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Changing the U.S. Health Care System
Key Issues in Health Services Policy and Management
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Main description:

Changing the U. S. Health Care System
Key Issues in Health Services Policy and Management
4th Edition


Since the first edition was published in 1996, Changing the U.S. Health Care System has provided a comprehensive, single–source account of the issues of most concern to health care policy and management students, health services researchers and policy analysts, health care managers, practitioners, and providers.


The fourth edition of Changing the U.S. Health Care System is a thoroughly revised and updated compendium of evidence–based views of the most important current issues in the field. Written by a panel of health care policy experts, this new edition highlights access to health care, cost of health care, quality of health care, special populations, and directions for change. This resource also offers deep coverage of health reform and its impact on all areas and regions of health services.


Each chapter is written by experts in the field who integrate evidence to explain the current condition and present support for needed change in our health care system.


Companion Web site: www.josseybass.com/go/kominski4e
Additional resources: www.josseybasspublichealth.com


Back cover:

Changing the U. S. Health Care System
Key Issues in Health Services Policy and Management
4th Edition


Since the first edition was published in 1996, Changing the U.S. Health Care System has provided a comprehensive, single–source account of the issues of most concern to health care policy and management students, health services researchers and policy analysts, health care managers, practitioners, and providers.


The fourth edition of Changing the U.S. Health Care System is a thoroughly revised and updated compendium of evidence–based views of the most important current issues in the field. Written by a panel of health care policy experts, this new edition highlights access to health care, cost of health care, quality of health care, special populations, and directions for change. This resource also offers deep coverage of health reform and its impact on all areas and regions of health services.


Each chapter is written by experts in the field who integrate evidence to explain the current condition and present support for needed change in our health care system.


Companion Web site: www.josseybass.com/go/kominski4e
Additional resources: www.josseybasspublichealth.com


Contents:

Figures and Tables xv


Foreword to the Third Edition xix


Foreword to the Fourth Edition xxi


The Editor xxv


The Authors xxvii


Introduction and Overview xliii


Acknowledgments lvii


PART ONE: ACCESS TO HEALTH CARE 1


1 The Patient Protection and Affordable Care Act of 2010 3
Gerald F. Kominski


Learning Objectives 3


Events Leading to the Enactment of the ACA 4


Major Provisions of the ACA 7


Future Directions 20


Summary 25


Key Terms 26


Discussion Questions 28


2 Improving Access to Care 33
Ronald M. Andersen, Pamela L. Davidson, Sebastian E. Baumeister


Learning Objectives 33


Understanding Access to Health Care 34


Future Directions 60


Summary 63


Key Terms 63


Discussion Questions 64


3 Racial and Ethnic Disparities in Health Status 71
Antronette K. Yancey, Roshan Bastani, Beth A. Glenn


Learning Objectives 71


Epidemiology of Health Disparities 73


Factors Underlying Chronic Disease–Related Disparities 82


Future Directions 92


Summary 94


Key Terms 94


Discussion Questions 95


4 Racial and Ethnic Disparities in Health Care 103
Arturo Vargas Bustamante, Leo S. Morales, Alexander N. Ortega


Learning Objectives 103


Definition of Disparity in Health Care 105


Historical Overview of Disparities in Medical Care 109


Scientific Evidence of Disparities in Health Care 115


Future Directions 122


Summary 125


Key Terms 126


Discussion Questions 126


5 Multilevel Social Determinants of Health 135
Ninez A. Ponce, Michelle Ko


Learning Objectives 135


Policy Frameworks for Social Determinants of Health 137


Mechanisms by Which Social Context Affects Health Care 142


Future Directions 147


Summary 148


Key Terms 149


Discussion Questions 150


6 Public Health Insurance 157
Shana Alex Lavarreda, E. Richard Brown


Learning Objectives 157


Medicare, Medicaid, and CHIP 159


Who is Left Out of Public Coverage? 169


Enactment of the Affordable Care Act of 2010: A Political Success Story 179


Future Directions 183


Summary 183


Key Terms 184


Discussion Questions 185


7 Private Health Insurance 191
Nadereh Pourat, Gerald F. Kominski


Learning Objectives 191


Evolution of Private Health Insurance 192


Concepts in Private Health Insurance 194


Employment–Based Health Insurance 200


Individually Purchased Health Insurance 207


Significant Trends in Private Health Insurance 208


Future Directions 213


Summary 216


Key Terms 216


Discussion Questions 218


PART TWO: COST OF HEALTH CARE 223


8 Measuring Health Care Expenditures and Trends 225
Thomas H. Rice


Learning Objectives 225


Measuring Health Care Expenditures 226


Trends in Health Care Expenditures 233


Future Directions 239


Summary 239


Key Terms 242


Discussion Questions 243


9 Containing Health Care Costs 245
Thomas H. Rice, Gerald F. Kominski


Learning Objectives 245


Framework 246


Future Directions 263


Summary 264


Key Terms 264


Discussion Questions 265


10 Promoting Pharmaceutical Access While Controlling Prices and Expenditures 269
Stuart O. Schweitzer, William S. Comanor


Learning Objectives 269


The Problem of Drug Expenditures 271


Interpreting Pharmaceutical Price Data 275


International Price Comparisons 279


Determining Drug Prices 281


Approaches for Containing Pharmaceutical Costs 289


The Link Between Pharmaceutical Expenditures and Research 293


Recent Events Surrounding Pharmaceutical Costs and Access 294


Future Directions 298


Summary 298


Note 299


Key Terms 299


Discussion Questions 300


PART THREE: QUALITY OF HEALTH CARE 305


11 Measuring Health–Related Quality of Life and Other Outcomes 307
Patricia A. Ganz, Ron D. Hays, Robert M. Kaplan, Mark S. Litwin


Learning Objectives 307


Definition, Conceptualization, and Measurement of Quality of Life 310


Contributions From the Literature 318


Comparative Effectiveness Research 328


Future Directions 331


Summary 332


Key Terms 333


Discussion Questions 334


12 Evaluating the Quality of Care 343
Elizabeth A. McGlynn


Learning Objectives 343


The Multiple Dimensions of Quality 344


Criteria for Evaluating Quality Measures 345


A Conceptual Framework for Quality Assessment 347


Structure 348


Process 355


Outcomes 365


Future Directions 371


Summary 372


Key Terms 373


Discussion Questions 374


13 Public Release of Information on Quality 381
Elizabeth A. McGlynn, John L. Adams


Learning Objectives 381


Public Information on Quality 383


Some Methodological Issues in Performance Reporting 391


What is Known About the Impact of Public Reporting? 402


Future Directions 406


Summary 406


Key Terms 407


Discussion Questions 408


14 Health Care Information Systems 413
Jeff Luck, Leah J. Vriesman, Paul Fu Jr.


Learning Objectives 413


Information Systems and Informatics 414


Benefits, Implementation Barriers, and Federal Policy Responses 414


Applications of Information Systems by Health Care Providers 417


Public Health Informatics 434


Applications of Information Systems by Health Plans and Payers 438


Future Directions 441


Summary 445


Key Terms 445


Discussion Questions 446


15 Performance Measurement of Nursing Care 455
Jack Needleman, Ellen T. Kurtzman, Kenneth W. Kizer


Learning Objectives 455


Why Measure Nursing Performance? 455


The Scope of Nursing s Contribution to Inpatient Hospital Care 457


Issues in Constructing Nursing–Sensitive Performance Measures 461


Measuring Nursing Performance 463


Measuring Nursing Performance: The State of the Science 478


Future Directions 485


Summary 486


Key Terms 487


Discussion Questions 487


PART FOUR: SPECIAL POPULATIONS 493


16 Long–Term Services and Supports for the Elderly Population 495
Steven P. Wallace, Nadereh Pourat, Linda Delp, Kathryn G. Kietzman


Learning Objectives 495


Institutional Care 497


Community–Based Services 502


Informal Care 507


Workers in the Long–Term Care System 509


Future Directions 516


Summary 517


Note 517


Key Terms 517


Discussion Questions 518


17 HIV and AIDS in the Twenty–First Century 523
Erin G. Grinshteyn, William E. Cunningham


Learning Objectives 523


The Changing Epidemiology and Clinical Treatment of HIV/AIDS 525


Prevention and Education 538


Policy Implications and Research Needs for Management, Planning, and AIDS Policy 543


Future Directions 546


Summary 547


Key Terms 548


Discussion Questions 550


18 Children s Health 559
Moira Inkelas, Neal Halfon, David Lee Wood


Learning Objectives 559


Special Health Needs of Children 561


Health Service Delivery for U.S. Children 564


Financing Children s Health Care 569


Improving the Child Health System 576


Future Directions 585


Summary 585


Key Terms 586


Discussion Questions 587


19 Homeless Persons 593
Lisa Arangua, Lillian Gelberg


Learning Objectives 593


A Profile of the Homeless 594


Health Status 597


Mental Illness and Substance Abuse 604


Use of Physical Health Services 606


Use of Mental Health and Substance Abuse Services 608


Barriers to Health Care 609


Future Directions 610


Summary 612


Key Terms 612


Discussion Questions 613


PART FIVE: DIRECTIONS FOR CHANGE 621


20 Changing the Health Care Delivery System 623
Nadereh Pourat, Hector P. Rodriguez


Learning Objectives 623


Conceptual Framework: Intervention and Innovations to Correct System Failures 625


Future Directions 641


Summary 642


Key Terms 642


Discussion Questions 644


21 Medicare Reform 651
Gerald F. Kominski, Jeanne T. Black, Thomas H. Rice


Learning Objectives 651


Origin and Philosophy of Medicare 652


Evolution of Medicare 656


Is Medicare Facing a Crisis? 663


Future Directions 670


Summary 673


Key Terms 674


Discussion Questions 675


22 Public Health and Clinical Care 681
Jonathan E. Fielding, Lester Breslow, Steven M. Teutsch


Learning Objectives 681


Public Health s Mission and Scope 682


Prevention In Clinical Care Services 685


Public Health and Provision of Clinical Care Services 689


Direct Medical Service Delivery by Government 691


Future Directions 692


Summary 699


Key Terms 700


Discussion Questions 700


23 Strengthening the Safety Net 703
Dylan H. Roby


Learning Objectives 703


Defining the Safety Net 704


Ensuring Access to Care for the Poor, Uninsured, and Underserved 705


Financing the Safety Net 706


Size and Scope of the Safety Net 707


Reducing Costs 715


Improving Quality 716


Future Directions 719


Summary 719


Key Terms 720


Discussion Questions 721


24 Ethical Issues in Public Health and Health Services 727
Pauline Vaillancourt Rosenau, Ruth Roemer, Frederick J. Zimmerman


Learning Objectives 727


Overarching Public Health Principles: Our Assumptions 730


Ethical Issues in the Allocation of Resources 730


Ethical Issues in Research 737


Ethical Issues in Economic Support 738


Ethical Issues in Management of Health Services 740


Ethical Issues in Delivery of Care 741


Future Directions 744


Summary 745


Key Terms 746


Discussion Questions 747


Index 753


PRODUCT DETAILS

ISBN-13: 9781118418901
Publisher: John Wiley & Sons
Publication date: January, 2014
Pages: 600

Subcategories: General Practice, Public Health

MEET THE AUTHOR

Gerald F. Kominski, PhD, is professor, Department of Health Policy and Management in the UCLA Fielding School of Public Health, and director of UCLA Center for Health Policy Research. He is co–developer of the California Simulation of Insurance Markets (CalSIM) model currently being used to estimate eligibility and enrollment in health insurance exchanges in California and Hawaii.