Purchasing Population Health: Paying for ResultsUniversity of Michigan Press, 1997 - 194 من الصفحات David Kindig's training as a physician, a health care executive, and his academic work in the field of health policy came together to inspire this innovative approach for extracting a higher quality of care at reasonable cost by establishing clear health outcomes measures as a purchasing standard. Despite the massive resources it consumes, the American health care system remains under stress. While we are global leaders in technical accomplishments in medicine, the quality of health outcomes we achieve per dollar invested is far from optimal. Neither market nor regulatory reforms have addressed this failure of our system. In the wake of the failed 1994 federal reform effort the system is changing without legislation through market forces. There is no evidence, however, that these changes are reducing costs, increasing quality, or covering the uninsured. This book details how Dr. Kindig's plan could work and the stages of implementation. It concludes with an examination of the price of inertia in facing this long-standing problem. This work will appeal to senior policymakers in the private and public sector, including legislators and staff, officials of corporations, and professional organizations. In addition, faculty and students in schools of medicine, nursing, public health, and business, as well as health services researchers and a sophisticated lay audience will find it interesting. "...a major contribution to our understanding of the forces driving the health care system and the need to create the incentives for a healthier America in the 21st century." --Philip R. Lee, M.D., former Assistant Secretary for Health, Department of Health and Human Services David A. Kindig is Professor of Preventive Medicine, University of Wisconsin- Madison School of Medicine. |
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الصفحة iv
... . Outcome assessment ( Medical care ) — United States . 4. Medical care - United States - Cost effectiveness . I. Title . RA395.A3K52 1997 338.4'33621'0973 - dc21 97-29010 CIP To my parents , for their love and for my.
... . Outcome assessment ( Medical care ) — United States . 4. Medical care - United States - Cost effectiveness . I. Title . RA395.A3K52 1997 338.4'33621'0973 - dc21 97-29010 CIP To my parents , for their love and for my.
الصفحة x
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الصفحة xiii
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الصفحة 8
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الصفحة 9
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المحتوى
A Vision | 1 |
How Healthy Are We? | 11 |
Are We Getting the Most for Our Money? | 25 |
Measuring Health Outcomes | 43 |
The Multiple Determinants of Health | 69 |
Can Rationing Be Rational? Balancing the Determinants of Health | 101 |
Managing Boundaries | 113 |
Different Populations Different Needs? | 133 |
Making It Happen | 149 |
The Case for Action the Price of Inertia | 169 |
177 | |
191 | |
عبارات ومصطلحات مألوفة
addition adjusted life expectancy African American age adjusted allocation approach cancer capacity to benefit capita cervical cancer chapter cholesterol clinical components concept coordination cost cost-effectiveness death rates determinants of health developed disability discussed disease economic effectiveness environment environmental example factors figure financial incentives genetic groups health adjusted health care system health expenditures health improvement health maintenance organization health outcomes health plans health services higher hospital impact income increase indicate individual initial interventions investments issues Kindig limited managed care measure of health Medicaid Medicare ment morbidity mortality rates National nonmedical determinants organizations outcome improvement outcome measures patients percent persons perspective physician Population Health framework primarily programs public health Purchasing Population Health QALYs reduced regard relationship responsibility role sectors Shortell social services socioeconomic strategy tion U.S. health United vertical integration World Bank