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Doody's Review ServiceReviewer: Carole A. Kenner, PhD, RN, FAAN (Council of International Neonatal Nurses)
Description: This book describes the U.S. healthcare delivery system within the context of the new healthcare reform legislation. An update of the 2007 edition, this edition addresses the new healthcare environment.
Purpose: The purpose is to place the delivery of healthcare in the U.S. within a systems context. Because healthcare is a global issue, the U.S. system is also compared with other major systems in Germany, Canada, and the U.K. in particular.
Audience: The intended audience is anyone interested in healthcare delivery systems from a policy perspective — within and outside the U.S. However, it is most appropriate for graduate-level students and readers interested in policy.
Features: The usual topics are covered — quality, healthcare financing, vulnerable populations, health policy, etc. However, this edition describes the Affordable Health Care Act, the movement for universal coverage — including the political climate that is resisting change — and the shift from disease orientation to primary care and case management. The illustrations are very good and help readers understand models, for example, of health and social determinants. The glossary and abbreviations are also helpful. However, there are some shortcomings. The description of the role of the nurse practitioner is very limited and there is no mention of fact that NPs may be able to be reimbursed for services, although not at the rate and the same way as physicians. Certified nurse anesthetists are mentioned, but not discussed as nurse midwives are, yet they have evolved and are a good example of a nurse whose model of reimbursement and services are more similar to physicians. Case management is noted, but the newer term is care coordination. The Naylor model of transitional care, which is evidence-based and supported by insurance companies, is not mentioned as a good example of translational research impacting practice and changing healthcare delivery models. The shortage of health professionals and its impact on care is not really discussed. All of these areas would strengthen the argument that healthcare is a complex issue.
Assessment: Now in its fifth edition, this book has a long history of success in the marketplace. There are other books on policy and others on delivery of healthcare. Jonas and Kovner's Health Care Delivery in the United States, 10th edition, Kovner et al. (Springer Publishing Company) book covers most of the same topics but includes more on the healthcare workforce than does Delivering Health Care in America. The books provide different perspectives, both are needed, and, as Kovner argues, healthcare depends on a stakeholder's viewpoint. The same is true for readers.