"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.
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.
This new edition continues to emphasize the use of data envelopment analysis (DEA) to create optimization-based benchmarks within hospitals, physician group practices, health maintenance organizations, nursing homes and other health care delivery organizations. Suitable for graduate students learning DEA applications in health care as well as for practicing administrators, it is divided into two sections covering methods and applications. Section I considers efficiency evaluations using DEA; returns to scale; weight restricted (multiplier) models; non-oriented or slack-based models, including in this edition two versions of non-controllable variable models and categorical variable models; longitudinal (panel) evaluations and the effectiveness dimension of performance evaluation. A new chapter then looks at new and advanced models of DEA, including super-efficiency, congestion DEA, network DEA, and dynamic network models. Mathematical formulations of various DEA models are placed in end-of-chapter appendices. Section II then looks at health care applications within particular settings, chapter-by-chapter, including hospitals, physician practices, nursing homes and health maintenance organizations (HMOs). Other chapters then explore home health care and home health agencies; dialysis centers, community mental health centers, community-based your services, organ procurement organizations, aging agencies and dental providers; DEA models to evaluate provider performance for specific treatments, including stroke, mechanical ventilation and perioperative services. A new chapter then examines international-country-based applications of DEA in health care in 16 different countries, along with OECD and multi-country studies. Most of the existing chapters in this section were expanded with recent applications. Included with the book is online access to a learning version of DEA Solver software, written by Professor Kaoru Tone, which can solve up to 50 DMUs for various DEA models listed in the User’s Guide at the end of the book.
The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
This book provides a balanced assessment of pay for performance (P4P), addressing both its promise and its shortcomings. P4P programs have become widespread in health care in just the past decade and have generated a great deal of enthusiasm in health policy circles and among legislators, despite limited evidence of their effectiveness. On a positive note, this movement has developed and tested many new types of health care payment systems and has stimulated much new thinking about how to improve quality of care and reduce the costs of health care. The current interest in P4P echoes earlier enthusiasms in health policy—such as those for capitation and managed care in the 1990s—that failed to live up to their early promise. The fate of P4P is not yet certain, but we can learn a number of lessons from experiences with P4P to date, and ways to improve the designs of P4P programs are becoming apparent. We anticipate that a “second generation” of P4P programs can now be developed that can have greater impact and be better integrated with other interventions to improve the quality of care and reduce costs.
