Definition of Serious and Complex Medical Conditions


Book Description

In response to a request by the Health Care Financing Administration (HCFA), the Institute of Medicine proposed a study to examine definitions of serious or complex medical conditions and related issues. A seven-member committee was appointed to address these issues. Throughout the course of this study, the committee has been aware of the fact that the topic addressed by this report concerns one of the most critical issues confronting HCFA, health care plans and providers, and patients today. The Medicare+Choice regulations focus on the most vulnerable populations in need of medical care and other services-those with serious or complex medical conditions. Caring for these highly vulnerable populations poses a number of challenges. The committee believes, however, that the current state of clinical and research literature does not adequately address all of the challenges and issues relevant to the identification and care of these patients.




Wellbeing, Recovery and Mental Health


Book Description

This book brings together two bodies of knowledge - wellbeing and recovery. Wellbeing and 'positive' approaches are increasingly influencing many areas of society. Recovery in mental illness has a growing empirical evidence base. For the first time, overlaps and cross-fertilisation opportunities between the two bodies of knowledge are identified. International experts present innovations taking place within the mental health system, which include wellbeing-informed new therapies, e-health approaches and peer-led recovery communities. State-of-the-art applications of wellbeing to the wider community are also described, across education, employment, parenting and city planning. This book will be of interest to anyone connected with the mental health system, especially people using and working in services, and clinical and administrators leaders, and those interested in using research from the mental health system in the wider community.




Improving Health in the Community


Book Description

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.




Culture and Meaning in Health Services Research


Book Description

Culture and Meaning in Health Services Research is a practical guide to applying interpretive qualitative methods to pressing healthcare delivery problems. A leading medical anthropologist who has spent many years working in applied healthcare settings, Sobo combines sophisticated theoretical insights and methodological rigor with authentic, real-world examples and applications. In addition to clearly explaining the nuanced practice of ethnography and guiding the reader through specific methods that can be used in focus groups or interviewing to yield useful findings, Sobo considers the social relationships and power dynamics that influence field entry, data ownership, research deliverables, and authorship decisions. Crafted to communicate the importance of culture and meaning across the many disciplines engaged in health services research, this book is ideal for courses in such fields as public health and health administration, nursing, anthropology, health psychology, and sociology.




Communities in Action


Book Description

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.




Health Literacy


Book Description

To maintain their own health and the health of their families and communities, consumers rely heavily on the health information that is available to them. This information is at the core of the partnerships that patients and their families forge with today's complex modern health systems. This information may be provided in a variety of forms â€" ranging from a discussion between a patient and a health care provider to a health promotion advertisement, a consent form, or one of many other forms of health communication common in our society. Yet millions of Americans cannot understand or act upon this information. To address this problem, the field of health literacy brings together research and practice from diverse fields including education, health services, and social and cultural sciences, and the many organizations whose actions can improve or impede health literacy. Health Literacy: Prescription to End Confusion examines the body of knowledge that applies to the field of health literacy, and recommends actions to promote a health literate society. By examining the extent of limited health literacy and the ways to improve it, we can improve the health of individuals and populations.




Insuring America's Health


Book Description

According to the Census Bureau, in 2003 more than 43 million Americans lacked health insurance. Being uninsured is associated with a range of adverse health, social, and economic consequences for individuals and their families, for the health care systems in their communities, and for the nation as a whole. This report is the sixth and final report in a series by the Committee on the Consequences of Uninsurance, intended to synthesize what is known about these consequences and communicate the extent and urgency of the issue to the public. Insuring America's Health recommends principles related to universality, continuity of coverage, affordability to individuals and society, and quality of care to guide health insurance reform. These principles are based on the evidence reviewed in the committee's previous five reports and on new analyses of past and present federal, state, and local efforts to reduce uninsurance. The report also demonstrates how those principles can be used to assess policy options. The committee does not recommend a specific coverage strategy. Rather, it shows how various approaches could extend coverage and achieve certain of the committee's principles.




The Dark Lord


Book Description

Tom Harlan brings his Oath of Empire series to a shattering conclusion in The Dark Lord. In what would be the 7th Century AD in our history, the Roman Empire still stands, supported by the twin pillars of the Legions and Thaumaturges of Rome. The Emperor of the West, the Augustus Galen Atreus, came to the aid of the Emperor of the East, the Avtokrator Heraclius, in his war with the Sassanad Emperor of Persia. But despite early victories, that war has not gone well, and now Rome is hard-pressed. Constantinople has fallen before the dark sorceries of the Lord Dahak and his legions of the living and dead. Now the new Emperor of Persia marches on Egypt, and if he takes that ancient nation, Rome will be starved and defeated. But there is a faint glimmer of hope. The Emperor Galen's brother Maxian is a great sorcerer, perhaps the equal of Dahak, lord of the seven serpents. He is now firmly allied with his Imperial brother and Rome. And though they are caught tight in the Dark Lord's net of sorcery, Queen Zoe of Palmyra and Lord Mohammed have not relinquished their souls to evil. Powerful, complex, engrossing --Thomas Harlan's Oath of Empire series has taken fantasy readers by storm. The first three volumes, The Shadow of Ararat, The Gate of Fire, and The Storm of Heaven have been universally praised. At the Publisher's request, this title is being sold without Digital Rights Management Software (DRM) applied.




Defining Primary Care


Book Description




Improving Diagnosis in Health Care


Book Description

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.