Understanding Health Services

No single discipline can provide a full account of why health care is the way it is. Introducing an accessible overview of health services and drawing on medicine, sociology, economics, history and epidemiology, this book provides a series of conceptual frameworks which help to clarify some of the complexity that confronts the inexperienced observer. Helping to determine what influences and shapes health services, it also examines some of the key processes involved in providing healthcare, considering three levels: individual patients, health care organizations such as hospitals, and regional or national institutions such as governments. This second edition has been updated to include recent developments and further examples and activities from low, middle and high income countries. The book examines: • how medical knowledge, staff, patients and finance shape health services • what factors influence utilization of health services • the roles played by users of health services • how to define and measure outcomes and assess performance • how practice and policy can be changed to improve the quality of health care Understanding Health Services, 2nd Edition is an essential resource for students of public health and health policy, researchers, public health practitioners and policy makers. Understanding Public Health is an innovative series published by Open University Press in collaboration with the London School of Hygiene & Tropical Medicine, where it is used as a key learning resource for postgraduate programmes. It provides self-directed learning covering the major issues in public health affecting low, middle and high income countries. "This excellent book provides an ideal background to understanding how health services work and how they can be studied. Not tied to any particular country, it includes key chapters on how health services have developed and are organised, need and demand, the role of health professionals, and measuring and improving quality of care. The book is ideal reading for students on Masters courses in public health and related subjects from high-, middle- and low-income countries and includes learning objectives and exercises in each chapter which can be completed individually or used for discussion. Strongly recommended." Martin Roland, Emeritus Professor of Health Services Research, University of Cambridge, UK "Health services are central to attaining high levels of population health and providing those services consumes a substantial share of our financial resources. This book provides a splendid introduction to many of the key building blocks including medical knowledge and other key inputs, payment and other factors that influence utilization, and in turn quality of care and outcomes. The learning objectives are a wonderful aid for self-directed learning as are the directed activities and feedback, the text is lucid and the main concepts are very easy to access. This is a great book for someone looking to develop a broad understanding of health services. I will be surprised if it does not become a classic. It will surely be at the top of my list of recommended readings for my own students." Arnold M Epstein, John H Foster Professor and Chair, Department of Health Policy and Management, Harvard School of Public Health, USA

“This timely book provides insight into the changing role of the ‘hospital’ in the face of technological, organizational innovation and ever-tightening health budgets.”James Barlow, Imperial College Business School, UK “This book covers various relevant aspects of the hospital in different states and contexts. Underlining the importance of business models for future hospitals, this publication presents models of care from a historic and a current perspective. All authors possess a deep insight into different health care systems, not only as scholars but as experts working for world-renowned health policy institutions such as the World Health Organization, the World Bank or the European Observatory for Health Systems.”Siegfried Walch, Management Center Innsbruck, Austria “For an organisation like mine, representing those involved in the strategic planning of healthcare infrastructure, this book provides invaluable insights into what really matters – now and for the future – in the complex and contentious field of hospital development.”Jonathan Erskine, European Health Property Network, Netherlands This book seeks to reframe current policy discussions on hospitals. Healthcare services turn expensive economic resources—people, capital, pharmaceuticals, energy, materials—into care and cure. Hospitals concentrate the use and the cost of these resources, particularly highly-trained people, expensive capital, and embedded technologies. But other areas of health, such as public health and primary care, seem to attract more attention and affection, at least within the health policy community. How to make sense of this paradox? Hospitals choose, or are assigned, to deliver certain parts of care packages. They are organised to do this via “business models”. These necessarily incorporate models of care – the processes of dealing with patients. The activity needs to be governed, in the widest senses. Rational decisions need to be taken about both the care and the resources to be used. This book pulls these elements together, to stimulate a debate.

This book examines the current state of American health care using a social science lens to focus on the interdependent, intercultural, economic, and communication aspects of access and delivery. This text explores how the cultures of health care organizations, health professions, governments, and capitalism, as well as communication, all contribute to a disease-focused, economically driven, technology-centered health care system. It seeks to understand 21st century health care from a macro-level view based on historical realizations and the current plethora of interdependent, but self-serving realities that provide few, if any, incentives for organizational collaboration and change. The fact that the most expensive health care system in the world does not provide the healthiest outcomes is a driving force in this exploration. By reflecting on American values and beliefs regarding health care from philosophical, clinical, communication, and cost perspectives, this text is designed to encourage an organizational transformation at every level, from government to providers to patients. This comprehensive survey is an important guide for those studying, or working in, health care professions, as well as health care policy and administration. It should also be of interest to any reader who seeks to better understand U.S. health care policy from social science, economic, and/or health communication perspectives.

Health care systems are highly complex and dynamic. Different systems around the world vary in the way services are managed yet, regardless of these differences, the need for effective managers and managerial leaders is essential in allowing organizations or professionals to achieve specific goals. This book provides an understanding of the concepts of management, managerial leadership and governance within health care systems. It provides a thorough introduction to, and conceptual framework for, the analysis of health systems management and goes on to examine fundamental management tasks, including: Managing income and finances Managing people Managing strategy and change Managing results Series Editors: Rosalind Plowman and Nicki Thorogood.

The need for informed analyses of health policy is now greater than ever. The twelve essays in this volume show that public debates routinely bypass complex ethical, sociocultural, historical, and political questions about how we should address ideals of justice and equality in health care. Integrating perspectives from the humanities, social sciences, medicine, and public health, this volume illuminates the relationships between justice and health inequalities to enrich debates. Understanding Health Inequalities and Justice explores three questions: How do scholars approach relations between health inequalities and ideals of justice? When do justice considerations inform solutions to health inequalities, and how do specific health inequalities affect perceptions of injustice? And how can diverse scholarly approaches contribute to better health policy? From addressing patient agency in an inequitable health care environment to examining how scholars of social justice and health care amass evidence, this volume promotes a richer understanding of health and justice and how to achieve both. The contributors are Judith C. Barker, Paula Braveman, Paul Brodwin, Jami Suki Chang, Debra DeBruin, Leslie A. Dubbin, Sarah Horton, Carla C. Keirns, J. Paul Kelleher, Nicholas B. King, Eva Feder Kittay, Joan Liaschenko, Anne Drapkin Lyerly, Mary Faith Marshall, Carolyn Moxley Rouse, Jennifer Prah Ruger, and Janet K. Shim.

This is the concise, accessible guide for students and practitioners who want a comprehensive introduction to health and social care. Engaging practical features, such as user-focused case studies and reflective exercises, promote understanding of theoretical and conceptual knowledge. In turn, clear explanations of social policy theory help frame the policy and practice dilemmas faced by students, front-line workers and policy makers. Chapters cover partnership working and integrated care, independent living, disability and long-term conditions, discrimination, user involvement and support for carers. This new edition has been updated to cover key developments under the Coalition and beyond, including the 2012 Health Act, the 2014 Care Act, the Francis inquiry, the Winterbourne View abuse scandal, the integrated care agenda and the impact of austerity.

The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.

How do communities protect and improve the health of their populations? Health care is part of the answer but so are environmental protections, social and educational services, adequate nutrition, and a host of other activities. With concern over funding constraints, making sure such activities are efficient and effective is becoming a high priority. Improving Health in the Community explains how population-based performance monitoring programs can help communities point their efforts in the right direction. Within a broad definition of community health, the committee addresses factors surrounding the implementation of performance monitoring and explores the "why" and "how to" of establishing mechanisms to monitor the performance of those who can influence community health. The book offers a policy framework, applies a multidimensional model of the determinants of health, and provides sets of prototype performance indicators for specific health issues. Improving Health in the Community presents an attainable vision of a process that can achieve community-wide health benefits.