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| Foreword | p. ix |
| Preface | p. xi |
| List of Exhibits | p. xv |
| List of Figures | p. xvii |
| List of Tables | p. xxi |
| List of Abbreviations/Acronyms | p. xxiii |
| A Distinctive System of Health Care Delivery | p. 1 |
| Introduction | p. 2 |
| An Overview of the Scope and Size of the System | p. 2 |
| A Broad Description of the System | p. 4 | ... MORE
| Basic Components of a Health Services Delivery System | p. 5 |
| A Disenfranchised Segment | p. 7 |
| Transition from Traditional Insurance to Managed Care | p. 8 |
| Primary Characteristics of the US Health Care System | p. 9 |
| Trends and Directions | p. 19 |
| Significance for Health Care Practitioners and Policymakers | p. 19 |
| Significance for Health Care Managers | p. 20 |
| Health Care Systems of Other Countries | p. 21 |
| The Systems Framework | p. 28 |
| Summary | p. 31 |
| Test Your Understanding | p. 32 |
| Review Questions | p. 32 |
| System Foundations | |
| Beliefs, Values, and Health | p. 37 |
| Introduction | p. 38 |
| Significance for Managers and Policymakers | p. 38 |
| Basic Concepts | p. 39 |
| Health Promotion and Disease Prevention | p. 44 |
| Developmental Health | p. 45 |
| Public Health | p. 45 |
| Health Protection | p. 46 |
| Quality of Life | p. 48 |
| Determinants of Health | p. 49 |
| Overarching Factors and Implications for Health Care Delivery | p. 53 |
| A Social Model of Health | p. 56 |
| Equitable Distribution of Health Care | p. 56 |
| Justice in the US Health Delivery System | p. 60 |
| Equality in the US Health Care Delivery System | p. 61 |
| Integration of Individual and Community Health | p. 64 |
| Measures of Health Status | p. 68 |
| Evaluation of Health Status | p. 68 |
| Demographic Change | p. 71 |
| Measures of Mental Health | p. 72 |
| Measures of Social Health | p. 72 |
| Measures of Spiritual Health | p. 73 |
| Measures of Health Services Utilization | p. 73 |
| Summary | p. 74 |
| Test Your Understanding | p. 74 |
| Review Questions | p. 75 |
| The Evolution of Health Services in the United States | p. 83 |
| Introduction | p. 84 |
| Medical Services in Preindustrial America | p. 85 |
| Medical Services in Postindustrial America | p. 89 |
| Medical Care in the Corporate Era | p. 109 |
| Summary | p. 113 |
| Test Your Understanding | p. 114 |
| Review Questions | p. 115 |
| System Resources | |
| Health Services Professionals | p. 119 |
| Introduction | p. 120 |
| Physicians | p. 122 |
| Some Key Issues in Medical Practice Involvement in the Development of Clinical Practice Guidelines | p. 128 |
| International Medical Graduates | p. 136 |
| Dentists | p. 137 |
| Pharmacists | p. 138 |
| Other Doctoral-Level Health Professionals | p. 139 |
| Nurses | p. 140 |
| Nonphysician Practitioners | p. 142 |
| Allied Health Professionals | p. 146 |
| Health Services Administrators | p. 148 |
| Summary | p. 150 |
| Test Your Understanding | p. 150 |
| Review Questions | p. 151 |
| List of Professional Associations | p. 152 |
| Medical Technology | p. 161 |
| Introduction | p. 162 |
| What Is Medical Technology? | p. 163 |
| Information Technology and Informatics | p. 163 |
| Innovation, Diffusion, and Utilization of Medical Technology | p. 168 |
| Managed Care and Technology Diffusion | p. 173 |
| The Government's Role in Technology Diffusion | p. 173 |
| The Impact of Medical Technology | p. 177 |
| The Assessment of Medical Technology | p. 182 |
| Current and Future Directions in Health Technology Assessment | p. 186 |
| Summary | p. 189 |
| Test Your Understanding | p. 190 |
| Review Questions | p. 190 |
| Health Services Financing | p. 197 |
| Introduction | p. 198 |
| The Role and Scope of Health Services Financing | p. 198 |
| Financing and Cost Control | p. 199 |
| The Insurance Function | p. 201 |
| Private Financing | p. 202 |
| Public Financing | p. 207 |
| Miscellaneous Private and Public Programs | p. 222 |
| The Payment Function | p. 224 |
| National Health Care Expenditures | p. 229 |
| Trends, Problems, and Issues in Insurance and Financing | p. 233 |
| Summary | p. 237 |
| Test Your Understanding | p. 238 |
| Review Questions | p. 238 |
| System Processes | |
| Outpatient and Primary Care Services | p. 243 |
| Introduction | p. 244 |
| What Is Outpatient Care? | p. 244 |
| The Scope of Outpatient Services | p. 245 |
| Primary Care | p. 245 |
| Community-Oriented Primary Care | p. 251 |
| Primary Care Providers | p. 251 |
| Growth in Outpatient Services | p. 253 |
| Reasons for the Growth in Outpatient Services | p. 255 |
| Types of Outpatient Care Settings and Methods of Delivery | p. 257 |
| Utilization of Outpatient Services | p. 275 |
| Summary | p. 281 |
| Test Your Understanding | p. 282 |
| Review Questions | p. 283 |
| Inpatient Facilities and Services | p. 289 |
| Introduction | p. 290 |
| Transformation of the Hospital in the United States | p. 290 |
| The Expansion Phase: Late 1800s to Mid-1980s | p. 294 |
| The Downsizing Phase: Mid-1980s Onward | p. 297 |
| Some Key Utilization Measures and Operational Concepts | p. 299 |
| Hospital Employment | p. 304 |
| Types of Hospitals | p. 305 |
| What Makes a Hospital Nonprofit? | p. 315 |
| Some Management Concepts | p. 317 |
| Licensure, Certification, and Accreditation | p. 319 |
| Ethical and Legal Issues in Patient Care | p. 321 |
| Hospitals and Public Trust | p. 323 |
| Summary | p. 324 |
| Test Your Understanding | p. 325 |
| Review Questions | p. 326 |
| Managed Care and Integrated Organizations | p. 333 |
| Introduction | p. 334 |
| What Is Managed Care? | p. 336 |
| Evolution of Managed Care | p. 338 |
| Growth of Managed Care | p. 341 |
| Efficiencies and Inefficiencies in Managed Care | p. 343 |
| Cost Control Methods in Managed Care | p. 344 |
| Types of Managed Care Organizations | p. 349 |
| Trends in Managed Care | p. 355 |
| Impact on Cost, Access, and Quality | p. 358 |
| Managed Care Backlash, Regulation, and the Aftermath | p. 360 |
| Consolidation, Expansion, Diversification, and Integration | p. 362 |
| Integrated Delivery Systems | p. 363 |
| Types of Integration | p. 364 |
| Issues Related to Integration | p. 368 |
| Summary | p. 370 |
| Test Your Understanding | p. 371 |
| Review Questions | p. 371 |
| Long-Term Care | p. 379 |
| Introduction | p. 380 |
| The Nature of Long-Term Care | p. 383 |
| Long-Term Care Services | p. 385 |
| The Clients of Long-Term Care | p. 392 |
| Types of Community-Based Long-Term Care Services | p. 396 |
| Institutional Long-Term Care | p. 403 |
| Specialized Facilities | p. 408 |
| Nursing Home Industry and Patient Demographics | p. 409 |
| Patient Assessment and Prospective Payment for SNFs | p. 418 |
| Requirements of Participation | p. 418 |
| Summary | p. 420 |
| Test Your Understanding | p. 421 |
| Review Questions | p. 421 |
| Health Services for Special Populations | p. 427 |
| Introduction | p. 428 |
| Racial/Ethnic Minorities | p. 428 |
| The Uninsured | p. 441 |
| Children | p. 443 |
| Women | p. 446 |
| Rural Health | p. 450 |
| The Homeless | p. 453 |
| Mental Health | p. 456 |
| The Chronically Ill and Disabled | p. 460 |
| HIV/AIDS | p. 462 |
| Summary | p. 474 |
| Test Your Understanding | p. 474 |
| Review Questions | p. 475 |
| System Outcomes | |
| Cost, Access, and Quality | p. 483 |
| Introduction | p. 484 |
| Cost of Health Care | p. 484 |
| Reasons for Cost Escalation | p. 491 |
| Cost Containment-Regulatory Approaches | p. 498 |
| Cost Containment-Competitive Approaches | p. 504 |
| Access to Care | p. 505 |
| Quality of Care | p. 514 |
| Dimensions of Quality | p. 515 |
| Quality Assurance | p. 518 |
| Quality Assessment | p. 519 |
| Quality Report Cards | p. 524 |
| Summary | p. 525 |
| Test Your Understanding | p. 526 |
| Review Questions | p. 526 |
| Health Policy | p. 533 |
| Introduction | p. 534 |
| What Is Health Policy? | p. 534 |
| The Principal Features of US Health Policy | p. 536 |
| The Development of Legislative Health Policy | p. 544 |
| Critical Policy Issues | p. 548 |
| The Future of Health Policy | p. 555 |
| Summary | p. 558 |
| Test Your Understanding | p. 559 |
| Review Questions | p. 559 |
| System Outlook | |
| The Future of Health Services Delivery | p. 561 |
| Introduction | p. 562 |
| Trends in Private and Public Health Insurance | p. 563 |
| Future Options in Financing and Insurance | p. 566 |
| Future Challenges for Managed Care | p. 569 |
| Comprehensive Reform: If and When It Occurs | p. 570 |
| National and Global Challenges | p. 574 |
| Bioterrorism and the Transformation of Public Health | p. 579 |
| The Future Outlook for US Hospitals | p. 580 |
| Future of the Health Care Workforce | p. 581 |
| Work Organization | p. 584 |
| Enhanced Focus on Customer Service | p. 585 |
| New Frontiers in Clinical Technology | p. 586 |
| The Era of Evidence-Based Health Care | p. 587 |
| Summary | p. 589 |
| Test Your Understanding | p. 590 |
| Review Questions | p. 590 |
| Glossary | p. 595 |
| Selected Web Sites | p. 621 |
| Index | p. 625 |
| Table of Contents provided by Ingram. All Rights Reserved. |