The United States spends greatly more per person on health care than any other country but the evidence shows that care is often poor and inappropriate. Despite expenditures of 1.7 trillion dollars ...in 2003, and growing substantially each year, services remain fragmented and poorly coordinated, and more than 46 million people are uninsured. Why can't America, with its vast array of resources, sophisticated technologies, superior medical research and educational institutions, and talented health care professionals, produce higher quality care and better outcomes?In The Truth about Health Care, David Mechanic explains how health care in America has evolved in ways that favor a myriad of economic, professional, and political interests over those of patients. While money has always had a place in medical care, "big money" and the quest for profits has become dominant, making meaningful reforms difficult to achieve. Mechanic acknowledges that railing against these influences, which are here to stay, can achieve only so much. Instead, he asks whether it is possible to convert what is best about health care in America into a well functioning system that better serves the entire population.Bringing decades of experience as an active health policy participant, researcher, teacher, and consultant to the public and private sectors, Mechanic examines the strengths and weaknesses of our system and how it has evolved. He pays special attention to areas often neglected in policy discussions, such as the loss of public trust in medicine, the tragic state of long-term care, and the relationship of mental health to health care.For anyone who has been frustrated by uncoordinated health networks, insurance denials, and other obstacles to obtaining appropriate care, this book will provide a refreshing and frank look at the system's current and future dilemmas. Mechanic's thoughtful roadmap describes how health plans, healthcare professionals, policymakers, and consumer groups can work together to improve access, quality, fairness, and health outcomes in America.About the Author:
`This is an excellent textbook for which there is currently a niche in the market. It will be invaluable to students of health policy, health studies and health service research′ - Professor Michael ...Calnan, University of Bristol Written by leading academics in their field this book provides a clear and considered overview of the politics of health care in Britain. Bringing together a wide range of material on both past events and recent developments, the chapters cover issues such as the politics of health professionalism, clinical knowledge and organisation and management. Each chapter offers a a unique combination of theory, historical detail and analysis of contemporary events. It features case studies to illustrate how policy has evolved and developed in recent years, and the implications these changes have for practice. Written in an accessible style the chapters also include comprehensive introductions, summaries and further reading sections.
Seeking Value Sowers, Wesley E; Ranz, Jules M; Psychiatry, Group for the Advancement of
2020, 2020-11-13
eBook
This comprehensive volume examines the myriad factors that have led to the current state of health care in the United States -- starting with an analysis of the meaning and history of value ...measurement -- but it does not stop there. It offers a holistic vision for health care reform, one in which psychiatric professionals play a pivotal role.
Over the period 1987–1991 an inter-disciplinary five-country group developed the EuroQol instrument, a five-dimensional three-level generic measure subsequently termed the ‘EQ-5D’. It was designed to ...measure and value health status. The salient features of its development and its consolidation and expansion are discussed. Initial expansion came, in particular, in the form of new language versions. Their development raised translation and semantic issues, experience with which helped feed into the design of two further instruments, the EQ-5D-5L and the youth version EQ-5D-Y. The expanded usage across clinical programmes, disease and condition areas, population surveys, patient-reported outcomes, and value sets is outlined. Valuation has been of continued relevance for the Group as this has allowed its instruments to be utilised as part of the economic appraisal of health programmes and their incorporation into health technology assessments. The future of the Group is considered in the context of: (1) its scientific strategy, (2) changes in the external environment affecting the demand for EQ-5D, and (3) a variety of issues it is facing in the context of the design of the instrument, its use in health technology assessment, and potential new uses for EQ-5D outside of clinical trials and technology appraisal.
Taking a political economic approach, Schneider examines the conditions under which community-based health groups are emerging and explores the ways different constituencies address health dilemmas. ...She delineates future roles for new participants in health care, new models of community health, and a new medical pluralism.
Context: During the 1980s and 1990s, innovations in the organization, funding, and delivery of primary health care in Canada were at the periphery of the system rather than at its core. In the early ...2000s, a new policy environment emerged. Methods: This policy analysis examines primary health care reform efforts in Canada during the last decade, drawing on descriptive information from published and gray literature and from a series of semistructured interviews with informed observers of primary health care in Canada. Findings: Primary health care in Canada has entered a period of potentially transformative change. Key initiatives include support for interprofessional primary health care teams, group practices and networks, patient enrollment with a primary care provider, financial incentives and blended-payment schemes, development of primary health care governance mechanisms, expansion of the primary health care provider pool, implementation of electronic medical records, and quality improvement training and support. Conclusions: Canada's experience suggests that primary health care transformation can be achieved voluntarily in a pluralistic system of private health care delivery, given strong government and professional leadership working in concert.
Strong primary care systems are often viewed as the bedrock of health care systems that provide high-quality care, but the evidence supporting this view is somewhat limited. We analyzed comparative ...primary care data collected in 2009-10 as part of a European Union-funded project, the Primary Health Care Activity Monitor for Europe. Our analysis showed that strong primary care was associated with better population health; lower rates of unnecessary hospitalizations; and relatively lower socioeconomic inequality, as measured by an indicator linking education levels to self-rated health. Overall health expenditures were higher in countries with stronger primary care structures, perhaps because maintaining strong primary care structures is costly and promotes developments such as decentralization of services delivery. Comprehensive primary care was also associated with slower growth in health care spending. More research is needed to explore these associations further, even as the evidence grows that strong primary care in Europe is conducive to reaching important health system goals.
"Jonas and Kovner's Health Care Delivery in the United States is one of the stronger health policy texts on the market. Readers and instructors looking for an up-to-date, broad-based overview of US ...health policy should strongly consider using the book."--The Journal of the American Medical Association (JAMA) (From reviews of the 10th Edition.) "Health care managers, practitioners, and students must both operate as effectively as they can the daunting and continually evolving system at hand and identify opportunities for reform advances Health Care Delivery in the US has been an indispensable companion to those preparing to manage this balance. The present edition demonstrates once again why this volume has come to be so prized. It takes the long view - charting recent developments in health policy, and putting them side-by-side with descriptions and analysis of existing programs in the US and abroad." Sherry Glied, PhD Dean and Professor of Public Service, NYU Wagner From the Foreword Named a 2013 Doody's Medical Reviews Essential Purchase! This fully updated and revised 11th edition of a highly esteemed survey and analysis of health care delivery in the U.S. keeps pace with the rapid changes that are reshaping our system. Fundamentally, this new edition presents the realities that impact our nation's achievement of the so-called Triple Aim: better health and better care at a lower cost. It addresses challenges and responses to the Accountable Care Act, the implementation of Obamacare, and many new models of care designed to replace outmoded systems. Contributions by leading scholars, practitioners, and educators within population health and medical care present the most up-to-date evidence-based information on health disparities, vulnerable populations, and immigrant health; nursing workforce challenges; new information technology; preventative medicine; emerging approaches to control health care costs, and much more.
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