CSUSM PH 305 Public Health Asssignment Time Stakeholder Discussion

CSUSM PH 305 Public Health Asssignment Time Stakeholder Discussion ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON CSUSM PH 305 Public Health Asssignment Time Stakeholder Discussion Each student will outline the role that physicians played in the development of the US health care system and identify the other stakeholders (hospitals, government, consumers). Briefly identify the key times/incidents when physicians exerted their influence (8 points). What other stakeholders were there at these times (4 points)? This assignment requires two outside references (besides the book chapter) for 3 points. Use APA style for your references. You will lost 2 points if this assignment is late. This assignment should stay close to one page single-spaced . CSUSM PH 305 Public Health Asssignment Time Stakeholder Discussion Please note that this assignment is extended until February 8th at 11 pm ph305.pdf ESSENTIALS OF THE U.S. Health Care System?FIFTH EDITION LEIYU SHI, DrPH, MBA, MPA Professor, Bloomberg School of Public Health Director, Johns Hopkins Primary Care Policy Center Johns Hopkins University Baltimore, Maryland DOUGLAS A. SINGH, PhD, MBA Associate Professor Emeritus of Management Judd Leighton School of Business and Economics Indiana University, South Bend South Bend, Indiana World Headquarters Jones & Bartlett Learning 5 Wall Street Burlington, MA 01803 978-443-5000 info@jblearning.com www.jblearning.com Jones & Bartlett Learning books and products are available through most bookstores and online booksellers. To contact Jones & Bartlett Learning directly, call 800-832-0034, fax 978-443-8000, or visit our website, www.jblearning.com. 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CSUSM PH 305 Public Health Asssignment Time Stakeholder Discussion Description: Fifth edition. | Burlington, Massachusetts: Jones & Bartlett Learning, [2019] | Abridgement of: Delivering health care in America: a systems approach / Leiyu Shi, Douglas A. Singh. Seventh edition. 2019. Identifiers: LCCN 2018014666 | ISBN 9781284156720 (pbk.) Subjects: | MESH: Delivery of Health Care | Health Policy | United States Classification: LCC RA395.A3 | NLM W 84 AA1 | DDC 362.10973—dc23 LC record available at https://lccn.loc.gov/2018014666 6048 Printed in the United States of America 22 21 20 19 18 10 9 8 7 6 5 4 3 2 1 © ninjaMonkeyStudio/Getty Images ts Conten Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . x Acknowledgments . . . . . . . . . . . . . . . . xiii List of . . . . 14 Fusion of Market Justice and Social Justice . . . . . . . . . . . . . . . . . . 14 Multiple Players and Balance of Power . . . . . . . . . . . . . . . . . . . . . . . . . 15 Exhibits . . . . . . . . . . . . . . . . . . . . xiv List of Tables . . . . . . . . . . . . . . . . . . . . . xvi List of Figures . . . . . . . . . . . . . . . . . . . xvii Chapter 1 ?Major Characteristics of U.S. Health Care Delivery. . . . . . . . . . . . . 1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Subsystems of U.S. Health Care Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Managed Care . . . . . . . . . . . . . . . . . . . . 3 Military Medical Care . . . . . . . . . . . . . 4 Subsystems for Special Populations . . . . . . . . . . . . . . . . . . . . 5 Integrated Systems . . . . . . . . . . . . . . . 6 Long-Term Care Delivery . . . . . . . . . . 7 Public Health System . . . . . . . . …..7 Health Care Reform . . . . . . . . . . . . . . . . . . . . 8 Characteristics of the U.S. Health Care System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 No Central Governing Agency; Little Integration and Coordination . . . . . . . . . . . . . . . . . . 10 Technology Driven and Focused on Acute Care . . . . . . . . . . . . . . . . . 10 High in Cost, Unequal in Access, and Average in Outcome . . . . . 11 Imperfect Market Conditions . . . . 12 Government as Subsidiary to the Private Sector . . . . . . . . . Quest for Integration and Accountability . . . . . . . . . . . . . . . . 15 Access to Health Care Services Selectively Based on Insurance Coverage . . . . . . . . . . . 16 Legal Risks Influence Practice Behaviors . . . . . . . . . . . . . . . . . . . . . 16 Health Care Systems of Other Developed Countries . . . . . . . . . . . . . . 16 Canada . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Germany . . . . . . . . . . . . . . . . . . . . . . . . 18 United Kingdom . . . . . . . . . . . . . . . . . 19 Systems Framework . . . . . . . . . . . . . . . . . . 21 System Foundations . . . . . . . . . . . . . 21 System Resources . . . . . . . . . . . . . . . 22 System Processes . . . . . . . . . . . . . . . . 22 System Outcomes . . . . . . . . . . . . . . . 22 System Outlook . . . . . . . . . . . . . . . . . 22 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 References . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Chapter 2 Foundations of U.S. Health Care Delivery. . . . . . . . . . . . 26 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . 26 What Is Health? . . . . . . . . . . . . . . . . . . . . . . . 27 Illness and Disease . . . . . . . . . . . . . . . 29 Acute and Chronic Conditions . . . . . . . . . . . . . . . . . . . . 29 Quality of Life . . . . . . . . . . . . . . . . . . . . 29 Determinants of Health . . . . . . . . . . . . . . . 30 Environment . . . . . . . . . . . . . . . . . . . . 31 Behavior and Lifestyle . . . . . . . . . . . 31 Heredity . . . . . . . . . . . . . . . . . . . . . . . . . 31 Medical Care . . . . . . . . . . . . . . . . . . . . 32 Cultural Beliefs and Values . . . . . . . . . . . . 32 iii iv ?Contents Distribution of Health Care . . . . . . . . . . . . 32 Market Justice . . . . . . . . . . . . . . . . . . . 33 Social Justice . . . . . . . . . . . . . . . . . . . . 35 Justice in the U.S. Health Care System . . . . . . . . . . . . . . . . . . . . . . . . 36 Strategies to Improve Health . . . . . . . . . . 36 ?Healthy People Initiatives . . . . . . . . . 36 Public Health . . . . . . . . . . . . . . . . . . . . 40 Focus on Determinants . . . . . . . . . . 40 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 References . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 Chapter 3 ?Historical Overview of U.S. Health Care Delivery. . . . . . . . . . . . 50 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Medical Services in Preindustrial America . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Medical Training . . . . . . . . . . . . . . . . . 52 Medical Practice . . . . . . . . . . . . . . . . . 53 Medical Institutions . . . . . . . . . . . . . . 55 Medical Services in Postindustrial America . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Medical Profession . . . . . . . . . . . . . . . 56 The American Medical Association . . . . . . . . . . . . . . . . . . . 58 Educational Reform . . . . . . . . . . . . . . 59 Development of Hospitals . . . . . . . 60 Reform of Mental Health Care…. 60 History of Health Insurance . . . . . . . . . . . 61 Worker’s Compensation . . . . . . . . . 61 Emergence and Rise of Private Health Insurance . . . . . . . . . . . . . . 61 First Hospital Plan and the Birth of Blue Cross . . . . . . . . . . . . . 61 First Physician Plan and the Birth of Blue Shield . . . . . . . . . . . . 62 Employment-Based Health Insurance . . . . . . . . . . . . . . . . . . . . . 62 Failure of National Health Insurance in the United States . . . . . . . . . . . . . . . . . . . . . . . . . 63 Creation of Medicare and Medicaid . . . . . . . . . . . . . . . . . . . . . . 64 Medical Services in the Corporate Era . . . . . . . . . . . . . . . . . . . . . . 68 Corporatization of Health Care Delivery . . . . . . . . . . . . . . . . . . . . . . . 68 Information Revolution . . . . . . . . . . 69 Globalization . . . . . . . . . . . . . . . . . . . . 69 Era of Health Care Reform . . . . . . . . . . . . . 70 Health Care Reform in a Flux . . . . . 71 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 References . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Community Health Workers……….. 94 Health Services Administrators . . . . . . . . 95 Patient-Centered Care . . . . . . . . . . . . . . . . 96 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 References . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 Chapter 4 ?Health Care Chapter 5 ?Technology Providers and and Its Effects. CSUSM PH 305 Public Health Asssignment Time Stakeholder Discussion . Professionals. . . . . . . . . . . . . . 101 . 75 Introduction . . . . . . . . . . . . . . . . . . . Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Physicians . . . . . . . . . . . . . . . . . 101 What Is Medical . . . . . . . . . . . . . . . . . 77 Similarities Technology? . . . . . . . . 103 Health Information Technology . . . . . . 103 and Differences Major Categories . . . . . . . . . . . Between MDs and DOs . . . . . . . . . 104 Electronic Health . . 78 Generalists and Records . . . . . . . 105 The Specialists . . . . . . . 79 Internet, E-Health, and Hospitalists . . . . . . . . . . . . . . . . E-Therapy . . . . . . . . . . . . . . . . . . . . . 79 Differences Between . . . . . 106 Telemedicine and Primary Remote and Specialty Care . . . . . . . . Monitoring . . . . . . . . . . . . . . . . . . . 80 Work Settings and . . . 107 Diffusion and Utilization of Practice Patterns . . . . . . . . . . . . . . . . . . . . . . Medical Technology . . . . . . . . . . . . . 80 Imbalance and Maldistribution . . . . . . . . . . . 108 Cultural Beliefs of Physicians . . . . . . . . . . . . . . . . . . and Values . . . . . . 109 Medical 81 Dentists . . . . . . . . . . . . . . . . . . . . Training and Practice . . . 110 . . . . . . . . . . 84 Pharmacists . . . . . . Insurance Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 Other 110 Competition Among Providers . 110 The Government’s Role in Doctoral-Level Health Technology Diffusion………….. Professionals . . . . . . . . . . . . . . . . . . 111 Regulation of Drugs, . . . . . 87 Nurses . . . . . . . . . . . . . . . . Devices, . . . . . . . . . . . . . . . . 88 and Biologics ………… Advanced-Practice Nurses . . . . . . . . . . . 111 The Affordable Care 89 Nonphysician Act and Practitioners………… 90 Value of Medical Technology . . . . . . . NPP Services . . . . . . . . . . . . 91 . . . 115 Research on Technology . . Allied Health Professionals . . . . . . . . . . . . . 115 Impact of Medical . . . . . 91 Technicians and Assistants Technology . . . . . . . 115 Impact on . . . . . . . 92 Technologists and Quality of Care . . . . . . . 116 Impact Therapists . . . . 92 Public Health on Quality of Life . . . . . . . . 117 Professionals . . . . . . . . . . . . 93 Impact on Health Care Costs . . . . 117 Impact on Access . . . . . . . . . . . . . . . 119 Impact on the Structure and Processes of Health Care Delivery . . . . . . . . . 119 Impact on Global Medical Practice . . . . . . . . . . . . . . . . . . . . . . 119 Impact on Bioethics . . . . . . . . . . . . 120 Assessment of Medical Technology . . . . . . . . . . . . . . . . . . . . . . . 120 Efficacy . . . . . . . . . . . . . . . . . . . . . . . . . 120 Safety . . . . . . . . . . . . . . . . . . . . . . . . . . 121 Cost-Effectiveness . . . . . . . . . . . . . . 121 Benefits of Technology Assessment . . . . . . . . . . . . . . . . . . . . . . . 122 Delivering Value . . . . . . . . . . . . . . . . 122 Cost Containment . . . . . . . . . . . . . . 122 Contents ?v . . . . . 134 Managed Care Plans . . . . . . . . . . . . 134 High-Deductible Health Plans . . . . . . . . . . . . . . . . . . . . . . . . . 134 The Affordable Care Act and Private Insurance . . . . . . . . . . . . . . . . . . . . . . . . . 135 Public Insurance . . . . . . . . . . . . . . . . . . . . . 136 Medicare . . . . . . . . . . . . . . . . . . . . . . . 137 Medicaid . . . . . . . . . . . . . . . . . . . . . . . 141 Children’s Health Insurance Program . . . . . . . . . . . . . . . . . . . . . 141 Issues with Medicaid . . . . . . . . . . . . . . . . . 142 Reimbursement Methods . . . . . . . . . . . . 143 Fee for Service . . . . . . . . . . . . . . . . . . 143 Bundled Payments . . . . . . . . . . . . . 144 Resource-Based Relative Value Scale . . . . . . . . . . . . . . . . . . . 144 Reimbursement Standardized Practice Under Protocols . . . . . . . . . . . . . . . . Managed Care . . . . . . . . . . . . . . . 122 Conclusion . . . . . . . . . . . . . . . . 144 From Retrospective to . . . . . . . . . . . . . . 123 References . . Prospective Reimbursement . . . . . . . . . . . . . . . . . . . . . . . . . 123 . . 145 Payment Reform Initiatives . . . . . . . . . . . 148 National Health Chapter 6 ?Financing and Expenditures . . . . . . . . 148 Conclusion . . . . . . . . . . . . . . . . . . . . Reimbursement Methods. . . . . . . . . . . 126 . . . . . . 151 References . . . . . . . . . . . . . . . . . . . . . . . . . . 151 Introduction . . . . . . . . . . . . . . . . . . . vi ?Contents . . . . . . 126 Effects of Health Care Financing and Insurance . . . . . . . . . . . . . . . . . . . . . 128 Insurance: Its Chapter 7 ?Outpatient Nature and Purpose . . . . 130 Basic Services and Insurance Concepts . . . . . . . 130 Primary Care. . . . Cost Sharing . . . . . . . . . . . . . . . . . . . . . 154 . . 130 Private Insurance . . . . . . . . . . . . . . . . . . . . 132 Group Insurance . Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 . . . . . . 154 What Is Outpatient Self-Insurance . . . . . . . . . . . . . . . . . Care? . . . . . . . . . . . . 155 Scope of . 133 Direct-Purchase Private Outpatient Services . . . . . . . . 155 Insurance . . . . . . . . . . . . . . . Reimbursement . . . . . . . . . . . . . . . . 156 Technological Factors . . . . . . . . . . . 158 Utilization Control Factors . . . . . . 158 Social Factors . . . . . . . . . . . . . . . . . . . 158 Outpatient Care Settings and Methods of Delivery . . . . . . . . . . . . . . 158 Private Practice . . . . . . . . . . . . . . . . . 158 Hospital Outpatient Clinics . . . . . 159 Freestanding Facilities . . . . . . . . . . 159 Mobile Facilities for Medical, Diagnostic, and Screening Services . . . . . . . . . . . . . . . . . . . . . . 160 Telephone or Internet Triage . . . . 160 Home Care . . . . . . . . . . . . . . . . . . . . . 160 Hospice Care . . . . . . . . . . . . . . . . . . . 161 Outpatient Long-Term Care Services . . . . . . . . . . . . . . . . . . . . . . 161 Public Health Services . . . . . . . . . . 161 Community Health Centers . . . . . 161 Free Clinics . . . . . . . . . . . . . . . . . . . . . 162 Alternative Medicine Clinics . . . . 162 Primary Care . . . . . . . . . . . . . . . . . . . . . . . . . 163 What Is Primary Care? . . . . . . . . . . . 163 WHO Definition . . . . . . . . . . . . . . . . 164 IOM Definition . . . . . . . . . . . . . . . . . . 164 Domains of Primary Care . . . . . . . 164 Community-Oriented Primary Care . . . . . . . . . . . . . . . . . 167 Primary Care Around the World . . . . . . 167 Effectiveness of Primary Care……… 168 Hospitalizations and Use of Emergency Care . . . . . . . . . . . . . 169 Cost of Care . . . . . . . . . . . . . . . . . . . . 170 Morbidity………………….. 170 Mortality . . . . . . . . . . . . . . . . . . . . . . . CSUSM PH 305 Public Health Asssignment Time Stakeholder Discussion 171 The Medical Home Strategy . . . . . . . . . 171 Use of Information Technology in Primary Care . . . . . . . . . . . . . . . . . . . . 172 Assessment of Community Health Centers . . . . . . . . . . . . . . . . . . . . . . . . . . . 175 CHCs’ Quality of Care . . . . . . . . . . . 175 CHCs’ Access to Care . . . . . . . . . . . . 176 CHCs’ Cost-Effectiveness . . . . . . . . 177 CHCs and the Affordable Care Act . . . . . . . . . . . . . . . . . . . . . . . . . . 177 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . 177 References . . . . . . . . . . . . . . . . . . . . . . . . . . 178 Chapter 8 ?Hospitals. . . . . . . . . . . 182 ?Introduction . . . . . . . . . . . . . . . . . . . . . . . . . 182 Evolution of the Hospital in the United States . . . . . . . . . . . . . . . . . . . . . 183 Stage 1 . . . . . . . . . . . . . . . . . . . . . . . . . 183 Stage 2 . . . . . . . . . . . . . . . . . . . . . . . . . 184 Stage 3 . . . . . . . . . . . . . . . . . . . . . . . . . 184 Stage 4 . . . . . . . . . . . . . . . . . . . . . . . . . 184 Stage 5 . . . . . . . . . . . . . . . . . . . . . . . . . 185 Stage 6 . . . . . . . . . . . . . . . . . . . . . . . . . 185 Expansion and Downsizing of Hospitals in the United States . . . . . 185 Access and Utilization Measures . . . . . 188 Measures of Access . . . . . . . . . . . . . 188 Measures of Utilization . . . . . . . . . 189 Utilization of Hospital Capacity . . . . . . . . . . . . . . . . . . . . . 189 Hospital Employment……………. 190 Types of Hospitals . . . . . . . . . . . . . . . . . . . 191 Community Hospitals . . . . . . . . . . 192 Public Hospitals . . . . . . . . . . . . . . . . 192 Private Nonprofit . . 211 Managed Care Backlash Hospitals . . . . . 193 Private . . . . . . . . 211 Transformation of For-Profit Hospitals . . . . . . 194 Managed General Hospitals . . . . . . . . . . . . . . Care . . . . . . . . . . . . . . . . . . . . 195 Specialty Hospitals . . . . . . . . . . . . . . . 212 Utilization Control . . . . 195 Psychiatric Hospitals . . . . . Methods in . . . . . . . 196 Rehabilitation Managed Care . . . . . . . . . . . . . . . Hospitals . . . . . . . . . 196 Children’s . . . . . 212 Gatekeeping . . . . . . Hospitals . . . . . . . . . . . . . 196 Rural . . . . . . . . . . . . . 213 Utilization Hospitals……………… … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10