Essentials of the U.S. Health Care System

Description

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 Title Copyright Contents Preface New in the Fourth Edition Acknowledgments List of Exhibits List of Tables List of Figures CHAPTER 1 MAJOR CHARACTERISTICS OF U.S. HEALTH CARE DELIVERY Introduction Subsystems of U.S. Health Care Delivery Characteristics of the U.S. Health Care System Health Care Systems of Other Developed Countries Systems Framework Conclusion CHAPTER 2 FOUNDATIONS OF U.S. HEALTH CARE DELIVERY Introduction What Is Health? Determinants of Health Cultural Beliefs and Values Distribution of Health Care Strategies to Improve Health Conclusion CHAPTER 3 HISTORICAL OVERVIEW OF U.S. HEALTH CARE DELIVERY Introduction Medical Services in Preindustrial America Medical Training Medical Services in Postindustrial America History of Health Insurance Medical Services in the Corporate Era Era of Health Care Reform U.S. Health Care Today Conclusion CHAPTER 4 HEALTH CARE PROVIDERS AND PROFESSIONALS Introduction Physicians Dentists Pharmacists Other Doctoral-Level Health Professionals Nurses Nonphysician Practitioners Allied Health Professionals Public Health Professionals Health Services Administrators Conclusion CHAPTER 5 TECHNOLOGY AND ITS EFFECTS Introduction What Is Medical Technology? Health Information Technology Diffusion and Utilization of Medical Technology The Government’s Role in Technology Diffusion Impact of Medical Technology Assessment of Medical Technology Benefits of Technology Assessment Conclusion CHAPTER 6 FINANCING AND REIMBURSEMENT METHODS Introduction Effects of Health Care Financing and Insurance Insurance: Its Nature and Purpose Private Insurance The Affordable Care Act and Private Insurance Public Insurance The Affordable Care Act and Public Insurance Reimbursement Methods The Affordable Care Act and Payment Reform National Health Expenditures Conclusion CHAPTER 7 OUTPATIENT SERVICES AND PRIMARY CARE Introduction What Is Outpatient Care? Scope of Outpatient Services Outpatient Care Settings and Methods of Delivery Primary Care Effectiveness of Primary Care The Medical-Home Strategy Assessment of Community Health Centers Conclusion CHAPTER 8 HOSPITALS Introduction Evolution of the Hospital in the United States Expansion and Downsizing of Hospitals in the United States Access and Utilization Measures Hospital Employment Types of Hospitals The Affordable Care Act and Hospitals Licensure, Certification, and Accreditation Hospital Organization Ethics and Public Trust Conclusion CHAPTER 9 MANAGED CARE AND INTEGRATED SYSTEMS Introduction What Is Managed Care? Evolution of Managed Care Growth and Transformation of Managed Care Utilization Control Methods in Managed Care Types of Managed Care Plans Impact on Cost, Access, and Quality Integrated Systems Types of Integration Managed Care and Organizational Integration Under the Affordable Care Act Conclusion CHAPTER 10 LONG-TERM CARE SERVICES Introduction What Is LTC? Community-Based Long-Term Care Services Institutional Long-Term Care Licensing and Certification of Nursing Homes Other Long-Term Care Services The Affordable Care Act and Long-Term Care Nursing Home Industry and Expenditures Conclusion CHAPTER 11 POPULATIONS WITH SPECIAL HEALTH NEEDS Introduction Framework to Study Vulnerable Populations Predisposing Characteristics Enabling Characteristics Eliminating Socioeconomic Disparities Need Characteristics Conclusion CHAPTER 12 COST, ACCESS, AND QUALITY Introduction Cost of Health Care The High Cost of U.S. Health Care Reasons for High Health Care Costs Cost Containment Unequal in Access Average in Quality Quality Strategies and Initiatives Developments in Process Improvement Conclusion CHAPTER 13 HEALTH POLICY Introduction What Is Health Policy? Principal Features of U.S. Health Policy Development of Legislative Health Policy Critical Policy Issues International Health Policy: Comparisons Conclusion CHAPTER 14 THE FUTURE OF HEALTH SERVICES DELIVERY Introduction Forces of Future Change Challenges of Coverage, Access, and Cost The Future of Health Care Reform Future Models of Care Delivery Future Workforce Challenges Global Challenges New Frontiers in Clinical Technology Care Delivery of the Future Conclusion APPENDIX GLOSSARY INDEX