integrated Health Systems91
Market Responses to Managed Care95
The Quality of Hospital Care97
Variations in Medical Care99
Hazards of Hospitalization100
Current Research Efforts in Quality Improvement102
Responsibility of Governing Boards for Quality of Care103
Incremental Quality Improvement105
Forces of Reform: Cost, Quality, and Access106
Chapter 4Ambulatory Care110
Overview and Trends110
Private Medical Office Practice113
Other Ambulatory Care Practitioners116
Ambulatory Care Services of Hospitals: History and Trends116
Hospital Emergency Services121
Free-Standing Services123
Community Health Centers129
Public Health Services131
Voluntary Agencies133
Chapter 5Medical Education and the Changing Practice of Medicine137
The Flexner Report and Medical School Reforms139
Academic Medical Centers140
Graduate Medical Education Consortia143
Delineation and Growth of Medical Specialties145
Specialty Boards and Residency Performance146
Funding of Graduate Medical Education149
Physician Surplus and U.S. Medical Schools149
The Generalist/Specialist Imbalance151
Primary Care Physicians--Gatekeepers of the System152
Preventive Medicine153
Changing Physician/Hospital Relationships154
Cost Containment and the Restructuring of Medical Practice155
Hold Harmless Clauses157
Clinical Practice Guidelines157
Physician Report Cards159
Growing Concern about Ethical Issues160
Physicians and the Internet161
Provider Network Contracting162
The Future of Medical Practice163
Chapter 6Health Care Personnel169
Health Professions170
Health Care Personnel and Health Care Reforms171
Credentialing and Regulating Health Professionals171
Health Care Occupations173
Alternative Therapists194
Factors That Influence Demand for Health Personnel197
Health Care Work Force Issues200
Chapter 7Financing Health Care207
Health Care Expenditures in Perspective207
New Diagnostic and Treatment Technology209
The Aging of America210
The Growth of Specialized Medicine212
The Uninsured and Underinsured212
A Labor-Intensive Industry214
Economic Incentives That Fuel Rising Costs214
Components of Health Care Expenditures214
Sources of Health Care Payment215
Evolution of Health Insurance: Third-Party Payment217
Self-Funded Insurance Programs221
Government as a Source of Payment222
The Future: Continuing Change250
Chapter 8Managed Care257
Historical Perspective257
Managed Care Fundamentals260
HMO Act of 1973262
The Evolution of Managed Care264
Emerging Developments in Managed Care268
Medicare and Medicaid Managed Care270
Managed Care Organizations and Quality272
The Future of Managed Care275
Chapter 9Long-Term Care279
Long-Term Care and the Continuum of Care279
Development of Long-Term Care Services281
Modes of Long-Term Care Service Delivery284
Innovations in Long-Term Care305
Long-Term Care Insurance308
The Future of Long-Term Care309
Chapter 10Mental Health Services316
Historical Perspective316
Recipients of Mental Health Services320
Special Populations326
The Organization and Financing of Mental Health Services328
Health Insurance Coverage and Managed Behavioral Health Care331
Barriers to Accessing Services338
Priorities for Mental Health Services339
Need for Further Research341
Chapter 11Public Health and the Role of Government in Health Care348
Historical Perspective348
Decline in Influence of the Public Health Service358
Responsibilities of the Public Health Sector359
Relationships of Public Health and Private Medicine362
Resource Priorities Favor Curative Medicine364
Health Care Reform and the Public Health/Medicine Relationship365
Hospital-Sponsored Public Health Activities366
Public Health Services of Voluntary Agencies367
Changing Roles of Government in Public Health368
Public Health in an Era of Privatization and Managed Care369
Federal Support To Address Emerging Health Issues371
Future Role of Government in Promoting the Public's Health372
Chapter 12Research: How Health Care Advances376
The Focus of Different Types of Research377
Research in Health and Disease377
Health Services Research380
Agency for Healthcare Research and Quality (Formerly the Agency for Health Care Policy and Research)380
Health Services Research and Health Policy383
Quality Improvement384
Outcomes Research390
Patient Satisfaction391
Research Ethics392
Future Challenges393
Chapter 13The Future of Health Care398
The Paradox of U.S. Health Care399
Organizations and Facilities400
Corporate Growth in Health Care402
Corporate Alliances404
Future of Managed Care405
Growth of Home, Outpatient, and Ambulatory Care407
Academic Health Centers413
Health Professions414
Nurse Practitioners417
Physician Assistants417
Future Role of the Federal Government417
Appendix AAbbreviations and Acronyms428
Appendix BWeb Sites439
About the Authors461

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