"Entitlement Politics" describes partisan attempts to shrink the size of government by targeting two major federal health care entitlements. Efforts to restructure or eliminate entitlements as such, and to privatize and decentralize programs, along with more traditional attempts to amend and reform Medicare and Medicaid have radically transformed policymaking with respect to these programs. However, they have failed to achieve fundamental or lasting reform.

Smith combines historical narrative and case studies with descriptions of the technical aspects and dynamics of policymaking to help the consumer understand how the process has changed, evaluate particular policies and outcomes, and anticipate future possibilities. His account intentionally goes at some length into the substance of the programs, the policies that are involved, and the views of different protagonists about the major issues in the dispute.

One unhealthy consequence of politicizing Medicare and Medicaid policy has been to separate public debate from the technical and organizational realities underlying issues of cost containment or program structure. Smith considers this development unfortunate, since it leaves even informed citizens unable to evaluate the claims being made. Ironically, strife over Medicare has complicated the political and policy issues in American life. Only a serious and genuine bipartisan effort bringing forth the best efforts of both political parties--and some of the best industry leaders and policy experts in the field--is likely to achieve genuine reform. The more people and parties know about the history, politics, and policies of these programs, the better our prospects for devising workable, equitable, and lasting solutions. This volume leads the way toward that understanding.

Over the last two decades across the globe we have seen a multitude of programs, projects and books to help improve the safety of patient care in healthcare. However, the full potential of these has not yet been reached. Most of the current approaches are top down, programmatic and target driven. These look at problems in isolation one harm at a time with simplistic solutions that fail to support a holistic, systematic approach. They are focused on collecting incident data and learning from failure using tools that are not fit for purpose in a complex nonlinear system. Very rarely do the solutions help build the conditions, cultures and behaviours that support a safer system and help the people involved work safely. Healthcare is stuck in a relentlessly negative approach to safety. Those working in patient safety and healthcare are struggling, and books on patient safety to date instruct the reader to continue doing the same things we have been doing for the last 20 years. This book uniquely combines the latest thinking in safety, including creating a balanced approach to learning from what works as a way to understand why it fails, together with the evidence on building a just culture, positive workplaces and working relationships that we now know are so important for safety. It helps people understand how to address issues despite their complexities and improve safety with practical ways to truly understand what day to day healthcare work is actually like, rather than what people imagine it is like. This book builds on the author's first book Rethinking Patient Safety which exposed what we need to do differently to truly transform our approach to patient safety. It updates the reader further on the concepts explored in the first book but also vitally helps readers understand the 'how'. Implementing Patient Safety goes beyond the rhetoric and provides the reader with ideas and examples for how the latest thinking can actually be achieved. It is based on the author's personal experience of leading a national culture change campaign in the National Health Service for five years. The lessons arise from helping hundreds of organisations and people rethink and implement a whole new way of thinking about improving patient safety in healthcare.

The 1980 Black Report by Sir Douglas Black has kept health inequalities at the forefront of the public health agenda. This volume explores the history and development of studies and concern over health inequalities especially in relation to the 1980 report.

Revolutionary advances in biomedical research and information systems technology pose new and difficult issues for American health care policy, especially in the context of managed care. Health Care Policy in an Age of New Technologies takes on this challenging array of issues, where the dignity of individual life meets the imperatives of the national-level health care system: the right to die, rationing of care, organ transplants, experiments with human embryos, genetic research, confidentiality of medical records, and other ethical dilemmas.

Chapters on a patient's bill of rights, and on medical education and physician training, link the book to policy issues of direct concern to the public and practitioners. Throughout the book, the authors place critical questions in their political, legal, social, economic, and ethical context. Each chapter ends with discussion points, and a multimedia bibliography directs readers to relevant films, documentaries, and case studies.

Improving access to hospital services has been a goal of public policy in Britain for over seventy years, but the means by which this goal is to be attained have changed significantly over time. Drawing substantially on original research,
lanning, Markets and Hospitals represents a systematic attempt to access the strengths and weaknesses of different forms of planning and coordination of hospital development.
The period covered includes: services prior to 1948; wartime hospital policy; the successes and failures of the mixed economy of health care in the inter-war period; the national hospital plan of 1962 and ultimately the market based reforms of 1991 and the changes since.
This book makes a fresh contribution to enduring debates about planning and regulation of health care, about the governance of welfare services and about the appropriate role for voluntary, commercial and charitable provision of services. It reinterprets previous histories of hospital policy and questions whether current policies will reconcile competing goals of equity and choice.

Watershed Health Monitoring: Emerging Technologies is a concise reference that defines the concept of watershed health and explains that monitoring the health of watersheds is a critical precursor to adaptive resource management on a watershed basis. The focus of the text is a clear description of an innovative "Closed Loop" model that specifies four key aspects of successful monitoring programs: political linkages and support, sound scientific assessment techniques, a community education and awareness component; and a sustainable cost-recovery framework achieved through partnership.

Divided into two sections, the book begins with an introduction that defines watershed health, explains how monitoring fits into watershed planning and management, describes frequent shortfalls of monitoring programs around the world (with an emphasis on North America) and proposes a "Closed Loop" approach that will help ensure successful programs. Subsequent chapters detail each component of the "Closed Loop" model with special emphasis on scientific assessment. The second part features a set of six case studies that describe successful real-world applications of the "Closed Loop" approach to watershed monitoring.

Written in an easily understood manner with the practitioner in mind, Watershed Health Monitoring balances the need for a detailed yet concise treatment of the topic of watershed health monitoring. It is the first book to recognize the multidisciplinary nature of successful monitoring programs-programs that go far beyond science.

Contents:
Part One: Introduction Part Two: Pre-NHS Initiatives: The Limits to Voluntarism 2. Legacies, Donations and Municipal Priorities 3. Roots of Regionalism 4. Wartime Debates on Regionalism Part Three: The Attractions of and Limits to State Planning 1948-1973 5. Negotiations Over the Capital Programme 6. Genesis and Proposals of the Hospital Plan 7. Public Expenditure Restraint and Hospital Policy 8. Medical Dominance and the Sectoral Allocation of Resources Part Four: State Failure? The Death of Planning and the Proposals for Reform 9. Economic Realities: Cuts in Capital Programmes and the Privatisation of Capital Development 10. The Death of Regionalism? The NHS Reforms and Beyond Part Five: 11. Concluding Comments

Revolutionary advances in biomedical research and information systems technology pose new and difficult issues for American health care policy, especially in the context of managed care. Health Care Policy in an Age of New Technologies takes on this challenging array of issues, where the dignity of individual life meets the imperatives of the national-level health care system: the right to die, rationing of care, organ transplants, experiments with human embryos, genetic research, confidentiality of medical records, and other ethical dilemmas.

Chapters on a patient's bill of rights, and on medical education and physician training, link the book to policy issues of direct concern to the public and practitioners. Throughout the book, the authors place critical questions in their political, legal, social, economic, and ethical context. Each chapter ends with discussion points, and a multimedia bibliography directs readers to relevant films, documentaries, and case studies.

This special issue identifies three interrelated constructs--discourse, expertise, and the definition and management of risk--located in various healthcare sites: genetic counseling, nursing, and medical practice. The papers highlight the relationship between the management of risk situations and the nature of expertise displayed or achieved by practitioners and their patients/clients. The papers suggest that healthcare outcomes can be related closely to the quality of the discoursal encounters between professional practitioners and their patients/clients, and/or among professional practitioners themselves. Presenting differentiated goals and outcomes from a range of professional encounters, the research focuses on the resource of discoursal strategies drawn upon in the achievement of discoursal and professional goals by both professional and lay participants.

Socio-economic inequalities in health are present to a greater or lesser extent in all European countries and the available data suggests that the health gap is increasing. Many studies have been conducted to explain inequalities in health and from them much has been learnt about the different contributory factors. However, in practice it seems hard to translate the knowledge of causes into effective interventions and policies. Reducing Inequalities in Health: a European Perspective:
* brings together an unrivalled collection of contemporary data on successful policies and interventions
* compares differences in approach in several European countries
* includes recent evaluation studies
* discusses conceptual issues for research
* provides examples of good and bad practice in Europe
* draws out the policy and research implications for the future
With contributions from leading researchers in 14 different European countries, this book provides a comprehensive source of reference for the reader interested in what really works in the field of health promotion and what sort of policies reduce the health gap.

Socio-economic inequalities in health are present to a greater or lesser extent in all European countries and the available data suggests that the health gap is increasing. Many studies have been conducted to explain inequalities in health and from them much has been learnt about the different contributory factors. However, in practice it seems hard to translate the knowledge of causes into effective interventions and policies. Reducing Inequalities in Health: a European Perspective:
* brings together an unrivalled collection of contemporary data on successful policies and interventions
* compares differences in approach in several European countries
* includes recent evaluation studies
* discusses conceptual issues for research
* provides examples of good and bad practice in Europe
* draws out the policy and research implications for the future
With contributions from leading researchers in 14 different European countries, this book provides a comprehensive source of reference for the reader interested in what really works in the field of health promotion and what sort of policies reduce the health gap.

For the growing number of health professionals who are engaged in processes of evaluation in a variety of contexts within the world of healthcare, The Evaluation Handbook is an easy-to-use resource. Encouraging an evidence-based approach to practice, it provides:
* guidelines on how to design and evaluate an intervention
* examples of good practice
* reliable and easy-to-use measures
* advice on how to work effectively.

The handbook is designed to prompt self-evaluation and group project evaluation. It illustrates how simple evaluation methods can help to break down the divisions between research and practice and how more practitioners can apply such methods to improve the quality of care as well as the treatments and services which they offer their patients and clients. The examples, drawn from clinical settings, community practice and work in the voluntary sector, illustrate the kind of evaluation that can be undertaken by a small-scale team or a single practitioner with limited resources.
The Evaluation Handbook will be a useful source of reference for those new to evaluation as well as more experienced managers and researchers.

bbThe health care system in Britain at the beginning of the twenty-first century is being subjected to radical rethinking. Health Policy examines how the NHS has developed to the point it has reached today as well as placing it in the wider context of the kinds of health care which are available to people in Britain.
It looks at key issues which have arisen in the provision of health care such as rationing, the operation of interest groups, relationships between the public, voluntary and private sectors and whether the NHS has delivered care equally to all sectors of the population.
In this second edition, the authors pay particular attention to the policy changes introduced by the Labour government following it selection in 1997 and places these within a wider discussion of the concept of a primary care-led system.
Health Policy will be especially useful to readers who wish to inform themselves about what is happening in the NHS today or to deepen their understanding of current developments through an appreciation of how the health care system has evolved over the past fifty years. It includes useful summaries of key points, guides to further reading and a glossary of key terms.

Contents:
Acknowledgements Foreword Part One: Background 1. Preparing the Ground 2. Change and Development The Health Care Arena Part Two: The Issues 4. Resources, Rationing and Morality 5. Interest Groups in Health Care 6. Managerialism, Cultures and Control 7. Inequality in Health and Care Part Three: The Future - New Possibilities 8. The Mixed Economy of Health 9. Realigning the System: Towards a Primary Care Led NHS 10.Promoting Health and Preventing Illness 11. The NHS - Fit for the Future? Glossary List of References Index

Healthcare in the U.S. is a critical juncture. We face a sharp upward rise in the number of people with chronic diseases and disabilities. As demands on our current health system grow, so will costs. But as a society we are approaching the upper limit of how much we are willing (or able) to spend on health care. Health care policy makers know this. That is why major health reform measures are focused on population health and value-based care. These are the so-called second curve objectives. But these initiatives are doomed to failure. We are asking a system to do things that it was not designed to do. In fact, we don't have a health care "system" as such. We have a parts bin of disconnected silos. Fragmented delivery systems. Specialized caregivers. Professional groups. Trade associations. All with distinct cultures. Each with their own motivations and agendas. Our payer and regulatory structures have evolved over the decades in response to political and policy initiatives. However well intentioned (or not), these structures defy logic. They reward and reinforce counter-productive industry behaviors. They pose formidable roadblocks to achieving needed changes. Current reform initiatives are an implicit recognition that our health model is flawed. The attitude seems to be, "Yes, we know the overall health system is a problem, but we can make failure less severe if we implement these measures." We are at a critical juncture. We can continue to place additional demands on an industry model that has outlived its functional utility. Or we can take more of a clean slate approach and move toward a model that is in keeping with today's needs. The outlook is not good if we stay on the current curve. The demands on resources will continue their upward trajectory. The default scenario will be one of rationing and less to invest in new cures and new technologies. The good news is that we are within sight of a future state of health care that can really work. In this future state, we have gotten rid of the artificial barriers to effective and efficient patient care. Physicians and other health professionals work in a coordinated, inter-disciplinary fashion. They have accountability for the whole care cycle. Caregivers have both the flexibility and encouragement to innovate and come up with optimal delivery approaches. And because they are in a risk-reward relationship with payers, they have the incentives to provide true value. Patients feel intimately connected to a system that is focused on their specific needs. The key to this future state is good old-fashioned market discipline. Other delivery models must either improve or get out of the way. The market will demand cost-efficiencies and won't tolerate waste. Much of our regulatory structure will be rendered unnecessary. There will be not rewards for poor performance. This book takes a unique macro-level perspective of clinical, economic, and regulatory problems and possible solutions. It takes an objective and something scathing look at current industry structure: a silo-driven culture and entrenchment that is driven by self-interest; as well as the complicity of government in preserving the status quo through regulations, licensure, payment systems, etc.

Medical Professionals: Conflicts and Quandaries in Medical Practice offers a fresh approach to understanding the role-related conflicts and quandaries that pervade contemporary medical practice. While a focus on professional conflicts is not new in the literature, what is missing is a volume that delves into medical professionals' own experience of the conflicts and quandaries they face, often as a result of inhabiting multiple roles. The volume explores the ways in which these conflicts and quandaries are exacerbated by broader societal forces, including changing scientific and technological paradigms, commercialization, and strengthened consumer movements, which simultaneously expand the scope of roles and responsibilities that medical professionals are expected to fulfill, and make it more difficult to do so. Several empirical chapters analyze data from qualitative interview studies with clinicians and other stakeholders. The studies highlight the burdens on clinicians who are expected to make informed and justified judgments and decisions in the midst of competing pressures; authors describe the methods that clinicians use to address the associated tensions within specific contexts. Two conceptual chapters follow and offer some innovative ways to think about the challenges facing medical professionals as they strive to make sense of the changing landscape within healthcare. The first reflects on the challenges to clinical practice in the midst of shifting and often competing definitions of disease and associated ideologies of care. The second reflects more broadly on the utility of value pluralism as a framework for conceptualizing and working through moral and professional quandaries. The book concludes with a chapter containing suggestions for how members of the medical profession might reframe their thinking about their roles, responsibilities, and decision-making in the midst of inevitable quandaries such as those presented here. This book will be of vital reading for academics, researchers, educators, postgraduate students, and interested health care practitioners and administrators.

Among the first books to focus on physician engagement during a Lean effort, Sustaining Lean in Healthcare: Developing and Engaging Physician Leadership explains how to ensure ongoing physician participation long after the consultant leaves. Dr. Michael Nelson, an early adopter of Lean in healthcare, explains how to use these synergic tools to achieve consistently high levels of quality and clinical care outcomes. The book begins with a Lean primer that provides a firm foundation in essential Lean concepts including value stream maps, 6S, Kanban, Heijunka, and Gemba Walks. Next, it examines how to create a physician engagement plan and covers the specific responsibilities of physician leadership through the Lean transformation. Explaining what to look for when judging success, it provides numerous examples that demonstrate how to sustain success over the long term. Complete with tips for spotting the danger signs that might indicate your plan is off course, this book details time-tested techniques and strategies for reducing waste in healthcare. It supplies a methodology for establishing shared expectations of success with your medical team early on in the process, as well as a proven framework for simultaneous Lean deployment across multiple locations. Praise for the book: In this book , Dr. Nelson draws on his forty years of medical practice and his experience as an early adopter of Lean for healthcare, to identify a crucial piece to aligning healthcare organizations for success; Physician Engagement. Healthcare executives and clinicians will appreciate and learn from Dr. Nelson s insight. Robert Iversen, Director, Accenture Management Consulting Instead of writing another how-to book, Mike has taken the opportunity to provide insights that are sure to help any healthcare organization sustain the impact of its Lean engagement. Rick Malik,

Artificial intelligent systems, which offer great improvement in healthcare sector assisted by machine learning, wireless communications, data analytics, cognitive computing, and mobile computing provide more intelligent and convenient solutions and services. With the help of the advanced techniques, now a days it is possible to understand human body and to handle & process the health data anytime and anywhere. It is a smart healthcare system which includes patient, hospital management, doctors, monitoring, diagnosis, decision making modules, disease prevention to meet the challenges and problems arises in healthcare industry. Furthermore, the advanced healthcare systems need to upgrade with new capabilities to provide human with more intelligent and professional healthcare services to further improve the quality of service and user experience. To explore recent advances and disseminate state-of-the-art techniques related to intelligent healthcare services and applications. This edited book involved in designing systems that will permit the societal acceptance of ambient intelligence including signal processing, imaging, computing, instrumentation, artificial intelligence, internet of health things, data analytics, disease detection, telemedicine, and their applications. As the book includes recent trends in research issues and applications, the contents will be beneficial to Professors, researchers, and engineers. This book will provide support and aid to the researchers involved in designing latest advancements in communication and intelligent systems that will permit the societal acceptance of ambient intelligence. This book presents the latest research being conducted on diverse topics in intelligence technologies with the goal of advancing knowledge and applications healthcare sector and to present the latest snapshot of the ongoing research as well as to shed further light on future directions in this space. The aim of publishing the book is to serve for educators, researchers, and developers working in recent advances and upcoming technologies utilizing computational sciences.

The third book in the Healthcare Payment Systems series, Prospective Payment Systems examines the various types of prospective payment systems (PPS) used by healthcare providers and third-party payers. Emphasizing the basic elements of PPS, it considers the many variations of payment for hospital inpatient and outpatient services, skilled nursing facilities, home health agencies, long-term hospital care, and rehabilitation facilities along with other providers. The book describes the anatomy of PPS, including cost reports, adjudication features and processes, relative weights, and payment processes. It outlines the features and documentation requirements for Medicare Severity Diagnosis Related Groups (MS-DRGs), the Medicare Ambulatory Payment Classifications (APCs), Medicare HHPPS, Medicare Skilled Nursing Resource Utilization Groups (RUGs), and private third-party payers. Provides a framework for understanding and analyzing the characteristics of any PPS Discusses Medicare prospective payment systems and approaches Includes specific references to helpful resources, both online and in print Facilitates a clear understanding of the complexities related to PPS covering specific topics at a high level and revisiting similar topics to reinforce understanding Complete with a detailed listing of the acronyms most-commonly used in healthcare coding, billing, and reimbursement, the book includes a series of case studies that illustrate key concepts. It concludes with a discussion of the challenges with PPS including compliance and overpayment issues to provide you with the real-world understanding needed to make sense of any PPS.

In our post-welfare society, health is increasingly viewed as a commodity and individuals are defined as 'health care consumers'. At the same time, the notion that the state should care for the health of its citizens is being replaced by an expectation that citizens should play a more active role in caring for themselves. These developments are by no means uncontentious.
Consuming Health explores the diverse meanings and applications of the term 'consumer' in the field of health care and the implications for policy-making, health care delivery and experiences of health care. Contributors are well-known innovative researchers and lecturers from the Australia, the UK and Canada. Between them they cover a wide range of topics - from the medicalisation of the menopause to the participation of consumer groups in the national policy process - to create an original and thought-provoking text for students and practitioners in the field of health care.

Anti-Racist Practice (ARP), Anti-Discriminatory Practice (ADP) and Anti-Oppressive Practice (AOP) form a trinity of concepts, nested into one another, which have evolved in welfare services over the last fifteen years. They tend to have developed as forms of practice panaceas and as a result have been subject to both unrealistic expectations and, at times, to political ridicule. This book clarifies the distinctions between three key concepts - ARP, ADP and AOP. Critically and constructively analysing these three approaches to practice it reappraises their potential in the light of emerging equality issues in the health service
With contributions from leading teachers and practitioners in the field, Equalising Opportunities provides students and practitioners in health and social care with a clear overview of an area where there is much confusion and imperfect understanding.

Appropriate for health administrators in departments of sociology, social policy and nursing. Students in pre-registration programmes and those meeting management theory for the first time. There can be little doubt that the reforms of the last few decades within the health service have had a major impact on the management responsibilities for nurses, midwives and health visitors. Integrating management theory and principles with nursing practice, Managing in the Healthcare demonstrates how the concepts and principles of management are intrisically linked to the work that nurses do.

Contents:
Table of contents, List of figures, List of boxes, Acknowledgements,Chapter 1:Introduction, Introduction, Culture, Place, Health, Narrating change. Chapter 2:Culture matters to health, Introduction, What is culture?, A brief history of traditional cultural geography, The emergence of a new cultural geography, Structuralism and humanism, postmodernism, Cultures of health, Cultural geographies of health, Cultural matters!, Further reading. Chapter 3:Studying culture/placing ourselves, Introduction, Surveying the field, The place of observation, Observation through participating/participating while observing, Embodied power, knowledge and observation, Interpreting texts, Conclusion, Further reading. Chapter 4:Structure and agency, Introduction, The structural approach, Unhealthy societies, The humanist approach, Deprived people, Integrating structure and agency, Treating the mad, Conclusions, Further reading. Chapter 5:Language/metaphor/health, Introduction, Word, words, words, Metaphors and meaning, Stories of illness, Knowledge, power, resistance, Medical encounters, And what about place?, Health and the media, Medical soaps, Imaginative literature, Listening to language, Further reading. Chapter 6:Cultural difference in health and place, Introduction, A woman's place in health care, Ethnic differences in health experience, Geographies of sexual orientation, People with disabilities, Conclusion, Further reading. Chapter 7:Landscapes of healing, Introduction, Nature as healer, Selling the places that heal, Symbolic healing landscapes, Therapeutic landscapes, Landscape/place/healing, Further reading. Chapter 8:Consumption, place and health, Introduction, The character of consumerism, The changing face of consumption landscapes, Symbolism, landscape and health care, Consumerist ideology in the landscape, Finding space for non-consumers, Conclusion, Further reading. Chapter 9:Conclusion, Introduction, Theoretical diversity, Key questions, The disciplinary/interdisciplinary tension, What makes a health geographer today? Bibliography

Series Information:
Critical Geographies

Designed as a practical guide for the pharmaceutical industry, Pharmaceutical Marketing applies cutting-edge marketing concepts and tools to the real-world intricacies of marketing a heavily regulated product whose success is determined not by the actual end-user, but by various industry stakeholders. From creating a worldwide vision that cascades into local tactics to managing a drug portfolio or pricing a particular product, this book guides readers through developing, implementing, and auditing a successful marketing strategy geared specifically to the pharmaceutical industry. It provides graphs, tables, sample worksheets, pharmaceutical case studies, and a sample marketing strategy.