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.
Table of Contents
Figures, Tables, and Exhibits xiii
Introduction xvii
Acknowledgments xix
About the Authors xxi
About the Contributors xxiii
Part One: Overview of Health Care Service Delivery 1
Chapter 1 An Overview of Health Care Delivery in the United States 3
Bernard J. Healey
Health Care Costs 4
Health Care Access 15
Health Levels and Outcomes 17
Health Care Quality 24
Summary 26
Discussion Questions 27
Chapter 2 The Forces of Change in Health Care 31
Bernard J. Healey
Consequences of Forty Years of Health Care Cost Escalation 32
Health Care Reform 38
Summary 49
Discussion Questions 51
Part Two: The Major Players in Health Care Services 55
Chapter 3 Providers of Health Care Services 57
Tina Marie Evans
Primary Care Physicians and Primary Care Assistants 57
Specialty Care Providers 59
Dentists, Dental Hygienists, and Dental Assistants 61
Mental Health Care Providers 62
Nurses 66
Radiologic and Imaging Professionals 67
Allied Health Rehabilitation Professionals 70
Collaboration in Health Care 73
Employment Trends in the Health Care Sector 74
Summary 77
Discussion Questions 78
Chapter 4 Hospitals 81
Denice Yanchik
History of Hospitals 81
Management of Hospitals 85
Quality and Safety in Hospitals 93
Magnet Recognition Program 96
Challenges and the Future 99
Summary 100
Discussion Questions 101
Chapter 5 Ambulatory Care Services 105
Tina Marie Evans
History of Ambulatory Care Services 107
Reasons for the Expansion of Ambulatory Care 110
Hospital-Based Ambulatory Care 112
Non-Hospital-Based Ambulatory Care 114
Primary Care Management 120
Home Health Care Services 121
Hospice Services 124
Quality Assurance in Ambulatory Care 126
Summary 127
Discussion Questions 128
Chapter 6 Health Insurance and Payment for Health Care Services 131
Jeffrey R. Helton and Bernard J. Healey
Basics of U.S. Health Insurance 134
History of Health Insurance 135
How Health Insurance Markets Work 138
Health Insurance Providers 139
Reimbursement for Health Care Providers 145
Why Health Insurance Is Such a Huge Problem in the United States 148
Creative Destruction of Health Insurance 149
Summary 152
Discussion Questions 153
Chapter 7 Managed Care 155
Bernard J. Healey
Concepts of Managed Health Care 157
History of Managed Health Care 158
Types of Managed Care Plans 161
Managed Care Utilization Control 163
Managed Care Quality Issues 166
Managed Care and Prevention of Disease 168
Comparative Effectiveness Research 169
Future of Managed Health Care 172
Summary 174
Discussion Questions 176
Chapter 8 Long-Term Care 179
Tina Marie Evans
The Aging of Americans 180
History of Long-Term Care 184
Organization of Long-Term Care 186
Payment for Long-Term Care Services 193
Chronic Diseases and Their Complications 198
Challenges for Long-Term Care in the Future 202
Summary 205
Discussion Questions 205
Chapter 9 Mental Health Care 209
Tina Marie Evans
History of Mental Health 210
The Role of Stress 216
Types of Mental Illnesses 218
Mental Health Care Providers 226
Mental Health Parity 229
Summary 233
Discussion Questions 234
Chapter 10 Public Health Services 237
Bernard J. Healey
History of Public Health 240
Structure of Public Health Departments 242
Determinants of Health 244
Core Functions of Public Health 247
Epidemiology and Public Health 248
Population-Based Health 250
Public Health Leadership 255
Future of Public Health 258
Summary 260
Discussion Questions 261
Part Three: Challenges in Health Care Delivery 265
Chapter 11 The Pursuit of Quality Care 267
Tina Marie Evans
Origins of the Quality Movement 268
IOM Report on Medical Errors 274
IOM Report on the Quality Chasm 278
Quality Improvement Strategies 286
Medical Errors 292
Health Care–Associated Infections 293
Summary 296
Discussion Questions 297
Chapter 12 The Chronic Disease Epidemic 299
Bernard J. Healey
Chronic Diseases and Their Complications 301
Costs of Chronic Diseases 307
Chronic Disease Prevention and Behavioral Changes 310
Applying Business and Other Models to Chronic Disease Prevention 311
Summary 318
Discussion Questions 319
Chapter 13 Leadership Solutions to Health Care Problems 323
Bernard J. Healey
Health Care Reform Beyond the ACA 325
Reengineering the Health Care Sector 326
Understanding Power in the Health Care Sector 327
Changing the Health Care Environment 328
How Leaders Can Meet These Challenges 337
Summary 340
Discussion Questions 341
Chapter 14 Integrating Clinical Services and CommunityPrevention: The Community-Centered Health Home Model 345
Larry Cohen, Leslie Mikkelsen, Jeremy Cantor, Rea Pa˜nares, Janani Srikantharajah, and Erica Valdovinos
History of Clinical Services and Community Prevention Integration 346
Elements of the Community-Centered Health Home 354
Capacities Needed for Effective Implementation 365
Overarching Systems Change Recommendations 367
Summary 371
Discussion Questions 372
Chapter 15 A Look into the Future 375
Bernard J. Healey
Major Challenges Facing Health Care Delivery 376
Areas of Future Concern 385
How to Meet These Challenges 389
Summary 396
Discussion Questions 397
Case Study 1 Innovation in Physician Leadership Education 401
Francis G. Belardi
Case Study 2 Using Marketing Tools to Increase Early Referrals of Children with Developmental and Behavioral Disorders 405
Jeff Kile and Bernard J. Healey
Case Study 3 Fall Reduction at Geisinger Wyoming Valley Medical Center: ‘‘Above All, Do No Harm’’ 409
Daniel J. Amorino
Case Study 4 The VA Reinvents Itself 419
Joseph J. Marrone
Index 427
