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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
A comprehensive guide to the structure, synergy, and challenges in U.S. health care delivery
Introduction to Health Care Services: Foundations and Challenges offers new insights into the most important sectors of the United States' health care industry and the many challenges the future holds. Designed to provide a comprehensive and up-to-date understanding of the system, this textbook covers the many facets of health care delivery and details the interaction of health, environments, organizations, populations, and the health professions. Written by authors with decades of experience teaching and working in health care administration and management, the book examines the current state and changing face of health care delivery in the United States. Each chapter includes learning objectives and discussion questions that help guide and engage deeper consideration of the issues at hand, providing a comprehensive approach for students. Cases studies demonstrating innovations in the delivery of health care services are also presented.
Health care administration requires a thorough understanding of the multiple systems that define and shape the delivery of health care in the United States. At the same time, it is important for students to gain an appreciation of the dilemma confronting policy makers, providers, and patients in the struggle to balance cost, quality, and access. Introduction to Health Care Services: Foundations and Challenges is an in-depth examination of the major health care issues and policy changes that have had an impact on the U.S. health care delivery system.
- Includes information on U.S. health care delivery, from care to cost, and the forces of change
- Focuses on major industry players, including providers, insurers, and facilities
- Highlights challenges facing health care delivery in the future, including physician shortages, quality care, and the chronic disease epidemic
The U.S. health care system is undergoing major reform, and the effects will ripple across every sector of the industry. Introduction to Health Care Services: Foundations and Challenges gives students a complete introduction to understanding the issues and ramifications.
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Veröffentlichungsjahr: 2014
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Table of Contents
Title Page
Copyright
Dedication
Figures, Tables, and Exhibits
Figures
Tables
Exhibits
Introduction
Acknowledgments
About the Authors
About the Contributors
PART ONE: OVERVIEW OF HEALTH CARE SERVICE DELIVERY
Chapter 1: An Overview of Health Care Delivery in the United States
Health Care Costs
Health Care Access
Health Levels and Outcomes
Health Care Quality
Summary
Key Terms
Discussion Questions
References
Chapter 2: The Forces of Change in Health Care
Consequences of Forty Years of Health Care Cost Escalation
Health Care Reform
Summary
Key Terms
Discussion Questions
References
PART TWO: THE MAJOR PLAYERS IN HEALTH CARE SERVICES
Chapter 3: Providers of Health Care Services
Primary Care Physicians and Primary Care Assistants
Specialty Care Providers
Dentists, Dental Hygienists, and Dental Assistants
Mental Health Care Providers
Nurses
Radiologic and Imaging Professionals
Allied Health Rehabilitation Professionals
Collaboration in Health Care
Employment Trends in the Health Care Sector
Summary
Key Terms
Discussion Questions
References
Chapter 4: Hospitals
History of Hospitals
Management of Hospitals
Quality and Safety in Hospitals
Magnet Recognition Program
Challenges and the Future
Summary
Key Terms
Discussion Questions
References
Chapter 5: Ambulatory Care Services
History of Ambulatory Care Services
Reasons for the Expansion of Ambulatory Care
Hospital-Based Ambulatory Care
Non-Hospital-Based Ambulatory Care
Primary Care Management
Home Health Care Services
Hospice Services
Quality Assurance in Ambulatory Care
Summary
Key Terms
Discussion Questions
References
Chapter 6: Health Insurance and Payment for Health Care Services
Basics of U.S. Health Insurance
History of Health Insurance
How Health Insurance Markets Work
Health Insurance Providers
Reimbursement for Health Care Providers
Why Health Insurance Is Such a Huge Problem in the United States
Creative Destruction of Health Insurance
Summary
Key Terms
Discussion Questions
References
Chapter 7: Managed Care
Concepts of Managed Health Care
History of Managed Health Care
Types of Managed Care Plans
Managed Care Utilization Control
Managed Care Quality Issues
Managed Care and Prevention of Disease
Comparative Effectiveness Research
Future of Managed Health Care
Summary
Key Terms
Discussion Questions
References
Chapter 8: Long-Term Care
The Aging of Americans
History of Long-Term Care
Organization of Long-Term Care
Payment for Long-Term Care Services
Chronic Diseases and Their Complications
Challenges for Long-Term Care in the Future
Summary
Key Terms
Discussion Questions
References
Chapter 9: Mental Health Care
History of Mental Health
The Role of Stress
Types of Mental Illnesses
Mental Health Care Providers
Mental Health Parity
Summary
Key Terms
Discussion Questions
References
Chapter 10: Public Health Services
History of Public Health
Structure of Public Health Departments
Determinants of Health
Core Functions of Public Health
Epidemiology and Public Health
Population-Based Health
Public Health Leadership
Future of Public Health
Summary
Key Terms
Discussion Questions
References
PART THREE: CHALLENGES IN HEALTH CARE DELIVERY
Chapter 11: The Pursuit of Quality Care
Origins of the Quality Movement
IOM Report on Medical Errors
IOM Report on the Quality Chasm
Quality Improvement Strategies
Medical Errors
Health Care–Associated Infections
Summary
Key Terms
Discussion Questions
References
Chapter 12: The Chronic Disease Epidemic
Chronic Diseases and Their Complications
Costs of Chronic Diseases
Chronic Disease Prevention and Behavioral Changes
Applying Business and Other Models to Chronic Disease Prevention
Summary
Key Terms
Discussion Questions
References
Chapter 13: Leadership Solutions to Health Care Problems
Health Care Reform Beyond the ACA
Reengineering the Health Care Sector
Understanding Power in the Health Care Sector
Changing the Health Care Environment
How Leaders Can Meet These Challenges
Summary
Key Terms
Discussion Questions
References
Chapter 14: Integrating Clinical Services and Community Prevention: The Community-Centered Health Home Model
History of Clinical Services and Community Prevention Integration
Elements of the Community-Centered Health Home
Capacities Needed for Effective Implementation
Overarching Systems Change Recommendations
Summary
Key Terms
Discussion Questions
References
Chapter 15: A Look into the Future
Major Challenges Facing Health Care Delivery
Areas of Future Concern
How to Meet These Challenges
Summary
Key Terms
Discussion Questions
References
Case Study 1: Innovation in Physician Leadership Education
Leadership Education at the Guthrie Clinic
Conclusion
Discussion Questions
Case Study 2: Using Marketing Tools to Increase Early Referrals of Children with Developmental and Behavioral Disorders
Using a PSA Program to Increase Awareness of Developmental Issues
Conclusion
Discussion Questions
References
Case Study 3: Fall Reduction at Geisinger Wyoming Valley Medical Center
Geisinger Health System and Geisinger Wyoming Valley
Types of Preventable Harm in Hospitals
Geisinger Quality Institute
Fall Rates and Best Practices in Fall Reduction
The Journey to Uphold the Oath
Conclusion
Discussion Questions
References
Case Study 4: The VA Reinvents Itself
The Dark Years
The Beginning of Change
Putting Veterans' Health First
The VA Answer for Everyone
Conclusion
Discussion Questions
References
Index
End User License Agreement
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Guide
Cover
Table of Contents
Introduction
PART ONE: OVERVIEW OF HEALTH CARE SERVICE DELIVERY
Begin Reading
List of Illustrations
Figure 1.1
Figure 1.2
Figure 1.3
Figure 2.1
Figure 2.2
Figure 2.3
Figure 3.1
Figure 3.2
Figure 5.1
Figure 5.2
Figure 6.1
Figure 6.2
Figure 6.3
Figure 7.1
Figure 7.2
Figure 7.3
Figure 8.1
Figure 8.2
Figure 8.3
Figure 8.4
Figure 8.5
Figure 10.1
Figure 10.2
Figure 10.3
Figure 10.4
Figure 10.5
Figure 11.1
Figure 12.1
Figure 12.2
Figure 12.6
Figure 12.3
Figure 12.4
Figure 12.5
Figure 12.7
Figure 12.8
Figure 12.9
Figure 14.3
Figure 14.1
Figure 14.2
Figure 14.4
Figure 15.1
Figure 15.2
Figure CS3.1
Figure CS3.2
List of Tables
Table 1.1
Table 1.2
Table 1.3
Table 2.1
Table 5.1
Table 7.1
Table 8.1
Table 8.2
Table 9.1
Table 10.1
Table 11.1
Table CS2.1
INTRODUCTION TO HEALTH CARE SERVICES
FOUNDATIONS AND CHALLENGES
Bernard J. Healey
Tina Marie Evans
Cover Design: Wiley
Cover image : © Thinkstock.com/Hilch
Copyright © 2015 by John Wiley & Sons, Inc. All rights reserved.
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Library of Congress Cataloging-in-Publication Data
Healey, Bernard J., 1947-
Introduction to health care services : foundations and challenges / Bernard J. Healey, Tina M. Evans.
pages cm
Includes bibliographical references and index.
ISBN 978-1-118-40793-6 (pbk.)
1. Medical care–United States. 2. Health care reform–United States. 3. Public health administration—
United States. 4. Medical economics–United States. I. Evans, Tina M., 1976- II. Title.
RA395.A3H3845 2015
368.38'2 — dc23
2014026473
To Kathy, my wife of forty-two years, my two wonderful children, Alison and Bryan, and my five-year-old grandson, John.
Bernard J. Healey
To my grandfather and fishing buddy, Edward Evans Sr., who has taught me so much about working hard and making a difference in the lives of others. I love you!
Tina Marie Evans
Figures, Tables, and Exhibits
Figures
1.1
U.S. Population Aged Sixty-Five and Older, by Size and Percentage of Total Population, 1900–2010
1.2
Trajectory of Health Disparities
1.3
Prevalence of Diagnosed Diabetes Among U.S. Adults Aged Eighteen and Over, 1997–September 2011
2.1
The Medicare Population Is Growing, but Fewer Workers Will Support This Population in the Future
2.2
Percentages Covered by Medicaid Within Specific Groups
2.3
The Disease Path
3.1
Employment and Earnings in Selected Health Care Practitioner and Health Care Support Occupations
3.2
Projected Change in Total Employment, Selected Health Care Occupations
5.1
Annual Number of Ambulatory Care Visits: United States, 1997–2007
5.2
Rate of Receipt of Home Health Care per 1,000 Civilian Noninstitutionalized Population Aged Sixty-Five and over by Sex: United States, 2007
6.1
National Health Care Expenditures per Capita, 1960–2010
6.2
Average Annual Growth Rate for NHE and GDP, per Capita for Selected Time Periods
6.3
Characteristics of Medicare's 45 Million Beneficiaries
7.1
Total Health Expenditure per Capita, United States and Selected Countries, 2008
7.2
Distribution of Health Plan Enrollment for Covered Workers, by Plan Type, 1988–2013
7.3
Drivers of Quality
8.1
People with Long-Term Care Needs
8.2
Number of People Aged Sixty-Five-Plus, 1900–2030 (in millions)
8.3
National Spending on Long-Term Care, 2003 (in billions)
8.4
Medicaid Is the Primary Payer for Long-Term Care Services
8.5
Growth in Medicaid Long-Term Care Services and Supports Expenditures, 2002–2011 (in billions)
10.1
Trajectory of Health Disparities
10.2
Core Functions and the Ten Essential Public Health Services
10.3
Flow of Surveillance Data
10.4
Triad of Disease
10.5
Chain of Infection for Disease
11.1
Health Care–Associated Infection Reporting Laws, as of January 2011
12.1
Number of People Reporting Selected Chronic Diseases, 2003
12.2
Avoidable Economic Costs Attributable to Decline in Obesity, 2023
12.3
Lost Productivity by Chronic Disease, 2003
12.4
Economic Impact of Chronic Disease, 2003
12.5
Projected Rise in Cases of Chronic Disease, 2003–2023
12.6
Current Path: Combined Value of Treatment Expenditures and Productivity Losses, 2003–2023
12.7
The Change Leader
12.8
Example of a Flowchart Applied to a Health Problem
12.9
The Model for Improvement
14.1
Discrepancy Between Health Determinants and Health Spending, 2012
14.2
Taking Two Steps to Prevention
14.3
The CCHH Model: An Evolving Approach to Health
14.4
Two Steps in Practice: Identifying Community-Level Factors That Affect Health
15.1
Prevalence of Obesity Among Adults Aged Twenty and over, by Sex and Age: United States, 2009–2010
15.2
Percentage of Adults Aged Eighteen and over Who Met the 2008 Federal Physical Activity Guidelines for Aerobic Activity Through Leisure-Time Aerobic Activity: United States, 1997–September 2011
CS3.1
GWV Fall Rates, 2008–2012
CS3.2
GWV Reduction in Falls with Injuries over a Two-Year Period
Tables
1.1
National Health Care Expenditures: Aggregate and per Capita Amounts, Annual Percentage Change and Percentage Distribution: Selected Calendar Years 1960–2011
1.2
Number of Deaths and Crude Mortality Rate for Leading Causes of Death in the United States in 1900
1.3
Number of Deaths and Crude Mortality Rate for Leading Causes of Death in the United States in 2000
2.1
Overview of Economic Evaluation Methods
5.1
Leading Primary Diagnosis Groups for Outpatient Department Visits: United States, 2009
7.1
Forces That Affect Overall Health Care Utilization
8.1
Life Expectancies at Birth, 1970–2007, and Projections, 2010–2020
8.2
Categories and Services in the Care Continuum
9.1
Common Classifications of Mental Illness
10.1
Healthy People 2020: The Leading Health Indicators
11.1
Taxonomy of QI Strategies with Examples of Substrategies
Exhibits
10.1
Recognizing the Differences Between Primary, Secondary, and Tertiary Prevention: Childhood Lead Poisoning
14.1
Thrive Community Health Factors
Introduction
The health care industry in the United States is undergoing very rapid change in all sectors of health services delivery. This change will continue into the foreseeable future due to pressures from government, third-party payers, health care providers, and the consumers of health services. One of the most important catalysts of this change is the Patient Protection and Affordable Care Act. This federal legislation was signed into law on March 23, 2010, and it will result in numerous reforms in the way health care services are delivered and received by almost all Americans. The final result of this health care reform will be a completely restructured health care delivery system.
Everyone seems to agree that change in the health services sector of the U.S. economy is inevitable and long overdue, even though the prospect of this change seems to terrify everyone, especially the providers of health care services. This is why there have been numerous efforts to bring about health care reform over the last fifty years with very little success. In fact, a great deal of the change that has occurred over the years has only made our problems in delivering health care services worse.
The major problems found in our current health care system continue to be cost escalation, lack of access to care for a large number of Americans, and poor health for a large percentage of Americans. Of course, many of these problems will go away if more people remain healthy rather than becoming ill. The leading cause of morbidity and mortality in our country is no longer curable communicable diseases but rather incurable chronic diseases. This silent epidemic of chronic diseases cannot be treated, but it can be prevented if we as a nation are willing to invest the necessary resources in health education and health promotion programs designed to help people avoid acquiring these diseases in the first place.
Almost all the money spent on health care every year goes toward diagnosing curable disease and then working to cure it. The problem with this strategy is that once one acquires a chronic disease there is no cure; one can only manage the chronic disease in an attempt to prevent later complications from it. Fortunately, there is another strategy that can be used to deal with the epidemic of chronic diseases. This strategy will take a long time to develop, implement, evaluate, and improve, but given time and resources it will work. Our health care system must move a large amount of resources away from disease detection and attempted cure and direct those resources instead to health education designed to prevent disease. Health education is also a valuable strategy for preventing the complications that usually arise from having a chronic disease for a long period of time.
This text outlines many of the changes that are coming in the very near future to the American health care delivery system. It is divided into three sections: an overview of health care services delivery in the United States, a thorough survey of the major players in health care services, and a discussion of the challenges in health care delivery. In addition to the usual topics found in an introduction to health care services, it provides extensive coverage of the chronic disease epidemic, discussions about the community-centered health home model, and a thorough explanation of how leadership and the empowerment of health care workers can unleash the creativity and innovation that are so necessary if we are to solve our major health care problems. This book concludes with four case studies that demonstrate the kinds of innovations already occurring in the delivery of health care services.
An instructor's supplement is available at www.wiley.com/go/healeyevans. Additional materials such as videos, podcasts, and readings can be found at www.josseybasspublichealth.com. Comments about this book are invited and can be sent to [email protected].
Acknowledgments
We would like to begin by acknowledging the dedicated individuals who work in the field of health care delivery on a daily basis with the goal of improving the health of those who become ill or are attempting to remain well. They are working during very difficult times as the American health care delivery system reorganizes the way it delivers health care.
During the process of gathering the research for this new text, we met many dedicated people who went out of their way to provide us with the vital information required to make this book accurate and to the point on the numerous topics covered. A number of individuals, to whom we are truly indebted, helped us with the writing of particular chapters. Several of the wonderful individuals who work at Prevention Institute, a nonprofit national center dedicated to improving community health and equity through effective primary prevention, wrote the chapter on the community-centered health home. They are Jeremy Cantor, Larry Cohen, Leslie Mikkelsen, Rea Pañares, Janani Srikantharajah, and Erica Valdovinos.
Two more individuals assisted us on two of the most important topics for a book designed to introduce students to the new world of health services delivery: hospitals and health insurance. Denise Yanchik contributed the comprehensive chapter about the historical development of hospitals and the many challenges these institutions are facing today in the United States. Jeffrey R. Helton contributed a great deal of up-to-date information as the coauthor of the chapter on health insurance in the United States.
In addition, Francis G. Belardi, Jeff Kile, Daniel J. Amorino, and Joseph J. Marrone contributed the case studies in health care administration that conclude this book. These case studies offer the reader a great deal of information about the enormous creativity and innovation going into the restructuring of the U.S. health care delivery system. Thanks to all of these generous individuals, we believe that this text captures the most important components of this country's new health care delivery system.
We would also like to thank reviewers Joy Renfro, Karoline Mortensen, Janice Frates, and Aaron G. Buseh, who provided thoughtful and constructive comments on the complete draft manuscript.
There are many wonderful people who gave of their time to help make our ideas better. We are very fortunate to have had the opportunity to write a book for a national publisher, and we are equally fortunate to have been able to work with such talent.
About the Authors
Bernard J. Healey is a professor of health care administration at King's College in Wilkes-Barre, Pennsylvania, and has been teaching college courses since 1974. He began his career in 1971 as an epidemiologist for the Pennsylvania Department of Health, retiring from that position in 1995. During his tenure with government he completed advanced degrees in business administration and public administration. He received his doctoral degree from the University of Pennsylvania in 1990. Healey has been teaching undergraduate and graduate courses in business, public health, and health care administration at several colleges for over thirty years.
The author of over one hundred published articles about public health; health policy, leadership, and marketing; and health care partnerships, Healey has also written and published four books on various topics in health care administration. He is a member of the Association of University Programs in Health Care Administration, a part-time consultant in epidemiology for the Wilkes-Barre City Health Department, and a consultant for numerous public health projects in Pennsylvania.
Tina Marie Evans is an associate professor and department head of applied health studies at the Pennsylvania College of Technology. She is a 1998 summa cum laude graduate of Marywood University with a bachelor's degree in sports medicine, and she completed her master's degree in health care administration at King's College in 1999. After teaching at King's College in the Department of Sports Medicine for five years, and serving as the interim director of sports medicine there, she then taught at Marywood University for two years, receiving her doctoral degree in 2004 from Marywood, with a specialization in health promotion. She is active in grant writing, publishing scholarly manuscripts, and presenting on various allied health topics on the local, regional, national, and international levels. She also engages in volunteer activities in her church and community. Outside of work, she enjoys the outdoors, swimming, golf, ballroom dancing, and spending time with her family.
About the Contributors
Daniel J. Amorino is a quality improvement specialist in the Geisinger Quality Institute at Geisinger Health System. In this role he acts as a process improvement consultant and coach, using Lean/Six Sigma methodologies on various projects throughout the health system. His work varies from improving the patient experience by addressing throughput and clinic flow to helping teams that are struggling with performance measures in the inpatient setting. Previously, he worked at the Department of Veterans Affairs in New York City, first as an administrative Fellow and then as a process improvement specialist. He earned his BA degree in sociology from Brigham Young University-Idaho and his MHA degree from The Pennsylvania State University. He lives in northeast Pennsylvania with his wife, Jennifer, two daughters, Ellie and Evangeline, and twin boys, Calvin and Cooper.
Francis G. Belardi is currently president and CEO of the Guthrie Medical Group in Sayre, Pennsylvania. While serving as executive vice president of the Guthrie Clinic, he developed a physician leadership curriculum in conjunction with King's College. This program has trained forty-five Guthrie physicians in physician leadership over the past five years, and twelve of those physicians are pursuing the MHA degree to further enhance their leadership skills. He has served in many other leadership roles at the Guthrie Clinic, including program director for the family medicine residency, chairman of family medicine for Guthrie-Robert Packer Hospital, and designated institutional official for all Guthrie graduate medical education programs. He is a Fellow of the American Academy of Family Practice, and he has contributed several articles to the primary care medical literature over his forty-year career. Born and raised in Pearl River, New York, Belardi received his BS degree from Iona College and his MD degree from the Creighton University School of Medicine. He completed an internship at the Rhode Island Hospital–Brown University Program in Medicine in Providence, Rhode Island, a family medicine residency at the Ohio State University Affiliated Hospitals, and an academic teaching fellowship at the University of North Carolina School of Medicine. He has been married to his wife, Ann Marie, for forty-four years and has three children and three grandchildren.
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Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
Lesen Sie weiter in der vollständigen Ausgabe!
