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Index
Foreword
Acknowledgments
Introduction
Chapter 1: Health Care Systems and Delivery
Hospitals
Ownership
Services
Organization
Non-Hospital Inpatient Facilities
Outpatient Care
Delivery Formats for Outpatient Medicine
Issues in Health Care Delivery
Primary Care Crisis
Changing Models of Care
Shortages
Hospital-Specific Concerns
The Concerns of Hospital CEOs
Readmissions under Reform
Uncompensated or Undercompensated Care
The Hospital–Physician Relationship
References
Chapter 2: Insurance and Economics
Health Economics 101
What Is Insurance and Why Have It?
Economic Terms
Health Insurance Basics
Insurance
Coverage and Organization Formats
Ways to Get Insurance
Reimbursement Types
Payment Models
How Fees Are Determined
How Much Does U.S. Health Care Cost?
An Important Disclaimer: Cost Does Not Equal Price
Distribution of Spending
Health Spending Slowdown
Why Does U.S. Health Care Cost So Much?
The System Itself
Insurance as Insulation
Lack of Transparency
Lack of Standardization
Overtreatment
Loose Governmental Regulations
High Physician Wages
Iterative Reimbursements
Emergency Department Overuse
Disease and Society
Consequences of High Costs
Rationing
Being Uninsured
Health Care Is Not a Normal Market
References
Chapter 3: Quality, Technology, and Medical Malpractice
Quality
Patient Safety
Medication Errors
Transitions of Care
Residency Work Hours
Checklists
Never Events
Health Care-Associated Infections
Importance of Nursing
Health Information Technology
Electronic Health Records in Context
Computerized Physician Order Entry
Clinical Decision Support
Meaningful Use
Health Information Exchange
Health IT and Outcomes
Culture Change
Medical Malpractice
Problems
Potential Reforms
References
Chapter 4: Research, Pharmaceuticals, and Medical Devices
Research
Types of Research
Institutions and Funding
The Research and Development Process
Research Is Important for Health
Pharmaceuticals
The Industry
Government Regulation
Intellectual Property
Generics and Biosimilars
Payments and PBMs
Medical Devices
The Industry
Government Regulation
Issues
Utility of Research Findings
Government Regulation
Why Are Drug Prices So High?
Intersections and Conflicts of Interest
References
Chapter 5: Policy and Reform
Health Policy
Major Health Policy and Regulatory Bodies
Policy Research
Politics and Lobbying
Health Care Reform
National Reform Efforts
State-Based Reforms
Other Potential Reform Options
The Affordable Care Act
Quick Summary—How the ACA Affects Seven Major Groups
Q&A About the Affordable Care Act
Financial Impact
Impact of Health Care Reform
Issues with Implementation
Criticisms of the Affordable Care Act
Challenges to the ACA
Public Opinion of the Affordable Care Act
References
Chapter 6: Health Care Providers
Training
Scope of Practice
Interprofessional Health Care Teams
Mid-Level Providers
Scope-of-Practice Reform
Health Care Provider Reference Guide
References
Suggested Reading
Index
About the Authors
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