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Health Policy Analysis: An Interdisciplinary Approach [Minkštas viršelis]

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  • Formatas: Paperback / softback, 438 pages, weight: 628 g
  • Išleidimo metai: 05-Sep-2007
  • Leidėjas: Jones and Bartlett Publishers, Inc
  • ISBN-10: 0763744425
  • ISBN-13: 9780763744427
Kitos knygos pagal šią temą:
  • Formatas: Paperback / softback, 438 pages, weight: 628 g
  • Išleidimo metai: 05-Sep-2007
  • Leidėjas: Jones and Bartlett Publishers, Inc
  • ISBN-10: 0763744425
  • ISBN-13: 9780763744427
Kitos knygos pagal šią temą:
Rather than pushing a single solution set, this text draws on a variety of disciplines to analyze health policy, considering perspectives from economics, political science, management, communications, technology, and public health. Beginning chapters explore the history and current issues of the US health system, and review alternatives for the future. The second section of the book examines the policy analysis process, introducing technology assessment applicable to health care, political processes that influence the planning process, ethical issues, and methods of economic and financial analysis. The third section deals with the roles, skills, and leadership that health professionals can bring to the policy making process in their local and national communities. The book also offers personal suggestions and observations from the point of view of two generations of the authors' family. Ten case studies look at topics including global medical coverage, the politics of the Clinton health plan, and evidence-based practice in mental health in North Carolina. The book is for graduate students in public health, health administration, and executive MBA programs. Curtis McLaughlin is affiliated with the University of North Carolina-Chapel Hill. Craig McLaughlin is executive director of the Washington State Board of Health. Annotation ©2008 Book News, Inc., Portland, OR (booknews.com)
Preface xi
About the Authors xv
Acknowledgments xvii
Chapter 1 Introduction
1
The Many Actors
2
The System in the United States Is Unique, But Not Unparalleled
4
Health Care: What Is It?
5
Health Policy: What Is It?
7
The Policy Analysis Process
7
Supporting Implementation
9
Health Professionals and the Policy Process
9
Big Issues to Keep Our Eyes On
11
The Road Ahead
19
Part I The Context
Chapter 2 Where Are We?
23
Current Outcomes and Costs
23
A More Systematic Evaluation
30
Complexity
38
Leadership at the State and Local Level
42
Industrializing Structures for Delivery
43
Medicalization of Society
55
Conclusion
57
Chapter 3 How Did We Get Here?
59
Contending Visions of a System for Delivering Health Care
60
A Chronology
61
The Current "Era" Emerges
69
Employers Want Out: Backing for Consumer-Driven Health Care
74
Conclusion
75
Case 3-1 International Comparisons: Where Else Might We Have Gone?
76
Chapter 4 Where Do We Want to Go?
87
Alignment with the Rest of Society
88
Who Is the "We" in "Where Do We Want to Be"?
88
Conclusion
98
Case 4-1 National Standards on Culturally and Linguistically Appropriate Services (CLAS)
98
Chapter 5 What Are the Governmental Alternatives? Many Actors, Many Proposals
103
Federal Level Alternatives
106
Access to Care—Administered System
106
Access to Care— Oligopolistic Competition
108
Access to Care—Free-Market Competition
110
Quality of Care—Administered System
111
Quality of Care— Oligopolistic Competition
112
Quality of Care—Free-Market Competition
113
Cost of Care—Administered System
113
Cost of Care— Oligopolistic Competition
114
Cost of Care—Free-Market Competition
115
Other Interventions
119
State and Local Government Options
121
Access to Care—Administered System
123
Access to Care— Oligopolistic System
125
Access to Care—Free-Market Competition
127
Quality of Care—Administered System
128
Quality of Care— Oligopolistic System
129
Quality of Care—Free-Market System
129
Cost of Care—Administered System
130
Cost of Care — Oligopolistic System
131
Cost of Care — Free-Market System
133
Other Interventions
134
Conclusion
136
Case 5-1 Specialty Hospitals and Community Hospitals
136
Chapter 6 Alternative Responses and Initiatives of Institutions and Professions
143
Common Responses
145
Payers
145
Providers
154
Consumers
167
For-Profit Versus Not-for-Profit
168
The Value-Driven Care Initiative
169
Conclusion
170
Case 6-1 Global Medical Coverage
171
Part II The Policy Analysis Process
Chapter 7 The Policy Analysis Process Identification and Definition
179
Getting the Scenario Right
181
Hidden Assumptions
186
Defining What Is a Medical Problem
191
Conclusion
192
Case 7-1 Small Area Variations
193
Chapter 8 The Policy Analysis Process Evaluation — Technology Assessment
195
Terminology
196
Technological Forecasting
197
Levels of Technological Forecasting
198
Not Just What, But When
200
Forecasting Methods
206
Changing Business Models
213
Organizations Devoted to Health Care Technology Assessment
213
Conclusion
218
Case 8-1 Regional Health Information Organizations (RHIOs): Disruptive Technology or Business As Usual?
219
Chapter 9 The Policy Analysis Process — Evaluation— Political Feasibility
233
Terminology
234
Overview
236
Authorizing Environments
236
Key Government Actors
240
Political Inputs
253
Nongovernmental Actors
258
Methods for Analyzing Political Feasibility
265
Conclusion
270
Case 9-1 Politics of the Clinton Health Plan
272
Chapter 10 The Policy Analysis Process — Evaluation—Economic Viability
283
Defining the Health Care Process Involved
285
Agreeing in Detail on the Delivery System Involved
287
Selecting the Analytical Approach
287
Basic Tools
288
Supply and Demand Concepts
291
Benefit/Cost Concepts
292
Agreeing on the Resources Required
294
Determining Relevant Costs
295
Agreeing on the Outcomes Produced
296
Valuing the Outcomes Produced
298
Determining the Present Values of Costs and Outcomes
298
Inflation Adjusting
299
Discounting
301
An Example
301
Computing Ratios
302
Dealing with Important Uncertainties
302
Identifying Financing Methods
304
Considering Distributional Effects
304
Comparing with Competing Alternatives
305
Financial Feasibility
305
Conclusion
308
Case 10-1 Folic Acid Fortification Decision: Before and After
308
Chapter 11 The Policy Process —Analysis of Values Last But Not Least
321
Fair Access
322
Efficiency
322
Patient Privacy and Confidentiality
323
Informed Consent
323
Personal Responsibility
323
Malpractice Reform
326
Professional Ethics
326
Consumer Sovereignty
327
Social Welfare
327
Rationing
329
Process Equity
335
Influence on Society: A Broader Question
335
Ethical Review
337
Conclusion
338
Case 11-1 The 100K Lives Campaign: A Voluntary Code In Action
338
Chapter 12 Implementation Strategy and Planning
351
Levels of Implementation Failure
352
Implementation Planning
353
Setting Up to Succeed
358
That All-Important Start
361
Providing for Periodic Reviews
362
Implementing Policies That Affect Clinical Decision Making
362
The Postmortem
364
Conclusion
365
Case 12-1 Introducing Evidence-Based Practice in Mental Health in North Carolina (B)
366
Part III The Professional as a Participant
Chapter 13 What Is Likely to Work
375
Working Out Your Own Scenarios
380
Chapter Exercise: Working Out Your Own Scenarios
384
So, What Is Likely to Work?
384
Conclusion
388
Chapter 14 Health Professional Leadership
389
Disinterestedness
390
Informational Credibility
390
To Influence Globally, Start Locally
391
Risk Taking
392
Health Policy Analysis: A Relevant School for Leadership
392
Governance
393
Planning Alternatives
394
Communities
394
Enhancing the Professional's Role
395
Chapter Exercise: Gender Discrimination Issues in Health Care
397
Conclusion
398
Chapter 15 Conclusion—All Those Levers and No Fulcrum
399
Where to Stand
400
The Physician's Dilemma
402
The ERISA Problem
403
Chapter Exercise: Tradeoffs
404
Conclusion
404
References 407
Index 425