America's Children
America's Children

Author: Institute of Medicine and National Research Council

Publisher: National Academies Press

Published: 1998-11-27

Total Pages: 217

ISBN-13: 0309065607

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America's Children is a comprehensive, easy-to-read analysis of the relationship between health insurance and access to care. The book addresses three broad questions: How is children's health care currently financed? Does insurance equal access to care? How should the nation address the health needs of this vulnerable population? America's Children explores the changing role of Medicaid under managed care; state-initiated and private sector children's insurance programs; specific effects of insurance status on the care children receive; and the impact of chronic medical conditions and special health care needs. It also examines the status of "safety net" health providers, including community health centers, children's hospitals, school-based health centers, and others and reviews the changing patterns of coverage and tax policy options to increase coverage of private-sector, employer-based health insurance. In response to growing public concerns about uninsured children, last year Congress voted to provide $24 billion over five years for new state insurance initiatives. This volume will serve as a primer for concerned federal policymakers and regulators, state agency officials, health plan decisionmakers, health care providers, children's health advocates, and researchers.

Care Without Coverage
Care Without Coverage

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2002-06-20

Total Pages: 213

ISBN-13: 0309083435

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Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

The Future of the Public's Health in the 21st Century
The Future of the Public's Health in the 21st Century

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2003-02-01

Total Pages: 536

ISBN-13: 0309133181

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The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.

Evidence-Based Medicine and the Changing Nature of Health Care
Evidence-Based Medicine and the Changing Nature of Health Care

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2008-09-06

Total Pages: 202

ISBN-13: 0309113695

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Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.

Primary Care
Primary Care

Author: Barbara Starfield

Publisher:

Published: 1998

Total Pages: 454

ISBN-13: 9780195125436

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Primary Care now highlights two additional areas compared to the previous edition, equity in health services and health, and the overlap between clinical medicine and public health. It provides a basis for future directions in health policy.

Crossing the Quality Chasm
Crossing the Quality Chasm

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2001-07-19

Total Pages: 359

ISBN-13: 0309132967

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Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

Ethical Patient Care
Ethical Patient Care

Author: Mathy D. Mezey

Publisher: JHU Press

Published: 2003-04-29

Total Pages: 380

ISBN-13: 0801876524

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The delivery of good medical care often involves professionals from various disciplines working together. Interdisciplinary health care teams can be especially valuable in managing patients with complex medical and social needs, such as older persons in hospital, community, or home settings. Such teams, however, can also complicate or even create problems because of their diverse views and responsibilities. Ethical Patient Care: A Casebook for Geriatric Health Care Teams is designed to teach effective and responsible group decision making to clinicians working in teams to treat older patients. The editors use the case study method to present ethical dilemmas that team members encounter in the management of geriatric patients. Patients with multiple chronic conditions so often require the care of more than one medical specialist, and in the introductory chapters the editors suggest ways to resolve conflicts among patients, health care professionals, and the institutions that support them, including hospitals, HMOs, insurance companies, and the government. The book is then divided into four sections, each dealing with one angle of the team-care picture. The first section treats the diverse ethical imperatives of various professionals, conflicts among disciplinary approaches, and and varying attitudes toward end-of-life- decision making. Section two focuses on the patient and covers patient confidentiality, family decisionmaking and interaction with the healthcare team, issues of patient and team nonadherence to the care plan, and elder abuse and neglect. Section three examines the emerging difficulties of decentralized health care in settings such as hospitals, nursing homes, and the home, including clinician accountability and how ethical dilemmas differ across settings. Section four discusses the problems arising from the increasing responsibility of clinicians to manage costs and serve the interests of hospitals and insurers. Ethical Patient Care is a valuable resource for bioethicists, gerontologists, and the physicians, nurses, social workers, and therapists who care for aging persons.