This book tells the story of how the Health Services Restructuring Commission developed a vision of an effective health services system for the twenty-first century and attempted to fill a policy and leadership void. (Midwest).
Health service delivery is being restructured in both industrialised and developing countries. Public health scholars and policy makers in this volume show how this process is accelerating as a result of diverse factors including fiscal pressure, privatisation of infrastructure, and the impending renegotiation of the WTO General Agreement on Trade in Services (GATS). The key policy issues that arise concern the implications of these changes for access and equity in public health provision. The volume reviews the rapidly changing context in which financing health care and its relationship to globalization and privatisation are taking place. It examines the specific mechanisms and institutional processes involved. And it explores various contrasting experiences, including HMOs in the USA, Britain's NHS, social health insurance in Western Europe, developing countries, and Cuba.
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
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.
The recent Chaoulli Supreme Court decision and health care proposals by Quebec and Alberta have led to renewed debate on how best to restructure the Canadian health care system. This volume offers a timely analysis of access and wait-times, alternative modes of health care delivery, and funding methods from the perspective of evidence-based policy making.
Hospitals and nursing homes are responding to changes in the health care system by modifying staffing levels and the mix of nursing personnel. But do these changes endanger the quality of patient care? Do nursing staff suffer increased rates of injury, illness, or stress because of changing workplace demands? These questions are addressed in Nursing Staff in Hospitals and Nursing Homes, a thorough and authoritative look at today's health care system that also takes a long-term view of staffing needs for nursing as the nation moves into the next century. The committee draws fundamental conclusions about the evolving role of nurses in hospitals and nursing homes and presents recommendations about staffing decisions, nursing training, measurement of quality, reimbursement, and other areas. The volume also discusses work-related injuries, violence toward and abuse of nursing staffs, and stress among nursing personnelâ€"and examines whether these problems are related to staffing levels. Included is a readable overview of the underlying trends in health care that have given rise to urgent questions about nurse staffing: population changes, budget pressures, and the introduction of new technologies. Nursing Staff in Hospitals and Nursing Homes provides a straightforward examination of complex and sensitive issues surround the role and value of nursing on our health care system.
One of the greatest challenges in health care is reaorganizing its core processes. These reorganization initiatives are most often pursued under pressure from empoyers, consumers, advances in medical technologies, and changes in payer policy. Redesigning Healthcare Delivery teaches practitioners, managers, and executives proven new ways to predict and manage the needs of patient populations, improve customer service, and refocus their organizations on administrative and clinical tasks to ensure future success.
Examining the issues of treatment, organizational planning, and research, this multidimensional study offers a critique of both the theoretical and programmatic aspects of providing mental health services to traditionally underserved populations. Focusing on minority groups, the book uses the case of Hispanics to illustrate the largely unaddressed need for services that are relevant to social groups with diverse cultural and linguistic backgrounds. Vega and Murphy maintain that the present service system is socially insensitive, that mental health services in the United States were never designed to serve a multicultural population, and that, in general, those who dominate the current mental health system from administrator-clinicians to bureaucrats and politicians do not know how to direct their services to minority groups. Calling for fundamental reconceptualization and change, the book argues for community-based planning and intervention as an enlightened and necessary alternative, and provides a detailed description of such a program in terms of both philosophy and method. The eight chapters offer a reassessment based on understanding not only the rationale for these necessary services, but also the important philosophical and pragmatic issues that have resulted in the current, inadequate system; they provide the new thinking necessary to reframe the objectives of mental health services for cultural minorities. The early chapters explore some of the critical junctures in the community mental health movement between 1946 and 1981, the development of theory in the movement's early days, and the thrust of community-based intervention--the culture-specific methodology that has not been well-understood or implemented. Chapters 4 and 5 focus on the relationship between medicalization and the degradation of culture and on the reconceptualization of knowledge, order, illness, and intervention. The last three chapters analyze an example of community-based intervention in operation, and citizen involvement and the political aspects of community-based policies are reviewed. This timely discussion of the requirements for a socially responsible and community-based services delivery program lays the theoretical foundation for a future public mental health system. As such, it will prove invaluable and important reading for advanced undergraduate and graduate students in the health and human services areas, including social work, clinical psychology, and medical sociology; it also has much to offer professional administrators and planners. Culture and the Restructuring of Community Mental Health has been designed to meet the needs of both academics and practitioners.
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.