Treating Health Care

Focusing on Canada's health care system, Raisa B. Deber introduces the reader to the facts and concepts necessary to understand health care policy in Canada and to evaluate how we might want to reform our health care system.

Canada has been among the world leaders in recognizing the multiple factors that impact health. Focusing on Canada’s health care system, Raisa B. Deber provides brief descriptions of some key facts and concepts necessary to understand health care policy in Canada and place it in an international context. An accessible guide, Treating Health Care unpacks key concepts to provide informed discussions that help us understand and diagnose Canada’s health care system and to clarify which proposed changes are likely to improve it - and which are not. This book provides background information to clarify such concepts as: determinants of health; how health systems are organized and financed (including international comparisons); health economics; health ethics; and roles and responsibilities of different stakeholders, including government, providers, and patients. It then addresses some key issues, including equity, efficiency, access and wait times, quality improvement and patient safety, and coverage and payment models. Using analysis rather than advocacy, Deber provides a toolkit to help understand health care and health policy.

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.

As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.

Longlisted for British Columbia's National Award for Canadian Non-Fiction 2018 Dr. Danielle Martin sees the challenges in our health care system every day. As a family doctor and a hospital vice president, she observes how those deficiencies adversely affect patients. And as a health policy expert, she knows how to close those gaps. A passionate believer in the value of fairness that underpins the Canadian health care system, Dr. Martin is on a mission to improve medicare. In Better Now, she shows how bold fixes are both achievable and affordable. Her patients’ stories and her own family’s experiences illustrate the evidence she presents about what works best to improve health care for all. Better Now outlines “Six Big Ideas” to bolster Canada’s health care system. Each one is centred on a typical Canadian patient, making it clear how close to home these issues strike. · Ensure every Canadian has regular access to a family doctor or other primary care provider · Bring prescription drugs under medicare · Reduce unnecessary tests and interventions · Reorganize health care delivery to reduce wait times and improve quality · Implement a basic income guarantee to alleviate poverty, which is a major threat to health · Scale up successful local innovations to a national level Passionate, accessible, and authoritative, Dr. Martin is a fervent supporter of the best of medicare and a persuasive critic of what needs fixing.

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.

Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health was released in September 2019, before the World Health Organization declared COVID-19 a global pandemic in March 2020. Improving social conditions remains critical to improving health outcomes, and integrating social care into health care delivery is more relevant than ever in the context of the pandemic and increased strains placed on the U.S. health care system. The report and its related products ultimately aim to help improve health and health equity, during COVID-19 and beyond. The consistent and compelling evidence on how social determinants shape health has led to a growing recognition throughout the health care sector that improving health and health equity is likely to depend â€" at least in part â€" on mitigating adverse social determinants. This recognition has been bolstered by a shift in the health care sector towards value-based payment, which incentivizes improved health outcomes for persons and populations rather than service delivery alone. The combined result of these changes has been a growing emphasis on health care systems addressing patients' social risk factors and social needs with the aim of improving health outcomes. This may involve health care systems linking individual patients with government and community social services, but important questions need to be answered about when and how health care systems should integrate social care into their practices and what kinds of infrastructure are required to facilitate such activities. Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health examines the potential for integrating services addressing social needs and the social determinants of health into the delivery of health care to achieve better health outcomes. This report assesses approaches to social care integration currently being taken by health care providers and systems, and new or emerging approaches and opportunities; current roles in such integration by different disciplines and organizations, and new or emerging roles and types of providers; and current and emerging efforts to design health care systems to improve the nation's health and reduce health inequities.