A fundamental problem of public sector governance relates to the very way of thinking it reflects; where organization is thought of as a 'thing', a system designed to deliver what its designers choose. This volume questions that way of thinking and takes a perspective in which organizations are complex responsive processes of relating between people. Bringing together the work of participants on the Doctor of Management program at Hertfordshire University, this book focuses on the move to marketization and managerialism, paying particular attention to human relationships and group dynamics. The contributors provide narrative accounts of their work addressing questions of management, pressures, accountability, responsiveness and traditional systems perspectives. In considering such questions in terms of their daily experience, they explore how the perspective of complex responsive processes assists them in making sense of experience and developing practice. Including an editors' commentary which introduces and contextualizes these experiences as well as drawing out key themes for further research, this book will be of value to academics, students and practitioners looking for reflective accounts of real life experiences rather than further prescriptions of what organizational life ought to be.

Examining the health care market in a historical framework, Drake analyzes the forces and events that have shaped American health care in the twentieth century and sheds new light on why and how our health care system has dampened competitive market forces and failed to provide sound value for much of our health care expenditures. He examines the roles that physicians, hospitals, insurance companies, businesses, individual consumers, and government legislation have played in creating a provider-dominated market in which the cost of care has been concealed from consumers. Comparing U.S. health care expenditures with those of other developed countries, he concludes that a significant part of our health care problem is the style of medicine practiced in the United States, which is much more specialized and high tech than in other developed nations. Drake develops proposals for health care financing reform that consider the political and economic difficulties involved. He first examines the Clinton health care reform plan and makes specific recommendations for revisions that would improve its likelihood of controlling costs. He then offers an alternative proposal that would both maintain the principle of universal, noncancelable coverage and eliminate the flaws in the market for health care services by giving consumers a financial stake in cost containment. This timely argument, combining economic and historical analysis with thoughtful consideration of the motivating humanitarian and political concerns, will be of interest to everyone seeking to understand and to reform our ailing health care system.

Employment relations within the health sector have undergone radical reform over recent years. This book is an important new study that examines the responses of managers and workers to these different reforms, at both national and local level. Bringing together analyses of both employment relations and public sector management, the book focuses on understanding why certain initiatives have been adopted, how managers have responded to them and the consequences of the HR modernisation agenda. Topics covered include: HR strategy and structure at the workplace employee involvement and union influence pay modernisation management of work. Featuring detailed case study research in three NHS trusts, the book illustrates precisely how government policies are implemented in the workplace and in doing so offers a unique insight into the sector's changing work environment. A comprehensive study of atopical area, this book will be of interest to students and academics in health service management, human resource management and employment relations.

Statistics and evidence-based medicine are assessed in most postgraduate and undergraduate medical examinations and degrees in health sciences. All clinicians have to acquire skills in this area. This book aims to provide a brief overview of basic medical statistics and the numerical aspects of evidence-based medicine to give realistic worked examples to illustrate the interpretation of studies relevant to clinical practice and to allow examination practice. It aims to cover all major topics covered in the undergraduate and postgraduate examinations. Each chapter begins with an overview and summary of the main points followed by worked examples and exercises with full answers. It will be ideal for all postgraduate medical examination candidates. Other clincians and undergraduate students in medicine and health sciences will also find it useful.

This edited collection focuses on the global growth of privatisation and private sector medicine in both developed and lesser developed countries, and the impact of this on patients, health workers, managers and policy-makers. Drawing upon sociological theories, concepts and insights, as well as experts from several countries with extensive experience in researching the field either nationally or internationally, the collection offers a unique perspective on healthcare services and healthcare systems: a view from those trying to access healthcare services, working inside health systems, or responsible for managing and organising services. Collectively, the chapters contribute an international perspective on the navigation of healthcare systems, and addresses the growing salience of 'choice' between public and private medicine in a variety of different national systems and contexts.

Misadventures in Health Care: Inside Stories presents an alternative approach to attributing the cause of medical error solely to the health care provider. That alternative, the systems approach, pursues why an incident occurs in terms of factors in the context of care that affect the care provider to induce an error. The basis for this approach is the fact that an error is an act, an act is behavior, and behavior is a function of the person interacting with the environment. Eleven vignettes illustrate the importance of the systems approach by describing health care incidents from the perspective of the care providers--the perspective that can identify the factors that actually affect the provider. These stories provide general readers with opportunities to apply their knowledge in analyzing incidents to identify error-inducing factors. This book is important reading for policymakers, researchers and practitioners in law and in all medical specialties, and professionals in the social sciences, human factors, and engineering. In addition to sensitizing the reader to the importance of contextual factors in error, Misadventures in Health Care is a case study reference to supplement texts in professional schools such as law and medicine, as well as the full range of academic disciplines. It also is important reading for the general public because it presents an approach for addressing a very pressing social problem-- that of misadventures in health care.

A comprehensive guide to effective strategic management of health care organizations. Strategic Management of Health Care Organizations provides essential guidance for leading health care organizations through strategic management. This structured approach to strategic management examines the processes of strategic thinking, consensus building and documentation of that thinking into a strategic plan, and creating and maintaining strategic momentum - all essential for coping with the rapidly evolving health care industry. Strategic Management of Health Care Organizations fully explains how strategic managers must become strategic thinkers with the ability to evaluate a changing industry, analyze data, question assumptions, and develop new ideas. The book guides readers through the strategic planning process demonstrating how to incorporate strategic thinking and create and document a clear and coherent plan of action. In addition, the all-important processes of creating and maintaining the strategic momentum of the organization are fully described. Finally, the text demonstrates how strategic managers in carrying out the strategic plan, must evaluate its success, learn more about what works, and incorporate new strategic thinking into operations and subsequent planning. This strategic management approach has become the de facto standard for health care management as leadership and strategic management are more critical than ever in coping with an industry in flux. This book provides heath care management students as well as health care administrators with foundational guidance on strategic management concepts and practices, tailored to the unique needs of the health care industry. Included are a clear discussion of health services external analysis, organizational internal analysis, the development of directional strategies, strategy alternative identification and evaluation, and the development and management of implementation strategies providing an informative and insightful resource for anyone in the field. This new eighth edition has been fully updated to reflect new insights into strategic thinking, new methods to conceptualize and document critical environmental issues, practical steps for carrying out each of the strategic management processes, industry and management essentials for strategic thinkers, and new case studies for applying the strategic management processes. More specifically, readers of this edition will be able to: Create a process for developing a strategic plan for a health care organization. Map and analyze external issues, trends, and events in the general environment, the health care system, and the service area. Conduct a comprehensive service area competitor analysis. Perform an internal analysis and determine the competitive advantages and competitive disadvantages. Develop directional strategies. Identify strategic alternatives and make rational strategic decisions for a health care organization. Develop a comprehensive strategy for a health care organization. Create effective value-adding service delivery and support strategies. Translate service delivery and support plans into specific action plans. The health care industry's revolutionary change remains ongoing and organizational success depends on leadership. Strategic management has become the single clearest manifestation of effective leadership of health care organizations and the strategic management framework's strengths are needed now more than ever. The Strategic Management of Health Care Organizations provides comprehensive guidance and up-to-date practices to help leaders keep their organizations on track.

The second edition of this very successful 'how to do it' book on clinical governance. * The second edition of this successful book now includes more detail on NICE, CHI and other government initiatives * Expanded to include information appropriate for the whole of the UK * Completely updated in line with recent changes in the NHS * Additional examples of good practice from primary care and other specialties

"Misadventures in Health Care: Inside Stories" presents an alternative approach to attributing the cause of medical error solely to the health care provider. That alternative, the systems approach, pursues why an incident occurs in terms of factors in the context of care that affect the care provider to induce an error. The basis for this approach is the fact that an error is an act, an act is behavior, and behavior is a function of the person interacting with the environment. Eleven vignettes illustrate the importance of the systems approach by describing health care incidents from the perspective of the care providers--the perspective that can identify the factors that actually affect the provider. These stories provide general readers with opportunities to apply their knowledge in analyzing incidents to identify error-inducing factors.
This book is important reading for policymakers, researchers and practitioners in law and in all medical specialties, and professionals in the social sciences, human factors, and engineering. In addition to sensitizing the reader to the importance of contextual factors in error, "Misadventures in Health Care" is a case study reference to supplement texts in professional schools such as law and medicine, as well as the full range of academic disciplines. It also is important reading for the general public because it presents an approach for addressing a very pressing social problem-- that of misadventures in health care.

"A well organized and readable text on evaluating health programs. It covers the essentials of choosing an evaluation design, planning and conducting the evaluation, and using the results of the evaluation. It is a book that should be on the shelf of persons doing and teaching health program evaluation and should be seriously considered as a text for evaluation classes."

? RONALD ANDERSEN, Wasserman Professor in Health Services, UCLA"I found many instances where I thought students would get key concepts and ideas more quickly than they would from other texts. I was thrilled to see a discussion of ethics and culture in the text! The author provides clear explanations of important concepts and uses examples throughout the text, a strength of the book. I especially appreciate the author's detailed descriptions of program models and how they can be used in Chapter 3."

? ROBIN LIN MILLER, University of Illinois at Chicago

"This book is useful because it keeps the main concepts of program evaluation in an easy-to-follow format. The way the parts of a program evaluation were put together to resemble the parts of a play allowed me to review familiar material in detail, but at the same time remind me of the structure of an evaluation. This was useful for me to reintegrate, as sometimes when one is involved in particular "scenes" of an evaluation, they lose sight of the "act" or the "play." It gave me a great reminder of the big picture."

University of Alabama, BirminghamAs more and more money is spent developing programs and services to solve health problems, how can one know if a specific health program works or what it would take to improve it? Aimed at addressing this issue, The Practice of Health Program Evaluation provides readers with the methods to evaluate health programs and the expertise to navigate the political terrain so as to work more effectively with decision makers and other groups. To convey these principles, Grembowski uses the metaphor of evaluation being a three-act play with a variety of actors and interest groups, each having a role that involves entering and exiting the "stage" at different points in the evaluation process. The first section (Act I) shows evaluators how to work with decision makers and other groups to define the question they want answered about a program and how to develop evaluation questions. Act II covers the methods for selecting among one or more evaluation designs (experimental and quasi-experimental designs, program implementation, sample size, measurement, and cost-effectiveness analysis) to answer questions about the program. And, Act III covers the use of the answers, including methods for developing formal dissemination plans, factors that influence whether evaluation findings are used or not, and major challenges facing the discipline in the next decade. Through the use of relevant examples and the explanation of each step, this book will enable readers to apply research methods in the practice of health evaluation.

This Reader includes material relevant to everyone involved in developing new relationships in health and social care. Alongside articles on social care as traditionally conceived, it offers articles from a wide variety of settings, including those in health and education. It brings together classic management texts and material with a management focus, providing a stimulating range of perspectives on the manager's role. In the management of something as complex as care, this must involve:
* listening to service users
* maintaining professional values
* enabling participation
* facilitating learning.
The Managing Care Reader reflects these imperatives as it focuses in on the experience of being in the front line. In four parts, it looks at how managers experience what they do, their managerial responsibilities, the key professional issues, and the importance of the organisational environment. It offers a rich resource for all those undertaking management courses or moving into frontline management roles in the new world of social care.

In 1977 the average American spent $755 per year on health care, most physicians functioned as independent practitioners, and only 5.6 million people under the age of 65 were enrolled in HMOs. Twenty years later, per capita expenditures had more than tripled, most physicians practiced within a managed care environment, and HMO enrollment stood at 62 million. Keeping pace with these and other changes in the U.S. health system has been the job of the National Medical Expenditure Surveys (NMES). Since they were first started in the 1970s, these federal government surveys have defined our basic understanding of how individuals and families use and pay for America's health care systems and have directly influenced national policy changes, health care reform, and cost-control strategies.

Informing American Health Care Policy is the definitive resource that analyzes the overall effect of the National Medical Expenditure Surveys. This important edited collection is written by an outstanding panel of experts from a variety of disciplines and includes contributions from nationally known economists, sociologists, and survey researchers. Rich in insights and lessons learned, Informing American Health Care Policy
Offers a critical assessment and a discerning overview of NMES' outcomes
Describes how the design strategies and methods evolved over the past two decades
Provides a detailed discussion about the collection of a wide range of data on health insurance and employment status
Addresses troublesome issues in defining and measuring access in vulnerable populations
Summarizes the multiple and complex issues of survey design, population sampling, and analytical method
Demonstrates the indispensability of NMES data in the health reform debates

The contributors examine how the current health care environment reflects the successes and failures of previous research and makes recommendations on how to adapt survey research to be more effective in the future.

The Important Lessons Learned from the National Medical Expenditure Surveys

Informing American Health Care Policy provides a critical perspective on the National Medical Expenditure Surveys (NMES) and how these surveys have responded to the sometimes conflicting challenges of policy and research. Sponsored by the Agency for Health Care Policy and Research and written by a stellar panel of interdisciplinary experts including contributions from nationally known economists, sociologists, and survey researchers, this essential resource is filled with lessons learned and emerging strategies for the future.

"I enjoyed reading this book. Thanks to the major investment in health expenditure and insurance surveys and the increasingly sophisticated analytic capacity described in this volume, policy officials now have a much more precise and up-to-date understanding of the implications of policy choices."--Karen Davis, president, The Commonwealth Fund; developed President Carter's 1977 national health reform proposal

"In this important book, the lead researchers associated with NMES describe the development of this rich data source and, in a series of well-crafted papers, illustrate the use of these data in informing major areas of health policy. It is a must read for anyone interested in American health policy-especially for younger professionals entering this growing field."--Uwe E.Reinhardt, James Madison Professor of Political Economy, Princeton University

"National health expenditure surveys have provided policymakers with the information they need to make informed decisions. This volume tells us about the evolution and contributions of the federal government's most ambitious health care survey. I recommend it for those interested in improving the quality of data available to those who formulate policy."--John K. Iglehart, founding editor, Health Affairs

"Thoughtful and informed reflections on the lessons learned by NMES. Provides sound guidance and procedures required to address the enduring policy questions of Who's covered? Who pays?, and How much? in the emerging U.S. health care environment of the future."--Lu Ann Aday, professor of behavioral sciences and management and policy sciences, the University of Texas School of Public Health; and author, Designing and Conducting Health Surveys, Fourth Edition

Under managed care, health care has become a sometimes uneasy partnership between consumers, health care providers, and the communities they serve. Empowered by a broadly held understanding of medicine and an ability to collect and use performance information to improve health services, this alliance is reshaping our local health systems. In this constantly changing environment, competitive advantage will go to those physicians who are fast-and focused-in their ability to transform their practice into accountable, cooperative business units-reshaping society's expectations of medicine and ultimately improving the delivery of health care.

In The New Health Partners, physician Stephen Prather reveals how doctors can regain stewardship of their medical practices and strengthen their crucial role in the health care of their local communities. Prather?a nationally known physician consultant, educator, practitioner, and speaker--gives physicians effective techniques and practical advice needed to deliver bottom-line results.
Prather shows physicians, medical directors, and administrators how they can acquire the essential skills of leadership and team development for use in both office and community health settings. Step-by-step, Prather explains how to apply the transformative power of the "Six Dimensions of Health Systems" to integrate delivery of care, align economic and non-economic incentives, manage chronic illness, empower clinical groups, work with patients and their families, and redesign care for community benefit.

This groundbreaking book explores how to
A- Put in place successful methods for creating economic incentives to motivate physician change
A- Map outproven approaches for achieving clinical quality improvement and efficient office practices
A- Gain insight into a proven strategy for engaging the community in a rewarding partnership
A- Combine effective management principles, time-honored values, and useful guidelines for the most skillful use of performance data

The New Health Partners is based on the information gathered from in-depth organizational and marketplace assessments and surveys of physician-leaders from across the country. This vital resource also includes numerous examples of best practices that have proven to be easily reproducible, cost-effective, and beneficial to patients. This hands-on volume will prove to be an invaluable aid for any physician-leader who wants to work smarter and direct a health care organization to be ethically, clinically, and fiscally sound.

Discover t-he Six Dimensions of Health Systems That Can Transform Your Medical Practice

The New Health Partners is an essential handbook for physicians who want to reshape their practices to prosper within the managed care environment. This key resource offers a blueprint for helping physicians, medical directors, and administrators create the needed partnerships and cooperative business alliances, put in place the best practices that will maximize accountability, and, ultimately, achieve success in disease management.

"Steve Prather's book encapsulates the key forces in health care today. If followed, his practical solutions will dramatically change the way we organize and deliver care."--Henry G. Walker, president and CEO, Providence/Health System

"Prather has written a book full of helpful insights, tips, and examples for thosetrying to make sense of the leadership opportunity facing doctors today and tomorrow. His strategies and stories can help those who lead physician practice today and guide those who teach tomorrow's doctors."-Paul Batalden, professor and director, Health Care Improvement Leadership Development Center for the Evaluative Clinical Sciences, Dartmouth Medical School

"Using his vast experience and keen insight, Steve Prather presents exciting concepts and practices that will contribute greatly to the improvement of the delivery and quality of clinical care into the next millennium-a major concern for all health care leaders."-Dan S. Wilford, president, Memorial Hermann Healthcare System

"I urge the leaders of health care systems to read and study this enlightening book together. And, since integration, alignment, improvement, teamwork, and partnering are relevant activities at all levels of an organization, it would be wise for leaders to encourage and enable the many natural work groups in their organization to similarly study, digest, and adapt the rich knowledge available in [this book]. Doing so will produce a much more effective and competitive health care system."-From the foreword by James S. Roberts, senior vice president, physician leadership, VHA, Inc.

Risk management, assessment and reduction, alongside patient involvement, is an essential part of the current NHS reforms. This book draws together and summarises the latest information on risk in healthcare. It outlines the facts patients need and the level of involvement they require to make informed decisions, and emphasises the practical aspects of how practitioners can best explain risk. The first section of the book concentrates on defining risk and the factors influencing individuals as they make decisions about risk, and the latter part focuses on how clinical teams make decisions about organisational matters and the working environment. All health professionals, including doctors, nurses and managers throughout primary and secondary care will find it an essential reference.

This comprehensive, yet accessible, text demystifies the challenging area of competence assessement in medicine and the health sciences, providing a clear framework and the tools for anyone working or studying in this area. Written by a single, highly experienced, author, the content benefits from uniformity of style and is supported and enhanced by a range of pedagogic features including cases, questions and summaries. Essential reading for all students and practitioners of medical education, it will also be an invaluable guide for allied health professionals and psychologists with a general interest in assessment, evaluation and measurement and a useful library reference.

"E-Health Care Information Systems" is a comprehensive collection written by leading experts from a range of disciplines including medicine, health sciences, engineering, business information systems, general science, and computing technology. This easily followed text provides a theoretical framework with sound methodological approaches and is filled with numerous case examples. Topics include e-health records, e-public information systems, e-network and surveys, general and specific applications of e-health such as e-rehabilitation, e-medicine, e-homecare, e-diagnosis support systems, and e-health intelligence. "E-Health Care Information Systems" also covers strategies in e-health care technology management, e-security issues, and the impacts of e-technologies. In addition, this book reviews new and emerging technologies such as mobile health, virtual reality and nanotechnology, and harnessing the power of e-technologies for real-world applications.

Does restructuring health care delivery improve patient care?

After Restructuring examines nine hospital systems as they go through the process of restructuring and reports on the most effective strategies and practices for making organizational change within hospitals and other health care organizations.

The practical strategies presented in this much-needed book are based on solid qualitative research, case study methodology, and organizational theory. After Restructuring shows what actually happens in health care institutions that have restructured their clinical operations and offers valuable information on how to strategically plan and manage the effects of change on patient care, nursing, and the culture of the organization.

In clear and accessible terms, the book introduces a framework for understanding organizational transformation and defines the principles that guide health care change agents through the five stages of changereadiness to change, awareness of the need to change, identification and selection of changes, implementation, and institutionalization of changes. To aid organizations currently undertakingor considering this challenging process, the book is filled with specific, illustrative examples from the real life case studies.

The book is based on an extensive study conducted by a team of health services researchers led by Thomas Rundall, director of the Center for Health Management Studies at the University of California, Berkeley. The study surveyed nine hospital systems in urban, rural, and suburban regions that received Robert Wood Johnson Foundation grants and Pew Charitable Trust funding to restructure their patient processes. The standardsderived from the experiences of these hospitals lay the foundation for important best practices guidelines.
At the very heart of the authors transformational process is the introduction of the innovative concept bounding of empowerment--the strategy of focusing the work of empowered employees on activities that improve organizational performance. The authors explain how implementing this successful strategy can raise a hospitals overall level of effectiveness. The book also identifies specific strategies used by staff members to transform a hospitals hierarchical culture to become a cohesive and effective group culture. In addition, the book reveals how to implement the appropriate organizational changes that will address the unique needs of an individual hospital or health care institution.

Improving Patient Care Through Effective Managed Change

Is your health care organization undertakingor consideringrestructuring?
This book puts you on the front lines as it examines nine hospital systems as they attempt to redesign operations, reduce costs, and enhance patient care. Step by step, After Restructuring maps the best strategies used by these health care executives as they successfully restructured their institutions. After Restructuring shows how you can apply these same winning principles to successfully transform your institution.

"An in-depth treatment of organizational change in hospitals. After Restructuring provides a mother lode of insights and lessons that will be mined for years. A must read for all those committed to improving hospital performance in a radically changing health care system."--Stephen M. Shortell, Blue Cross of California DistinguishedProfessor of Health Policy and Management, professor of Organization Behavior, School of Public Health, University of California, Berkeley

"Unusual in its sensitivity to clinical and managerial agendas, this book demonstrates how hospital re-engineering principles can empower caregivers to improve hospital performance. Anyone hoping to change hospitals, or expecting to be affected by hospital changes, should read this book."Linda H. Aiken, director, Center for Health Services and Policy Research, University of Pennsylvania

"I would recommend this pathbreaking book to any health care executive, manager, physician, nurse, and anyone who is working to improve the performance of health care organizations."Mary A. Pittman, president, Health Research and Educational Trust

Despite more than a decade of change, the U.S. health care delivery system is still in the early stages of its transformation into a truly effective, cost efficient and compassionate system. In Healthcare.com: RX for Reform, Dr. David Friend, trained in both medicine and business, delineates the symptoms of our ailing healthcare system and offers a vision for the future.

Even with the enormous turmoil our health care system has undergone - from the proliferation managed care to the closing of hospitals - large numbers of people continue to receive sub-optimal care. The author discusses several symptoms including:
· increasing costs
· uncertain quality of care
· eroding trust in health care vendors
· increasing prospect of shareholder liability
· declining access to providers
· unclear impact on employee productivity

It is time to discard the old, traditional way of thinking about healthcare and take a fresh look at its issues and challenges. To tackle these challenges we must strike a balance between the seemingly dissimilar disciplines of economics, medicine, technology, and politics. Dr. Friend proposes that we tear down the brick and mortar delivery model and replace it with a Virtual Health Care System.

This new model changes the roles of everyone involved in the healthcare system, from the patient to the healthcare provider. It utilizes technology to redesign health care so that it can be delivered with higher quality and greater efficiency. Healthcare.com: RX for Reform examines the actions necessary for the evolution of our current system into a Virtual Health Care System.

Features

This is a practical book for health and IT professionals who need to ensure that patient safety is prioritized in the design and implementation of clinical information technology. Healthcare professionals are increasingly reliant on information technology to deliver care and inform their clinical decision making. Health IT provides enormous benefits in efficiency, communication and decision making. However a number of high-profile UK and US studies have concluded that when Health IT is poorly designed or sub-optimally implemented then patient safety can be compromised. Manufacturers and healthcare organizations are increasingly required to demonstrate that their Health IT solutions are proactively assured. Surprisingly the majority of systems are not subject to regulation so there is little in the way of practical guidance as to how risk management can be achieved. The book fills that gap. The author, a doctor and IT professional, harnesses his two decades of experience to characterize the hazards that health technology can introduce. Risk can never be eliminated but by drawing on lessons from other safety-critical industries the book systematically sets out how clinical risk can be strategically controlled. The book proposes the employment of a Safety Case to articulate and justify residual risk so that not only is risk proactively managed but it is seen to be managed. These simple techniques drive product quality and allow a technology's benefits to be realized without compromising patient safety.

Offers an account of economic concepts relevant to the nursing profession. The aims of the book are to explain the economic theory underlying health care policy in the National Health Service with particular reference to nursing, and to examine the economic techniques which may be used to improve the understanding of efficiency and cost-effectivenes in the nursing profession.

This book is vital for health service managers and clinicians, in both purchaser and provider organizations, in community and hospital settings. It helps the reader understand the principles and purposes of casemix and provides practical examples of using casemix groupings to manage services better. Its lessons are not just for acute services, but provide a way of understanding the complete spectrum of services required for a wide range of conditions, from individuals at risk to those with irreversible and progressive disease. The book explains why casemix groups are useful and the reasons for grouping and analysing patient records. It focuses on the difference between groupings of patients with conditions, and groupings of intervention episodes. Using both enables better identification of the services required to meet the needs of the population, and better communication between purchasers and providers. It has potential for managing the whole healthcare system from a population based perspective.

This text is part of a practical tool-kit designed to help managers take control of their budgets. It should enable managers to understand the reports from management accounts and to know what to expect or demand from them. It has been exclusively developed to suit the specific needs of the NHS.

Managed care organizations are paving the way to the future of health care delivery in the United States and countries around the world. As managed care systems evolve, a major concern is quality. Managed Care Quality: A Practical Guide is a collection of applications and experiences gathered from practicing health professionals in the field of managed care. This first "how to" guide was written to help managed care organizations meet the common objective of ensuring the best quality of services and care. Managed Care Quality: A Practical Guide presents successive steps in implementing quality in health care organizations. It introduces the methods, skills, and practices involved in quality health care programs and offers solutions to problems typically encountered in managed care.

Analysing Health Care Organizations seeks to link the world of health policy and management with the academic field of organization studies in a novel and additive way. It outlines the main developments in UK health care management apparent over the last thirty years and explores how they might be (re)seen with the application of some important organizational theories and perspectives. This book draws out contemporary and enduring themes from current literature on health care organization and considers them from a range of theoretical perspectives. Drawing on robust areas of research and some key academics who contribute to work in this field, it is a book relevant both to experts in the field and to those seeking to develop an understanding of health care organization from a theoretical perspective. Analysing Health Care Organizations provides a state of the art introduction foundation for subsequent works that will extend its content; providing a broad introductory overview of this theoretical terrain and setting the scene for further research.

There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we're overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet. Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med's emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms. In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised. This is an essential read for understanding the current state of the health care system in America-and the steps urgently needed to create an environment of better care for all of us.