Transition to Diagnosis-Related Group (DRG) Payments for Health
Transition to Diagnosis-Related Group (DRG) Payments for Health

Author: Caryn Bredenkamp

Publisher: World Bank Publications

Published: 2019-12-19

Total Pages: 69

ISBN-13: 1464815216

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This book examines how nine different health systems--U.S. Medicare, Australia, Thailand, Kyrgyz Republic, Germany, Estonia, Croatia, China (Beijing) and the Russian Federation--have transitioned to using case-based payments, and especially diagnosis-related groups (DRGs), as part of their provider payment mix for hospital care. It sheds light on why particular technical design choices were made, what enabling investments were pertinent, and what broader political and institutional issues needed to be considered. The strategies used to phase in DRG payment receive special attention. These nine systems have been selected because they represent a variety of different approaches and experiences in DRG transition. They include the innovators who pioneered DRG payment systems (namely the United States and Australia), mature systems (such as Thailand, Germany, and Estonia), and countries where DRG payments were only introduced within the past decade (such as the Russian Federation and China). Each system is examined in detail as a separate case study, with a synthesis distilling the cross-cutting lessons learned. This book should be helpful to those working on health systems that are considering introducing, or are in the early stages of introducing, DRG-based payments into their provider payment mix. It will enhance the reader's understanding of how other countries (or systems) have made that transition, give a sense of the decisions that lie ahead, and offer options that can be considered. It will also be useful to those working in health systems that already include DRG payments in the payment mix but have not yet achieved the anticipated results.

The Future of Nursing 2020-2030
The Future of Nursing 2020-2030

Author: National Academies of Sciences Engineering and Medicine

Publisher:

Published: 2021-09-30

Total Pages:

ISBN-13: 9780309685061

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The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.

Medicare Primer
Medicare Primer

Author: Patricia A. Davis

Publisher:

Published: 2016

Total Pages:

ISBN-13:

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This report provides a general overview of the Medicare program including descriptions of the program's history, eligibility criteria, covered services, provider payment systems, and program administration and financing.

The Healthcare Imperative
The Healthcare Imperative

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2011-01-17

Total Pages: 852

ISBN-13: 0309144337

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The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.

Evidence-Based Practice in Action: Comprehensive Strategies, Tools, and Tips From University of Iowa Hospitals & Clinics, Second Edition
Evidence-Based Practice in Action: Comprehensive Strategies, Tools, and Tips From University of Iowa Hospitals & Clinics, Second Edition

Author: Laura Cullen

Publisher: Sigma Theta Tau

Published: 2022-07-27

Total Pages: 670

ISBN-13: 1948057956

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“Building on extensive real-life experience with EBP, this expert team from University of Iowa Hospitals & Clinics provides vital guidance to clinicians at the cutting edge of care improvement.” –Kathleen R. Stevens, EdD, MS, RN, ANEF, FAAN Castella Endowed Distinguished Professor School of Nursing and Institute for Integration of Medicine & Science (CTSA) University of Texas Health Science Center San Antonio “This new edition is essential for all who want to deliver evidence-based care. Beautifully organized, it is readable, practical, and user-friendly.” –Kathleen C. Buckwalter, PhD, RN, FAAN Professor Emerita, University of Iowa College of Nursing Distinguished Nurse Scientist in Aging, Reynolds Center Oklahoma University Health Sciences Center, College of Nursing “Evidence-Based Practice in Action, Second Edition, will continue to ensure high-quality, evidence-based care is implemented in healthcare systems across the country — and the world. It should also be a well-worn tool in every implementation scientist’s toolkit. –Heather Schacht Reisinger, PhD Professor, Department of Internal Medicine Associate Director for Engagement, Integration and Implementation Institute for Clinical and Translational Science, University of Iowa Translate knowledge, research, and clinical expertise into action. The biggest barrier to effective evidence-based practice (EBP) is the failure to effectively translate available knowledge, research, and clinical expertise into action. This failure is rarely due to lack of information, understanding, or experience. In fact, it usually comes down to a simple lack of tools and absence of a clear plan to integrate EBP into care. Problem solved: Evidence-Based Practice in Action, Second Edition, is a time-tested, application-oriented EBP resource for any EBP process model and is organized based on The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care. This book offers a proven, detailed plan to help nurses and healthcare professionals promote and achieve EBP implementation, adoption, sustained use. TABLE OF CONTENTS Chapter 1: Identify Triggering Issues/Opportunities Chapter 2: State the Question or Purpose Chapter 3: Is This Topic a Priority? Chapter 4: Form a Team Chapter 5: Assemble, Appraise, and Synthesize Body of Evidence Chapter 6: Is There Sufficient Evidence? Chapter 7: Design and Pilot the Practice Change Chapter 8: Evaluation Chapter 9: Implementation Chapter 10: Is Change Appropriate for Adoption in Practice? Chapter 11: Integrate and Sustain the Practice Change Chapter 12: Disseminate Results Appendix A: The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care Appendix B: Iowa Implementation for Sustainability Framework Appendix C: Select Evidence-Based Practice Models Appendix D: Glossary