Essentials of the U.S. Health Care System Book

	Preface	ix
	List of Exhibits	xi
	List of Tables	xii
	List of Figures	xii
	List of Abbreviations	xiii
Chapter 1	Major Characteristics of US Health Care Delivery	1
	Introduction	1
	Subsystems of US Health Care Delivery	3
	Characteristics of the US Health Care System	8
	Health Care Systems of Other Developed Countries	15
	Systems Framework	17
	Conclusion	20
Chapter 2	Foundation of US Health Care Delivery	23
	Introduction	23
	What Is Health?	24
	Determinants of Health	27
	Cultural Beliefs and Values	30
	Strategies to Improve Health	30
	Conclusion	42
Chapter 3	Historical Overview of US Health Care Delivery	45
	Introduction	45
	Medical Services in Preindustrial America	47
	Medical Services in Postindustrial America	51
	History of Health Insurance	56
	Year 1970 into the 21st Century	63
	Conclusion	68
Chapter 4	Health Care Providers and Professionals	71
	Introduction	71
	Physicians	74
	Dentists	80
	Pharmacists	82
	Other Doctoral-Level Health Professionals	83
	Nurses	84
	Nonphysician Practitioners	86
	Allied Health Professionals	88
	Health Services Administrators	90
	Conclusion	92
Chapter 5	Technology and Its Effects	97
	Introduction	97
	What Is Medical Technology?	99
	Information Technology	100
	Use of Medical Technology	102
	Role of the Government in Technology Diffusion	105
	Impact of Medical Technology	109
	Assessment of Medical Technology	115
	Benefits of Technology Assessment	117
	Conclusion	118
Chapter 6	Financing and Reimbursement Methods	121
	Introduction	121
	Effects of Health Care Financing and Insurance	122
	Insurance: Its Nature and Purpose	125
	Private Insurance	127
	Public Insurance	129
	Reimbursement Methods	139
	National Health Expenditures	143
	Conclusion	146
Chapter 7	Outpatient Services and Primary Care	149
	Introduction	149
	What Is Outpatient Care?	150
	Scope of Outpatient Services	151
	Outpatient Care Settings and Methods of Delivery	153
	Primary Care	158
	Conclusion	168
Chapter 8	Hospitals	173
	Introduction	173
	Evolution of the Hospital in the United States	174
	Expansion and Downsizing of Hospitals in the United States	176
	Access and Utilization by the US Population	179
	Utilization of Hospital Capacity	180
	Hospital Employment	181
	Types of Hospitals	182
	Licensure, Certification, and Accreditation	189
	Hospital Organization	190
	Ethics and Public Trust	192
	Conclusion	194
Chapter 9	Managed Care and Integrated Organizations	197
	Introduction	197
	What Is Managed Care?	198
	Evolution and Growth of Managed Care	200
	Utilization Control Methods in Managed Care	204
	Types of Managed Care Organizations	206
	Impact of Cost, Access, and Quality	211
	Health Networks	212
	Types of Integration	214
	Conclusion	217
Chapter 10	Long-Term Care Services	221
	Introduction	221
	What Is LTC?	223
	Community-Based LTC Services	229
	Institutional LTC	233
	Licensing and Certification of Nursing Homes	238
	Other LTC Services	240
	State of the Nursing Home Industry	241
	Conclusion	243
Chapter 11	Underserved Populations	247
	Introduction	247
	Framework to Study Vulnerable Populations	248
	Enabling Characteristics	255
	Need Characteristics	257
	Conclusion	260
Chapter 12	Cost, Access, and Quality	263
	Introduction	263
	Cost of Health Care	264
	High in Cost	265
	Reasons for High Cost	266
	Cost Containment	272
	Unequal in Access	275
	Average in Quality	282
	Developments in Process Improvement	286
	Conclusion	287
Chapter 13	Health Policy	291
	Introduction	291
	What Is Health Policy?	292
	Principal Features of US Health Policy	294
	Development of Legislative Health Policy	302
	Critical Policy Issues	305
	Conclusion	310
Chapter 14	The Future of Health Services Delivery	313
	Introduction	313
	Future of Managed Care, Health Care Costs, and System Reform	316
	Trends in Health Insurance	319
	Options for Comprehensive Reform	322
	National and Global Challenges	323
	Bioterrorism and the Transformation of Public Health	326
	Future of Health Care Workforce	327
	New Frontiers in Technology	330
	Conclusion	332
	Index	337