’Health care managers, practitioners, and students must both operate as effectively as they can within the daunting and continually evolving system at hand and identify opportunities for reform advances… Health Care Delivery in the United States 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 United States and abroad.’
—Sherry Glied, Ph D, Dean and Professor of Public Service, NYU Wagner, From the Foreword
This fully updated and revised 11th edition of a highly esteemed survey and analysis of health care delivery in the United States 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 Affordable Care Act (ACA), the implementation of Obamacare, and many new models of care designed to replace outmoded systems. 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; preventive medicine; emerging approaches to control health care costs; and much more.
Designed for graduate and advanced undergraduate students of health care management and administration and public health, the text addresses all of the complex core issues surrounding our health care system in a strikingly readable and accessible format. Contributors provide an in-depth and objective appraisal of why and how we organize health care the way we do, the enormous impact of health-related behaviors on the structure, function, and cost of the health care delivery system, and other emerging and recurrent issues in health policy, health care management, and public health. The 11th edition features the writings of such luminaries as Michael K. Gusmano, Carolyn M. Clancy, Joanne Spetz, Nirav R. Shah, Michael S. Sparer, and Christy Harris Lemak, among others. Chapters include key words, learning objectives and competencies, discussion questions, case studies, and new charts and tables with concrete health care data. Included for instructors is an Instructor’s Manual,
Power Point slides, Syllabus, Test Bank, Image Bank, Supplemental e-chapter on the ACA, and a transition guide bridging the 10th and 11th editions.
Key Features:
- Integration of the ACA throughout the text, including a supplementary e-chapter devoted to this major health care policy innovation
- The implementation of Obamacare
- Combines acute and chronic care into organizations of medical care
- Nursing workforce challenges
- Health disparities, vulnerable populations, and immigrant health
- Strategies to achieve the Triple Aim (better health and better care at lower cost)
- New models of care including accountable care organizations (ACOs), patient homes, health exchanges, and integrated health systems
- Emerging societal efforts toward creating healthy environments and illness prevention
- Increasing incentives for efficiency and better quality of care
- Expanded discussion of information technology
- A new 5-year trend forecast
Spis treści
Contents
LIST OF TABLES AND FIGURES
FOREWORD Sherry Glied
ACKNOWLEDGMENTS
ORGANIZATION OF THIS BOOK
CONTRIBUTORS
PART I: HEALTH POLICY
CHAPTER 1 THE CHALLENGE OF HEALTH CARE DELIVERY AND HEALTH POLICY
James R. Knickman and Anthony R. Kovner
Context
The Importance of Good Health to American Life
Defining Characteristics of the U.S. Health System
Major Issues and Concerns
Key Stakeholders Influencing the Health System
Organization of This Book
Discussion Questions
Case Study
Bibliography
CHAPTER 2 A VISUAL OVERVIEW OF HEALTH CARE DELIVERY IN THE UNITED STATES
Catherine K. Dangremond
The U.S. Health Care System: A Period of Change
The Shared Responsibility for Health Care
Where the Money Comes From, and How It Is Used
A Comparative Perspective
Population Health: Beyond Health Care
Access to Care and Variation in Health Outcomes
Health and Behavior
The Health Care Workforce
Variations in Health Care Delivery
Health Care Quality
Health Care Cost and Value
The Future of Health Care Delivery
References
CHAPTER 3 GOVERNMENT AND HEALTH INSURANCE: THE POLICY PROCESS
Michael S. Sparer and Frank J. Thompson
Context
The Government as Payer: The Health Insurance Safety Net
Government and Health Insurance: The Policy Process
Conclusion
Discussion Questions
Case Study
References
CHAPTER 4 COMPARATIVE HEALTH SYSTEMS
Michael K. Gusmano and Victor G. Rodwin
Overview
Health System Models
NHS and NHI Systems Compared With the United States
The Health Systems in England, Canada, France, and China
Lessons
Discussion Questions
Case Study
References
PART II: KEEPING AMERICANS HEALTHY
CHAPTER 5 POPULATION HEALTH
Pamela G. Russo
Context
The Population Health Model
The Medical Model
Comparing the Medical and Population Health Models
The Influence of Social Determinants on Health Behavior and Outcomes
Leading Determinants of Health: Weighting the Different Domains
Health Policy and Returns on Investment
Conclusion
Discussion Questions
Case Study
References
CHAPTER 6 PUBLIC HEALTH: A TRANSFORMATION FOR THE 21ST CENTURY
Laura C. Leviton, Paul L. Kuehnert, and Kathryn E. Wehr
Who’s in Charge of Public Health?
A Healthy Population Is in the Public Interest
Core Functions of Public Health
Governmental Authority and Services
Rethinking Public Health for the 21st Century
Discussion Questions
Case Study
References
CHAPTER 7 HEALTH AND BEHAVIOR
Elaine F. Cassidy, Matthew D. Trujillo, and C. Tracy Orleans
Behavioral Risk Factors: Overview and National Goals
Changing Health Behavior: Closing the Gap Between Recommended and Actual Health Lifestyle Practices
Changing Provider Behavior: Closing the Gap Between Best Practice and Usual Care
Conclusion
Discussion Questions
Case Study
References
CHAPTER 8 VULNERABLE POPULATIONS: A TALE OF TWO NATIONS
Jacqueline Martinez Garcel, Elizabeth A. Ward, and Lourdes J. Rodríguez
Understanding Vulnerable Populations and Their Context
The Growing Number of Vulnerable Populations
Organization and Financing of Health Care and Other Services for Vulnerable Populations
Social Service Needs
Federal and State Financing of Care for Vulnerable Populations
Challenges for Service Delivery and Payment
Emerging and Tested Ideas for Better Health Delivery
Conclusion
Discussion Questions
Case Study
References
PART III: MEDICAL CARE: TREATING AMERICANS’ MEDICAL PROBLEMS
CHAPTER 9 ORGANIZATION OF CARE
Amy Yarbrough Landry and Cathleen O. Erwin
Description of the Current Care Delivery System
The Future of the Delivery System
Best Practices
Looking Forward
Discussion Questions
Case Study
References
CHAPTER 10 THE HEALTH WORKFORCE
Joanne Spetz and Susan A. Chapman
Who Is Part of the Health Workforce?
Traditional Approaches to Health Workforce Planning
Health Workforce Education
Critical Issues for the Health Workforce
Conclusion: Building the Future Health Care Workforce
Discussion Questions
Case Study
References
CHAPTER 11 HEALTH CARE FINANCING
James R. Knickman
General Overview of Health Care Financing
What the Money Buys and Where It Comes From
How Health Insurance Works
How Providers Are Paid for the Health Services They Deliver
Specialized Payment Approaches Used by Payers
Issues Shaping the Future of Health Care Financing
Conclusion
Discussion Questions
Case Study
References
CHAPTER 12 HEALTH CARE COSTS AND VALUE
Thad Calabrese and Keith F. Safian
The Issue of Health Care Spending Growth
Conclusion
Discussion Questions
Case Study
References
CHAPTER 13 HIGH-QUALITY HEALTH CARE
Carolyn M. Clancy and Irene Fraser
Defining Quality
How Are We Doing?
How Do We Improve Quality?
How Do We Incentivize Quality Care?
What Are Major Recent Developments Affecting Quality?
Core Competencies for Health Administrators
Conclusion
Discussion Questions
Case Study
References
CHAPTER 14 MANAGING AND GOVERNING HEALTH CARE ORGANIZATIONS
Anthony R. Kovner and Christy Harris Lemak
Governing Boards and Owners
Management Work
Conclusion
Discussion Questions
Case Study
References
CHAPTER 15 HEALTH INFORMATION TECHNOLOGY
Nirav R. Shah
HIT Defined
The Backing of Government
Transformative Powers of HIT
HIT at the VA
The New York Experience
Implementing HIT
Challenges and Shortcomings of HIT
Toward the Future
Discussion Questions
Case Study
References
PART IV: FUTURES
CHAPTER 16 THE FUTURE OF HEALTH CARE DELIVERY AND HEALTH POLICY
James R. Knickman and Anthony R. Kovner
Dynamics Influencing Change
Aspects of the Health System That Are Set to Change by
Future Prospects for Different Stakeholders in the Health Enterprise
Conclusion
Discussion Questions
Case Study
Bibliography
APPENDIX Major Provisions of the Patient Protection and Affordable Care Act of 2010
GLOSSARY
INDEX
O autorze
Anthony R. Kovner, Ph D, MPA, is professor emeritus of Public and Health Management at New York University (NYU) Wagner Graduate School of Public Service.
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