Health Care

The American health care industry has undergone such dizzying transformations since the 1960s that many patients have lost confidence in a system they find too impersonal and ineffectual. Is their distrust justified and can confidence be restored? David Dranove, a leading health care economist, tackles these and other key questions in the first major economic and historical investigation of the field. Focusing on the doctor-patient relationship, he begins with the era of the independently practicing physician--epitomized by Marcus Welby, the beloved father figure/doctor in the 1960s television show of the same name--who disappeared with the growth of managed care. Dranove guides consumers in understanding the rapid developments of the health care industry and offers timely policy recommendations for reforming managed care as well as advice for patients making health care decisions.

The book covers everything from start-up troubles with the first managed care organizations to attempts at government regulation to the mergers and quality control issues facing MCOs today. It also reflects on how difficult it is for patients to shop for medical care. Up until the 1970s, patients looked to autonomous physicians for recommendations on procedures and hospitals--a process that relied more on the patient's trust of the physician than on facts, and resulted in skyrocketing medical costs. Newly emerging MCOs have tried to solve the shopping problem by tracking the performance of care providers while obtaining discounts for their clients.


Many observers accuse MCOs of caring more about cost than quality, and argue for government regulation. Dranove, however, believes that market forces can eventually achieve quality care and cost control. But first, MCOs must improve their ways of measuring provider performance, medical records must be made more complete and accessible (a task that need not compromise patient confidentiality), and patients must be willing to seek and act on information about the best care available. Dranove argues that patients can regain confidence in the medical system, and even come to trust MCOs, but they will need to rely on both their individual doctors and their own consumer awareness.

Winner of the National Book Critics Circle Award for Nonfiction

When three-month-old Lia Lee Arrived at the county hospital emergency room in Merced, California, a chain of events was set in motion from which neither she nor her parents nor her doctors would ever recover. Lia's parents, Foua and Nao Kao, were part of a large Hmong community in Merced, refugees from the CIA-run "Quiet War" in Laos. The Hmong, traditionally a close-knit and fiercely people, have been less amenable to assimilation than most immigrants, adhering steadfastly to the rituals and beliefs of their ancestors. Lia's pediatricians, Neil Ernst and his wife, Peggy Philip, cleaved just as strongly to another tradition: that of Western medicine. When Lia Lee Entered the American medical system, diagnosed as an epileptic, her story became a tragic case history of cultural miscommunication.

Parents and doctors both wanted the best for Lia, but their ideas about the causes of her illness and its treatment could hardly have been more different. The Hmong see illness aand healing as spiritual matters linked to virtually everything in the universe, while medical community marks a division between body and soul, and concerns itself almost exclusively with the former. Lia's doctors ascribed her seizures to the misfiring of her cerebral neurons; her parents called her illness, qaug dab peg--the spirit catches you and you fall down--and ascribed it to the wandering of her soul. The doctors prescribed anticonvulsants; her parents preferred animal sacrifices.

"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, PhD, 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,
PowerPoint 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
We are surrounded by medical miracles: polio has been eradicated; childhood leukemia is now treatable; death by cardiovascular disease has declined by two-thirds in the last fifty years. Yet while American medicine has never been better, angst over American health care has never been greater. Why is American health care such a mess? In this path-breaking book--Nobel laureate Milton Friedman calls it "fascinating and thorough"--Dr. David Gratzer goes to the heart of the problem, showing that the crisis in American health care stems largely from its addiction to outmoded and discredited economic ideas. What needs to be done? Dr. Gratzer mounts a bold and provocative argument, rejecting the conventional wisdom that socialized health care is compassionate and that top-down government agencies like the FDA actually save lives. Instead, he prescribes a strong dose of capitalism. The Cure offers a detailed overview of American health care, from economics and politics to medical science. Weighing in on the most controversial topics in health care, Dr. Gratzer makes the case that it's possible to reduce health expenses, insure millions more, and improve quality of care while not growing government or raising taxes. An award-winning author and essayist, he is a master storyteller, enlivening his book with anecdotes, interviews, and stories drawn from his own extensive clinical experience. He details the cardiac woes of Robert E. Lee and Dick Cheney, describes a chat over coffee with Canada's foremost private medical entrepreneur (an acquaintance of Fidel Castro, as it happens), and explains the evolution of his own thinking, from advocating HillaryCare as a medical student to promoting individual choice and competition today. The patient is in critical condition; Dr. Gratzer diagnoses the disease and prescribes the cure.
Understand how the healthcare system works – and how you can succeed in it

A Doody's Core Title for 2019!

The Seventh Edition of Understanding Health Policy: A Clinical Approach remains the most trusted and comprehensive guide to healthcare available and provides everything you need to build a solid foundation on the field’s most critical issues. This concise and engaging textbook clearly explains the all major aspects of healthcare, including finance, organization, and reimbursement. It will help you develop a clearer, more systematic way of thinking about health care in the United States, its problems, and the alternatives for managing and solving these problems.

The book features a unique approach, using clinical vignettes to highlight key policy issues, clarify difficult concepts, and demonstrate how they apply to real-world situations, affecting both patients and professionals alike. Expert practitioners in both the public and private healthcare sectors, the authors cover the entire scope of our healthcare system. They carefully weave key principles, descriptions, and concrete examples into chapters that make important health policy issues interesting and understandable.

Understanding Health Policy makes otherwise difficult concepts easy to understand—so you can make better decisions, improve outcomes, and enact positive change on a daily basis.

The Seventh Edition features:

Updated throughout to reflect the latest changes and events, including additional content on value-based care, Choosing Wisely®, etc. Expanded coverage of the impact of the Affordable Care Act, including Accountable Care Organizations and their impact, and global issues in health policy End-of-chapter summaries and comprehensive lists of review questions to reinforce what you have learned Includes "Questions and Discussion Topics" for classroom or individual study
Pathologies of Power uses harrowing stories of illness, of life—and death—in extreme situations to interrogate our understanding of human rights. Paul Farmer, a physician and anthropologist with twenty years of experience studying diseases in Haiti, Peru, and Russia, argues that promoting the social and economic rights of the world’s poor is the most important human rights struggle of our times. A thoughtful memoir with passionate eyewitness accounts from the prisons of Russia and the beleaguered villages of Haiti and Chiapas, this book links the lived experiences of individual victims to a broader analysis of structural violence. Farmer challenges conventional thinking within human rights circles and exposes the relationships between political and economic injustice, on one hand, and the suffering and illness of the powerless, on the other.

Farmer shows that the same social forces that give rise to epidemic diseases such as HIV and tuberculosis also sculpt risk for human rights violations. He illustrates the ways that racism and gender inequality in the United States are mirrored in pathology, plague, disease and death. Yet this doctor’s autobiography is far from a hopeless inventory of human suffering. Farmer’s disturbing examples are linked to a guarded optimism that new medical and social technologies will develop in tandem with a more informed sense of social justice. Otherwise, he concludes, we will be guilty of managing social inequality rather than addressing structural violence. Farmer’s urgent plea to think about human rights in the context of global public health and to consider critical issues of quality and access for the world’s poor should be of fundamental concern to pathologists, medical students, and humanitarians in a world characterized by the bizarre proximity of surfeit and suffering.
A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 

"This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene  

At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems.

In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast?

Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. 

The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.
Provide outstanding healthcare while keeping within budget with this comprehensive, engagingly written guide

Understanding Value-Based Healthcare is a succinct, interestingly written primer on the core issues involved in maximizing the efficacy and outcomes of medical care when cost is a factor in the decision-making process. Written by internationally recognized experts on cost- and value-based healthcare, this timely book delivers practical and clinically focused guidance on one of the most debated topics in medicine and medicine administration today.

Understanding Value-Based Healthcare is divided into three sections:

Section 1 Introduction to Value in Healthcare lays the groundwork for understanding this complex topic. Coverage includes the current state of healthcare costs and waste in the USA, the challenges of understanding healthcare pricing, ethics of cost-conscious care, and more. Section 2 Causes of Waste covers important issues such as variation in resource utilization, the role of technology diffusion, lost opportunities to deliver value, and barriers to providing high-value care. Section 3 Solutions and Tools discusses teaching cost awareness and evidence-based medicine, the role of patients, high-value medication prescribing, screening and prevention, incentives, and implementing value-based initiatives.

The authors include valuable case studies within each chapter to demonstrate how the material relates to real-world situations faced by clinicians on a daily basis.

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Written by the President and CEO of the Institute for Healthcare Improvement (IHI) and a leading health care journalist, this groundbreaking book examines how leading organizations in the United States are pursuing the Triple Aim—improving the individual experience of care, improving the health of populations, and reducing the per capita cost of care.

Even with major steps forward – including the Affordable Care Act and the creation of the Center for Medicare and Medicaid Innovation -- the national health care debate is too often poisoned by negativity. A quieter, more thoughtful, and vastly more constructive conversation continues among health care leaders and professionals throughout the country. Innovative solutions are being designed and implemented at the local level, and countless health care organizations are demonstrating breakthrough remedies to some of the toughest and most expensive challenges in health care.

Pursuing the Triple Aim shares compelling stories that are emerging in locations ranging from Pittsburgh to Seattle, from Boston to Oakland, focused on topics including improving quality and lowering costs in primary care; setting challenging goals to control chronic disease with notable outcomes; leveraging employer buying power to improve quality, reduce waste, and drive down cost; paying for care under an innovative contract that compensates for quality rather than quantity; and much more. The authors describe these innovations in detail, and show the way toward a health care system for the nation that improves the experience and quality of care while at the same time controlling costs.

As the Triple Aim moves from being largely an aspirational framework to something that communities all across the US can implement and learn from, its potential to become a touchstone for the work ahead has never been greater. Pursuing the Triple Aim lays out the vision, the interventions, and promising examples of success.

Master the basics of rehab patient care with Pierson and Fairchild’s Principles & Techniques of Patient Care, 6th Edition. This proven text not only provides clear "how-to" information on everything from positioning and draping to patient transfers and ambulation activities, but it also includes easy-to-understand rationales explaining the "why" behind these proven techniques. This new edition has been thoroughly updated to reflect the most current accepted patient care standards, principles, and techniques. Plus, additional video clips and expanded learning resources will help ensure you have a solid mastery of patient care in the rehabilitation setting.Content based on the World Health Organization’s ICF model (International Classification of Functioning, Disability, and Health) — the model currently endorsed by the APTA and AOTA — ensures you are referencing information that stems from the most current theories and practice guidelines of physical and occupational therapy. Procedures boxes with clear written instructions are accompanied by full-color illustrations on performing a variety of proven techniques and patient care tasks such as proper lifting techniques, patient transfers, basic wound care, and assessment of vital signs. Insights into the rationales and physiological principles explain why specific techniques and procedures are used.More than 800 full color photographs clearly demonstrate proper performance of techniques and procedures used in the assessment and management of patients in the rehabilitation setting.Guidelines, principles, and precautions boxes throughout the text offer additional tips for optimal assessment and management of patients in the rehabilitation setting.Self-study and problem solving (case study) activities conclude each chapter to help you understand important concepts and improve your decision-making and problem solving skills. Video clips on companion Evolve website demonstrate the techniques and procedures described in the text.Content on professionalism and the concept of professional values and ethics reinforce existing workplace guidelines and how to apply those guidelines to your patient interactions.Online user resources on the companion Evolve website feature video clips and additional activities for you to hone your skills. (What additional activities?)NEW! Procedures index lists all of the procedures covered in the text to help you quickly locate procedure descriptions while working in the clinical setting.NEW! Additional video clips demonstrate patient transfers, ambulation with aids, donning and doffing PPE, and maneuvering a wheelchair.NEW! Video clip table of contents lists over 30 video clips in the front matter of the text.
Today, as never before, healthcare has the ability to enhance the quality and duration of life. At the same time, healthcare has become so costly that it can easily bankrupt governments and impoverish individuals and families.

Health services research is a highly multidisciplinary field, including such areas as health administration, health economics, medical sociology, medicine, , political science, public health, and public policy. The Encyclopedia of Health Services Research is the first single reference source to capture the diversity and complexity of the field. With more than 400 entries, these two volumes investigate the relationship between the factors of cost, quality, and access to healthcare and their impact upon medical outcomes such as death, disability, disease, discomfort, and dissatisfaction with care.

Key Features

Examines the growing healthcare crisis facing the United StatesEncompasses the structure, process, and outcomes of healthcareAims to improve the equity, efficiency, effectiveness, and safety of healthcare by influencing and developing public policiesDescribes healthcare systems and issues from around the globe

Key Themes

Access to CareAccreditation, Associations, Foundations, and Research OrganizationsBiographies of Current and Past LeadersCost of Care, Economics, Finance, and Payment MechanismsDisease, Disability, Health, and Health BehaviorGovernment and International Healthcare OrganizationsHealth InsuranceHealth Professionals and Healthcare OrganizationsHealth Services ResearchLaws, Regulations, and EthicsMeasurement; Data Sources and Coding; and Research MethodsOutcomes of CarePolicy Issues, Healthcare Reform, and International ComparisonsPublic HealthQuality and Safety of CareSpecial and Vulnerable Groups

The Encyclopedia is designed to be an introduction to the various topics of health services research for an audience including undergraduate students, graduate students, andgeneral readers seeking non-technical descriptions of the field and its practices. It is also useful for healthcare practitioners wishing to stay abreast of the changes and updates in the field.

Featuring analysis of cutting-edge healthcare issues and first-person stories, Policy & Politics in Nursing and Health Care, 7th Edition is the leader in helping students develop skills in influencing policy in today’s changing health care environment. Approximately 150 expert contributors present a wide range of topics in this classic text, providing a more complete background than can be found in any other policy textbook on the market. Discussions include the latest updates on conflict management, health economics, lobbying, the use of media, and working with communities for change. With these insights and strategies, you'll be prepared to play a leadership role in the four spheres in which nurses are politically active: the workplace, government, professional organizations, and the community. Comprehensive coverage of healthcare policies and politics provides a broader understanding of nursing leadership and political activism, as well as complex business and financial issues.Taking Action essays include personal accounts of how nurses have participated in politics and what they have accomplished.Expert authors make up a virtual Nursing Who's Who in healthcare policy, sharing information and personal perspectives gained in the crafting of healthcare policy.Winner of several American Journal of Nursing "Book of the Year" awards!NEW! Nine new chapters ensure you have the most up-to-date information on key topics such as ethical dimensions of policy and politics, patient engagement, public health, women's reproductive health, emergency preparedness, new health insurance exchanges, and much more.NEW! The latest information and perspectives are provided by nursing leaders who influenced health care reform, including the Affordable Care Act.NEW! Emphasis on evidence-based policy throughout the text.NEW! A list of web links is included in most chapters for further study.
The purpose of economic evaluation is to inform decisions intended to improve healthcare. The new edition of Methods for the Economic Evaluation of Health Care Programmes equips the reader with the necessary tools and understanding required to undertake evaluations by providing an outline of key principles and a 'tool kit' based on the authors' own experiences of undertaking economic evaluations. Building on the strength of the previous edition, the accessible writing style ensures the text is key reading for the non-expert reader, as no prior knowledge of economics is required. The book employs a critical appraisal framework, which is useful both to researchers conducting studies and to decision-makers assessing them. Practical examples are provided throughout to aid learning and understanding. The book discusses the analytical and policy challenges that face health systems in seeking to allocate resources efficiently and fairly. New chapters include 'Principles of economic evaluation' and 'Making decisions in healthcare' which introduces the reader to core issues and questions about resource allocation, and provides an understanding of the fundamental principles which guide decision making. A key part of evidence-based decision making is the analysis of all the relevant evidence to make informed decisions and policy. The new chapter 'Identifying, synthesising and analysing evidence' highlights the importance of systematic review, and how and why these methods are used. As methods of analysis continue to develop, the chapter on 'Characterising, reporting and interpreting uncertainty' introduces the reader to recent methods of analysis and why characterizing uncertainty matters for health care decisions. The fourth edition of Methods for the Economic Evaluation of Health Care Programmes has been thoroughly revised and updated, making it essential reading for anyone commissioning, undertaking, or using economic evaluations in health care, including health service professionals, health economists, and health care decision makers.
The New York Times bestselling author of Better and Complications reveals the surprising power of the ordinary checklist

We live in a world of great and increasing complexity, where even the most expert professionals struggle to master the tasks they face. Longer training, ever more advanced technologies—neither seems to prevent grievous errors. But in a hopeful turn, acclaimed surgeon and writer Atul Gawande finds a remedy in the humblest and simplest of techniques: the checklist. First introduced decades ago by the U.S. Air Force, checklists have enabled pilots to fly aircraft of mind-boggling sophistication. Now innovative checklists are being adopted in hospitals around the world, helping doctors and nurses respond to everything from flu epidemics to avalanches. Even in the immensely complex world of surgery, a simple ninety-second variant has cut the rate of fatalities by more than a third.

In riveting stories, Gawande takes us from Austria, where an emergency checklist saved a drowning victim who had spent half an hour underwater, to Michigan, where a cleanliness checklist in intensive care units virtually eliminated a type of deadly hospital infection. He explains how checklists actually work to prompt striking and immediate improvements. And he follows the checklist revolution into fields well beyond medicine, from disaster response to investment banking, skyscraper construction, and businesses of all kinds.

An intellectual adventure in which lives are lost and saved and one simple idea makes a tremendous difference, The Checklist Manifesto is essential reading for anyone working to get things right.

How We Do Harm exposes the underbelly of healthcare today—the overtreatment of the rich, the under treatment of the poor, the financial conflicts of interest that determine the care that physicians' provide, insurance companies that don't demand the best (or even the least expensive) care, and pharmaceutical companies concerned with selling drugs, regardless of whether they improve health or do harm.

Dr. Otis Brawley is the chief medical and scientific officer of The American Cancer Society, an oncologist with a dazzling clinical, research, and policy career. How We Do Harm pulls back the curtain on how medicine is really practiced in America. Brawley tells of doctors who select treatment based on payment they will receive, rather than on demonstrated scientific results; hospitals and pharmaceutical companies that seek out patients to treat even if they are not actually ill (but as long as their insurance will pay); a public primed to swallow the latest pill, no matter the cost; and rising healthcare costs for unnecessary—and often unproven—treatments that we all pay for. Brawley calls for rational healthcare, healthcare drawn from results-based, scientifically justifiable treatments, and not just the peddling of hot new drugs.

Brawley's personal history – from a childhood in the gang-ridden streets of black Detroit, to the green hallways of Grady Memorial Hospital, the largest public hospital in the U.S., to the boardrooms of The American Cancer Society—results in a passionate view of medicine and the politics of illness in America - and a deep understanding of healthcare today. How We Do Harm is his well-reasoned manifesto for change.

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