Basics of the U.S. Health Care System, Second Edition provides students with a broad, fundamental introduction to the workings of the healthcare industry. Engaging and activities-oriented, the text offers an especially accessible overview of the major concepts of healthcare operations, the role of government, public and private financing, as well as ethical and legal issues. Each chapter features review exercises and Web resources that make studying this complex industry both enjoyable and easy. Students of various disciplines–including healthcare administration, business, nursing, public health, and others–will discover in Basics of the U.S. Health Care System, Second Edition a practical guide that prepares them for professional opportunities in this rapidly growing sector.
The Second Edition has been updated substantially to reflect the passage and implementation of the health care reform act of 2010, as well as new information on information technology, Medicare, Medicaid, and much more.
Basics of the U.S. Health Care System features:
Table of Contents
Cover
Title Page
Copyright
Contents
About the Author
Acknowledgments
Preface
Chapter 1 History of the U.S. Healthcare System
Learning Objectives
Did You Know That?
Introduction
Consumer Perspective on Health Care
Milestones of Medicine and Medical Education
Milestones of the Hospital System
Milestones of Public Health
Milestones of the Health Insurance System
Current System Operations
Assessing Your Healthcare System Using the Iron Triangle
Conclusion
Vocabulary
References
Notes
Student Activities
Chapter 2 Impact of the Affordable Care Act on Healthcare Services
Learning Objectives
Did You Know That?
Introduction
Major Provisions of the Affordable Care Act
Conclusion
Vocabulary
References
Notes
Student Activities
Chapter 3 Current Operations of the Healthcare System
Learning Objectives
Did You Know That?
Introduction
Overview of the Current System
Major Stakeholders in the Healthcare Industry
Stakeholders’ Environment
Healthcare Statistics
Conclusion
Vocabulary
References
Notes
Student Activities
Chapter 4 Government’s Role in U.S. Health Care
Learning Objectives
Did You Know That?
Introduction
History of the Role of Government in Health Care
U.S. Government Agencies
Conclusion
Vocabulary
References
Notes
Student Activities
Chapter 5 Public Health’s Role in Health Care
Learning Objectives
Did You Know That?
Introduction
What is Health?
Primary, Secondary, and Tertiary Prevention
Origins of Public Health
What is Public Health?
The Epidemiology Triangle
Epidemiologic Surveillance
Environmental Health
Emergency Preparedness
State and Local Response to Disasters
Bioterrorism
Public Health Functions and Administration
Healthy People Reports
Public Health Infrastructure
Government Contributions to Public Health
Nongovernment Public Health Activities
Public Health Education and Health Promotion
Collaboration of Public Health and Private Medicine
Conclusion
Vocabulary
References
Notes
Student Activities
Chapter 6 Inpatient and Outpatient Services
Learning Objectives
Did You Know That?
Introduction
History of Hospitals
Hospital Types by Ownership
Hospital Types by Specialty
Other Hospital Classifications
Hospital Governance
Hospital Licensure, Certification, and Accreditation
Patient Rights
Current Status of Hospitals
Outpatient Services
Other Health Services
Conclusion
Vocabulary
References
Notes
Student Activities
Chapter 7 U.S. Healthcare Workforce
Learning Objectives
Did You Know That?
Introduction
Primary, Secondary, and Tertiary Care
Physician Education
Generalists and Specialists
Differences Between Primary and Specialty Care
Patterns of Physician Supply
Types of Healthcare Providers
Other Independent Healthcare Professionals
Allied Health Professionals
Non-CAAHEP Allied Health Professionals
Conclusion
Vocabulary
References
Notes
Student Activities
Chapter 8 Healthcare Financing
Learning Objectives
Did You Know That?
Introduction
Healthcare Spending by Service Type
Healthcare Spending by State
Health Insurance as a Payer for Healthcare Services
Types of Health Insurance
Cost Sharing of Health Services
Types of Health Insurance Policies
Types of Health Insurance Plans
Public Financing of Healthcare Services
Reimbursement Methods of Private Health Insurance Plans
Government Reimbursement Methods for Healthcare Services
Healthcare Financial Management
Funds Disbursement
Conclusion
Vocabulary
References
Notes
Student Activities
Chapter 9 Managed Care Impact on Healthcare Delivery
Learning Objectives
Did You Know That?
Introduction
History of Managed Care
Managed Care Characteristics
The Managed Care Organization Payment Plan
Cost Control Measures of Managed Care Organizations
Medicare and Medicaid Managed Care
Assessment of Managed Care Models
Managed Care Accreditation
Issues with Managed Care Operations
Conclusion
Vocabulary
References
Notes
Student Activities
Chapter 10 Information Technology Impact on Health Care
Learning Objectives
Did You Know That?
Introduction
History of Information Technology in the Healthcare Industry
Electronic Patient Records
Barriers to Electronic Health Record Implementation
Primary Care Information Project in New York City Model
Clinical Decision Support Systems
Computerized Physician Order Entry
Pharmacy Benefit Managers
Drug–Drug Interactions
Telehealth
Chief Information Officer
Council for Affordable Quality Health Care
Other Applications
Applied Health Information Technology
The Importance of Health Information Technology
Conclusion
Vocabulary
References
Notes
Student Activities
Chapter 11 Healthcare Law
Learning Objectives
Did You Know That?
Introduction
Basic Concepts of Healthcare Law
Tort Reform Discussion
The Legal Relationship Between the Provider and Consumer
Healthcare-Related Legislation
Antitrust Laws
Informed Consent
Patient Bill of Rights
Healthcare Fraud
Employment-Related Legislation
Other Employment-Related Legislation
Conclusion
Vocabulary
References
Notes
Student Activities
Chapter 12 Healthcare Ethics
Learning Objectives
Did You Know That?
Introduction
Healthcare Stakeholder Management Model
Basic Concepts of Ethics in the Healthcare Workplace
Healthcare Codes of Ethics
How to Develop a Code of Ethics
Workplace Bullying
Ethics and the Doctor–Patient Relationship
Physician–Patient Relationship Model
Pharmaceutical Marketing to Physicians
Decision Model for Healthcare Dilemmas
Ethics and Public Health
Ethics and Research
Bioethical Issues
Conclusion
Vocabulary
References
Notes
Student Activities
Chapter 13 Mental Health Issues
Learning Objectives
Did You Know That?
Introduction
History of U.S. Mental Health Care
Background of Mental Health Services
Private and Public Funding for Mental Health
Special Populations
Common Types of Mental Disorders in the Elderly
Mental Health and Culture, Race, and Ethnicity
Mental Health Issues and Disasters, Trauma, and Loss
Mental Health and Veterans
Managed Behavioral Health Care
National Institute for Mental Health Strategic Plan
The Virginia Tech Massacre: A Case Study of the Mental Health System
Alternative Approaches to Mental Health Care
Conclusion
Vocabulary
References
Notes
Student Activities
Chapter 14 Analysis of the U.S. Healthcare System
Learning Objectives
Did You Know That?
Introduction
Highlights of the U.S. Healthcare System
Affordable Care Act Impact
Government’s Role
Public Health
Hospital and Outpatient Services
Healthcare Personnel
Healthcare Expenditures
Information Technology
Healthcare Law
Healthcare Ethics
Mental Health
Trends in Health Care
International Healthcare Systems
Universal Healthcare Concepts
Local Government Healthcare Reform
Lessons to be Learned From Other Healthcare Systems
Conclusion
Vocabulary
References
Notes
Student Activities
Index
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