Essentials of the U.S. Health Care System, Second Edition

Contents
......Page 4
Preface......Page 10
About the Authors......Page 14
List of Exhibits......Page 16
List of Tables......Page 18
List of Figures......Page 20
List of Abbreviations......Page 22
INTRODUCTION......Page 26
SUBSYSTEMS OF U.S. HEALTH CARE DELIVERY......Page 28
CHARACTERISTICS OF THE U.S. HEALTH CARE SYSTEM......Page 34
HEALTH CARE SYSTEMS OF OTHER DEVELOPED COUNTRIES......Page 42
SYSTEMS FRAMEWORK......Page 46
CONCLUSION......Page 49
INTRODUCTION......Page 52
WHAT IS HEALTH?......Page 53
DETERMINANTS OF HEALTH......Page 56
CULTURAL BELIEFS AND VALUES......Page 58
CONCLUSION......Page 71
INTRODUCTION......Page 76
MEDICAL SERVICES IN PREINDUSTRIAL AMERICA......Page 78
MEDICAL SERVICES IN POSTINDUSTRIAL AMERICA......Page 82
HISTORY OF HEALTH INSURANCE......Page 87
MEDICAL SERVICES IN THE CORPORATE ERA......Page 95
CONCLUSION......Page 99
INTRODUCTION......Page 102
PHYSICIANS......Page 105
DENTISTS......Page 112
PHARMACISTS......Page 114
OTHER DOCTORAL-LEVEL HEALTH PROFESSIONALS......Page 115
NONPHYSICIAN PRACTITIONERS......Page 118
ALLIED HEALTH PROFESSIONALS......Page 120
HEALTH SERVICES ADMINISTRATORS......Page 122
CONCLUSION......Page 123
INTRODUCTION......Page 128
INFORMATION TECHNOLOGY......Page 130
USE OF MEDICAL TECHNOLOGY......Page 134
ROLE OF THE GOVERNMENT IN TECHNOLOGY DIFFUSION......Page 137
IMPACT OF MEDICAL TECHNOLOGY......Page 141
ASSESSMENT OF MEDICAL TECHNOLOGY......Page 146
BENEFITS OF TECHNOLOGY ASSESSMENT......Page 148
CONCLUSION......Page 149
INTRODUCTION......Page 154
EFFECTS OF HEALTH CARE FINANCING AND INSURANCE......Page 156
INSURANCE: ITS NATURE AND PURPOSE......Page 158
PRIVATE INSURANCE......Page 160
PUBLIC INSURANCE......Page 163
REIMBURSEMENT METHODS......Page 172
NATIONAL HEALTH EXPENDITURES......Page 176
CONCLUSION......Page 179
INTRODUCTION......Page 182
WHAT IS OUTPATIENT CARE?......Page 183
SCOPE OF OUTPATIENT SERVICES......Page 184
OUTPATIENT CARE SETTINGS AND METHODS OF DELIVERY......Page 186
PRIMARY CARE......Page 191
CONCLUSION......Page 202
INTRODUCTION......Page 206
EVOLUTION OF THE HOSPITAL IN THE UNITED STATES......Page 207
EXPANSION AND DOWNSIZING OF HOSPITALS IN THE UNITED STATES......Page 209
ACCESS AND UTILIZATION BY THE U.S. POPULATION......Page 212
UTILIZATION OF HOSPITAL CAPACITY......Page 214
TYPES OF HOSPITALS......Page 215
LICENSURE, CERTIFICATION, AND ACCREDITATION......Page 223
HOSPITAL ORGANIZATION......Page 224
ETHICS AND PUBLIC TRUST......Page 225
CONCLUSION......Page 227
INTRODUCTION......Page 230
WHAT IS MANAGED CARE?......Page 231
EVOLUTION AND GROWTH OF MANAGED CARE......Page 233
UTILIZATION CONTROL METHODS IN MANAGED CARE......Page 237
TYPES OF MANAGED CARE ORGANIZATIONS......Page 239
IMPACT ON COST, ACCESS, AND QUALITY......Page 244
HEALTH NETWORKS......Page 246
TYPES OF INTEGRATION......Page 247
CONCLUSION......Page 251
INTRODUCTION......Page 254
WHAT IS LTC?......Page 257
COMMUNITY-BASED LTC SERVICES......Page 262
INSTITUTIONAL LTC......Page 266
LICENSING AND CERTIFICATION OF NURSING HOMES......Page 270
OTHER LTC SERVICES......Page 273
STATE OF THE NURSING HOME INDUSTRY......Page 274
CONCLUSION......Page 276
INTRODUCTION......Page 280
FRAMEWORK TO STUDY VULNERABLE POPULATIONS......Page 281
ENABLING CHARACTERISTICS......Page 289
NEED CHARACTERISTICS......Page 291
CONCLUSION......Page 293
INTRODUCTION......Page 296
COST OF HEALTH CARE......Page 297
HIGH IN COST......Page 298
REASONS FOR HIGH COST......Page 301
COST CONTAINMENT......Page 304
UNEQUAL IN ACCESS......Page 308
AVERAGE IN QUALITY......Page 314
DEVELOPMENTS IN PROCESS IMPROVEMENT......Page 318
CONCLUSION......Page 320
INTRODUCTION......Page 324
WHAT IS HEALTH POLICY?......Page 325
PRINCIPAL FEATURES OF U.S. HEALTH POLICY......Page 327
DEVELOPMENT OF LEGISLATIVE HEALTH POLICY......Page 335
CRITICAL POLICY ISSUES......Page 338
CONCLUSION......Page 346
INTRODUCTION......Page 348
CONFLICTING REALITIES OF COST AND COVERAGE......Page 349
FUTURE OF MANAGED CARE, HEALTH CARE COSTS, AND SYSTEM REFORM......Page 351
TRENDS IN HEALTH INSURANCE......Page 356
OPTIONS FOR COMPREHENSIVE REFORM......Page 358
NATIONAL AND GLOBAL CHALLENGES......Page 360
BIOTERRORISM AND THE TRANSFORMATION OF PUBLIC HEALTH......Page 363
FUTURE OF THE HEALTH CARE WORKFORCE......Page 364
NEW FRONTIERS IN CLINICAL TECHNOLOGY......Page 366
EVIDENCE-BASED HEALTH CARE......Page 368
CONCLUSION......Page 369
Index......Page 374