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Jones & Bartlett Learning
Essentials Of The U.S. Health Care System / Edition 2

Essentials Of The U.S. Health Care System / Edition 2

by Leiyu Shi
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Essentials of the U.S. Health Care System, Fourth Edition is a clear and concise distillation of the major topics covered in the best-selling Delivering Health Care in America by the same authors. Designed for undergraduate and graduate students in programs across the health disciplines, Essentials of the U.S. Health Care System is a reader-friendly, well organized resource that covers the major characteristics, foundations, and future of the U.S. health care system. The text clarifies the complexities of health care organization and finance and presents a solid overview of how the various components fit together.
Readers will gain the necessary tools to understand the unique dynamics of the U.S. health care system, including health care delivery, public policy, and the placement of the U.S. health care system within the larger context of global health care.
This fully revised Fourth Edition has been updated with the most current health statistics and information including:
• The status and impact of the Affordable Care Act on all parts of the health care delivery system
• Implementation of Healthy People 2020
• The current U.S. physician workforce and challenges
• New topics such as nanomedicine; clinical decision support systems; HITECH Law; update on remote monitoring; regulation of biologics; and medical technology
• Health disparities in terms of access to care, quality of care, and health outcomes
• Quality initiatives from government and private sectors
• U.S. health care delivery in the context of forces of future change

Product Details

ISBN-13: 2900763763809
Publisher: Jones & Bartlett Learning
Publication date: 03/05/2009
Edition description: 2E
Pages: 360
Product dimensions: 6.00(w) x 1.25(h) x 9.00(d)

About the Author

Professor, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, Director, Johns Hopkins Primary Care Policy Center

Associate Professor of Management, School of Business and Economics, Indiana University at South Bend

Table of Contents

Preface ix

New in the Fourth Edition xi

Acknowledgments xiii

List of Exhibits xv

List of Tables xvii

List of Figures xix

Chapter 1 Major Characteristics of U.S. Health Care Delivery 1

Introduction 1

Subsystems of U.S. Health Care Delivery 3

Characteristics of the U-S. Health Care System 9

Health Care Systems of Other Developed Countries 19

Systems Framework 23

Conclusion 25

Chapter 2 Foundations of U.S. Health Care Delivery 29

Introduction 29

What Is Health? 30

Determinants of Health 33

Cultural Beliefs and Values 36

Distribution of Health Care 37

Strategies to Improve Health 41

Conclusion 48

Chapter 3 Historical Overview of U.S. Health Care Delivery 53

Introduction 53

Medical Services in Preindustrial America 55

Medical Training 56

Medical Services in Postindustrial America 59

History of Health Insurance 64

Medical Services in the Corporate Era 72

Era of Health Care Reform 74

U.S. Health Care Today 76

Conclusion 77

Chapter 4 Health Care Providers and Professionals 81

Introduction 81

Physicians 83

Dentists 91

Pharmacists 92

Other Doctoral-Level Health Professionals 93

Nurses 95

Nonphysician Practitioners 97

Allied Health Professionals 99

Public Health Professionals 101

Health Services Administrators 102

Conclusion 103

Chapter 5 Technology and Its Effects 107

Introduction 107

What Is Medical Technology? 109

Health Information Technology 110

Diffusion and Utilization of Medical Technology 114

The Governments Role in Technology Diffusion 117

Impact of Medical Technology 122

Assessment of Medical Technology 127

Benefits of Technology Assessment 129

Conclusion 130

Chapter 6 Financing and Reimbursement Methods 135

Introduction 135

Effects of Health Care Financing and Insurance 137

Insurance: Its Nature and Purpose 139

Private Insurance 141

The Affordable Care Act and Private Insurance 145

Public Insurance 147

The Affordable Care Act and Public Insurance 155

Reimbursement Methods 156

The Affordable Care Act and Payment Reform 160

National Health Expenditures 161

Conclusion 163

Chapter 7 Outpatient Services and Primary Care 167

Introduction 167

What Is Outpatient Care? 168

Scope of Outpatient Services 168

Outpatient Care Settings and Methods of Delivery 171

Primary Care 176

Effectiveness of Primary Care 181

The Medical-Home Strategy 185

Assessment of Community Health Centers 185

Conclusion 187

Chapter 8 Hospitals 193

Introduction 193

Evolution of the Hospital in the United States 194

Expansion and Downsizing of Hospitals in the United States 196

Access and Utilization Measures 200

Hospital Employment 202

Types of Hospitals 202

The Affordable Care Act and Hospitals 210

Licensure, Certification, and Accreditation 210

Hospital Organization 211

Ethics and Public Trust 212

Conclusion 215

Chapter 9 Managed Care and Integrated Systems 219

Introduction 219

What h Managed Care? 220

Evolution of Managed Care 222

Growth and Transformation of Managed Care 225

Utilization Control Methods in Managed Care 227

Types of Managed Care Plans 229

Impact on Cost, Access, and Quality 234

Integrated Systems 236

Types of Integration 238

Managed Care and Organizational Integration Under the Affordable Care Act 241

Conclusion 241

Chapter 10 Long-Term Care Services 245

Introduction 245

What Is LTC? 247

Community-Based Long-Term Care Services 253

Institutional Long-Term Care 257

Licensing and Certification of Nursing Homes 261

Other Long-Term Care Services 263

The Affordable Care Act and Long-Term Care 264

Nursing Home Industry and Expenditures 264

Conclusion 266

Chapter 11 Populations with Special Health Needs 269

Introduction 269

Framework to Study Vulnerable Populations 270

Predisposing Characteristics 271

Enabling Characteristics 279

Eliminating Socioeconomic Disparities 281

Need Characteristics 283

Conclusion 286

Chapter 12 Cost, Access, and Quality 291

Introduction 291

Cost of Health Care 292

The High Cost of U.S. Health Care 293

Reasons for High Health Care Costs 296

Cost Containment 298

Unequal in Access 301

Average in Quality 306

Quality Strategies and Initiatives 310

Developments in Process Improvement 311

Conclusion 312

Chapter 13 Health Policy 317

Introduction 317

What Is Health Policy9 318

Principal Features of U.S. Health Policy 320

Development of Legislative Health Policy 329

Critical Policy Issues 331

International Health Policy: Comparisons 337

Conclusion 338

Chapter 14 The Future of Health Services Delivery 341

Introduction 341

Forces of Future Change 342

Challenges of Coverage, Access, and Cost 346

The Future of Health Care Reform 348

Future Models of Care Delivery 352

Future Workforce Challenges 354

Global Challenges 355

New Frontiers in Clinical Technology 356

Care Delivery of the Future 358

Conclusion 358

Appendix 363

Glossary 367

Index 379

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