Health Care Systems

This book provides insight into how the Canadian health care system is financed and organized, how it has evolved over time, and how well it performs relative to peer countries.

As our nation enters a new era of medical science that offers the real prospect of personalized health care, we will be confronted by an increasingly complex array of health care options and decisions. The Learning Healthcare System considers how health care is structured to develop and to apply evidence-from health profession training and infrastructure development to advances in research methodology, patient engagement, payment schemes, and measurement-and highlights opportunities for the creation of a sustainable learning health care system that gets the right care to people when they need it and then captures the results for improvement. This book will be of primary interest to hospital and insurance industry administrators, health care providers, those who train and educate health workers, researchers, and policymakers. The Learning Healthcare System is the first in a series that will focus on issues important to improving the development and application of evidence in health care decision making. The Roundtable on Evidence-Based Medicine serves as a neutral venue for cooperative work among key stakeholders on several dimensions: to help transform the availability and use of the best evidence for the collaborative health care choices of each patient and provider; to drive the process of discovery as a natural outgrowth of patient care; and, ultimately, to ensure innovation, quality, safety, and value in health care.

America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.

Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine

For the last two decades, major Asian economies have successfully kept their economic growth momentum going. Now, as these economies are entering a new phase of economic growth, more attention is being paid to their respective states of social development, especially the provision and the expansion of social security and, in particular, health care. Academic study of the development of health care in developing countries has been for the most part neglected by the literature, and in-depth country case studies that are directly comparable on a one-to-one basis have not yet been conducted in a systematic manner. This book volume also proposes a new stance on health policy and the health care policy paradigm, one that focuses on "saving lives" from premature death, as well as illness, accidents, misery and poverty, based on the normative theory of developmental social policy (DSP). This groundbreaking book will therefore serve as a valuable reference volume for health policy, social policy and public policy experts, social development experts, health and development economists, health sociologists, social workers, government administrators as well as other medical and health professionals and academics.

This concise reference provides a one-stop point of research that examines major aspects of health care systems for over 190 countries worldwide. In a consistent format, ten major health care categories are systematically examined for each country: 1. Emergency Health Services; 2. Costs of Hospitalization; 3. Costs of Drugs; 4. Major Health Issues; 5. Government Role in Health Care; 6. Insurance; 7. Access to Health Care; 8. Health Care Facilities; 9. Health Care Personnel (doctor level of training, etc.); and 10. Public Health Programs. The volume is organized in alphabetical order of country names. Each country is presented on a two- or three-page spread with the same descriptive and statistical content, allowing readers to compare health care systems from country to country. For example, a reader may compare costs of drugs in France versus the United States versus Canada. Each country spread will feature short entries on the ten health care categories accompanied by charts, table, and photos as appropriate. The work culminates as a unique and essential resource for pre-med and medical students, as well as researchers in sociology, economics, and the health management fields.

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

This book brings together professionals who have dedicated their careers to the health system. It presents a canvas to paint their prediction of the future of healthcare. This third book complements the previous two books, Healthcare Reform, Quality, and Safety: Perspectives, Participants, Partnerships, and Prospects in 30 Countries, and Health Systems Improvement Across the Globe: Success Stories from 60 Countries, by covering from around the globe, what the future might hold for healthcare systems. Rather than focusing on western nations, like other healthcare literature, this book provides a snapshot, along with 57 case studies, of future predictions of health systems globally.