Surveys the many-faceted problem of access to health care and analyzes the strengths and weaknesses of the main approaches a state might take to expand coverage for the uninsured and underinsured. Although the original research was done with Michigan data, the authors provide lessons applicable to any state attempting to deal with access problems. Annotation copyrighted by Book News, Inc., Portland, OR
A Shared Destiny is the fourth in a series of six reports on the problems of uninsurance in the United States. This report examines how the quality, quantity, and scope of community health services can be adversely affected by having a large or growing uninsured population. It explores the overlapping financial and organizational basis of health services delivery to uninsured and insured populations, the effects of community uninsurance on access to health care locally, and the potential spillover effects on a community's economy and the health of its citizens. The committee believes it is both mistaken and dangerous to assume that the persistence of a sizable uninsured population in the United States harms only those who are uninsured.
Performance Measurement is the first in a new series of an ongoing effort by the Institute of Medicine (IOM) to improve health care quality. Performance Measurement offers a comprehensive review of available measures and introduces a new framework to examine these measures against the six aims of the health care system: health care should be safe, effective, patient-centered, timely, efficient, and equitable. This new book also addresses the gaps in performance measurement and introduces the need for measures that are longitudinal, comprehensive, population-based, and patient-centered. This book is directed toward all concerned with improving the quality and performance of the nation's health care system in its multiple dimensions and in both the public and private sectors.
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.
Health Insurance is a Family Matter is the third of a series of six reports on the problems of uninsurance in the United Sates and addresses the impact on the family of not having health insurance. The book demonstrates that having one or more uninsured members in a family can have adverse consequences for everyone in the household and that the financial, physical, and emotional well-being of all members of a family may be adversely affected if any family member lacks coverage. It concludes with the finding that uninsured children have worse access to and use fewer health care services than children with insurance, including important preventive services that can have beneficial long-term effects.
Five public hearings were conducted around Missouri to seek input on the issues related to school violence. Written comments on the issue were also encouraged. During this process, the Task Force heard from students, parents, counselors, teachers, school superintendents and others. The task force members also contributed their own experience and education. Chapters: members of the Governor's Task Force; goal; task force recommendations; summary of public testimony; public hearing agendas; indications of violent behavior; understanding youth violence; example of program components for preventing violence; and related Missouri statutes.
Health needs and health services in rural America are key issues directly related to education as well as community well-being. This report examines rural America's access to basic health care services and discusses options for congressional consideration. The focus is on trends in availability of primary and acute rural health care and on factors affecting those trends. The report describes the characteristics of rural populations and health programs, the availability of rural health services and personnel, and delivery of rural maternal and infant health and mental health care services. On each subject, options for congressional action are examined. The federal government currently finances several different types of rural health care programs, and has a strong interest in health care trends. Major declines in inpatient utilization, compounded by increasing amounts of uncompensated care, have undermined the financial health of many rural hospitals, which also are faced with the outmigration of rural residents to urban areas for care. Policy reform options are presented in regard to: (1) improvement of rural health facilities; (2) availability and training of health professionals in rural areas; and (3) enhancing maternal and infant care programs and mental health care programs in rural areas. This document contains numerous charts, graphics, data tables, and appendices that present background information about the study. It also includes a 745-item bibliography and a subject index.
In an era of federal deficits and struggling municipalities, states have emerged as the most significant governmental actors. But state governments face the major challenge of fiscal planning in the midst of economic change. Roy Bahl and William Duncombe tackle this challenge head-on. Using New York as a case study, they identify looming dangers for state revenue and expenditure planning.Bahl and Duncombe begin with the premise that one cannot separate an evaluation of fiscal performance from an evaluation of economic performance. Accordingly, they describe and analyze the patterns of population, employment, and personal income growth. Following this is a study of state and local government finances in New York since 1970 and a recounting of the fiscal adjustments that were taken in the face of slower and then faster growth in the economy.The authors conclude that based on current conditions, the state and its local governments are in for fiscal belt-tightening. They note that the state should take a comprehensive view in planning the development and retrenchment of its government sector. The book is thought-provoking, exhaustively researched, and sensibly written. Its lessons are applicable everywhere and should be read by all those seeking a route through the tangled thicket of government policy for economic growth.
