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.
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
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.
Health care reform has dominated public discourse over the past several years, and the recent passage of the Affordable Care Act, rather than quell the rhetoric, has sparked even more debate. Donald A. Barr reviews the current structure of the American health care system, describing the historical and political contexts in which it developed and the core policy issues that continue to confront us today. This comprehensive analysis introduces the various organizations and institutions that make the U.S. health care system work—or fail to work, as the case may be. A principal message of the book is the seeming paradox of the quality of health care in this country—on the one hand it is the best medical care system in the world, on the other it is one of the worst among developed countries because of how it is organized. Barr introduces readers to broad cultural issues surrounding health care policy, such as access, affordability, and quality. He discusses specific elements of U.S. health care, including insurance, especially Medicare and Medicaid, the shift to for-profit managed care, the pharmaceutical industry, issues of long-term care, the plight of the uninsured, medical errors, and nursing shortages. The latest edition of this widely adopted text updates the description and discussion of key sectors of America’s health care system in light of the Affordable Care Act.
Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.
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.
Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.
The contentious passage of the Affordable Care Act in 2010 highlighted the incredible complexity and controversy surrounding health care in the United States. While the U.S. federal government does not provide universal health care, it has an extremely wide reach when it comes to the health of its citizenry. From important scientific and medical research funding to infectious disease control and health services for veterans and the elderly, the pathway to legislation and execution of health policies is filled with competing interests and highly varied solutions. The Guide to U.S. Health and Health Care Policy provides the analytical connections showing researchers how issues and actions are translated into public policies and institutions for resolving or managing healthcare issues and crises. The Guide highlights the decision-making cycle that requires the cooperation of federal and state governments, business, and an informed citizenry in order to achieve a comprehensive approach to advancing the nation’s healthcare policies. Through 30 topical chapters, the book addresses the development of the U.S. healthcare system and policies, the federal agencies and public and private organizations that frame and administer those policies, and the challenges of balancing the nation’s healthcare needs with the rising costs of medical research, cost-effective treatment, and adequate health insurance. Additionally, the book comprehensively addresses significant disparities that exist in the U.S. system and the challenges to public health posed by our increasingly connected world. Taking a comprehensive approach, the Guide traces policy initiatives across time and takes into account the most recent scholarship: Part One: Evolution of American Health Care Policy Looks at the emerging and expanding role of government in the health care sector and the position the U.S. occupies today as the only advanced industrial nation without universal health care. Part Two: Government Organizations that Develop, Fund, and Administer Health Policy (1789-Today) Examines the role each branch of government plays in the forming, executing, and regulating health care policies. The authors examine the origins, organization, budget, and function of major government organizations including the FDA, CDC, and VA. An exploration of legal oversight and the roles states play in the health sector round out this section. Part Three: Contemporary Health Policy Issues: Goals and Initiatives (1920s-Today) Explores the wide range of players in the health care sphere and the role the government plays, particularly in funding them. Special attention is paid to policy issues surrounding medical research and medical professions. This section also looks at the ethical issues in play when making health policy and the inequalities that have plagued the U.S. health care system. Part Four: Contemporary Health Policy Issues: People and Policies (1960s-Today) This part of the book looks in-depth at health disparities in the U.S., health challenges particular to specific groups, mental health, obesity, and the influence of interest groups. Part Five: U.S. Response to Global Health Challenges (1980s-Today) The last section of the book looks beyond the borders of the United States and the serious challenges posed by our increasingly connected world.
"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.
Delivering Health Care in America, Sixth Edition is the most current and comprehensive overview of the basic structures and operations of the U.S. health system--from its historical origins and resources, to its individual services, cost, and quality. Using a unique "systems" approach, the text brings together an extraordinary breadth of information into a highly accessible, easy-to-read resource that clarifies the complexities of health care organization and finance while presenting a solid overview of how the various components fit together.While the book maintains its basic structure and layout, the Sixth Edition is nonetheless the most substantive revision ever of this unique text. Because of its far-reaching scope, different aspects of the Affordable Care Act (ACA) are woven throughout all 14 chapters. The reader will find a gradual unfolding of this complex and cumbersome law so it can be slowly digested. Additionally, as U.S. health care can no longer remain isolated from globalization, the authors have added new global perspectives, which the readers will encounter in several chapters.Key Features:- Comprehensive coverage of the ACA and its impact on each aspect of the U.S. health care system woven throughout the book- New "ACA Takeaway" section in each chapter as well as a new Topical Reference Guide to the ACA at the front of the book- Updated tables and figures, current research findings, data from the 2010 census, updates on Healthy People 2020, and more- Detailed coverage of the U.S. health care system in straightforward, reader-friendly language that is appropriate for graduate and undergraduate courses alike
