Health Care Coverage Determinations: An International Comparative Study

Health Care Coverage Determinations: An International Comparative Study
Author: Jost, Timothy
Publisher: McGraw-Hill Education (UK)
Total Pages: 295
Release: 2004-12-01
Genre: Education
ISBN: 0335214959

"A ground breaking set of case studies about how [health care] coverage decisions are made" Robert A. Berenson M.D. Senior Fellow at the Urban Institute, Washington D.C. and former Director of the Center for Health Plans and Providers of the Medicare program Developed countries are facing rapidly rising health care costs and one of the major factors driving health care cost growth is the continual development and diffusion of new, generally more expensive, health care technologies. This book contains: * A description of the institutions, procedures and criteria used by eight countries for assessing technologies for public insurance coverage * An analysis of the role of interest groups, and of the public interest, in these decision making processes * An examination of how particular technologies are treated differently by different countries, and why Based upon research from Australia, Canada, Germany, The Netherlands, Spain, Switzerland, the United States of America and the United Kingdom, the contributors argue that although each of these countries is committed to evidence-based scientific assessment of technologies, in fact adoption of technologies is significantly affected by political considerations, and in particular by the influence of interest groups. Moreover, it offers recommendations as to how technology assessment for coverage policy can be improved to serve better the public interest. Health Care Coverage Determinations is essential reading for health policy makers, managers, researchers and students with an interest in health economics, health care provision and the politics affecting health care legislation. Contributors: Liliana Bulfone, Tanisha Carino, Peter C. Coyte, Anna Garca-Alts, Colleen M. Flood, Stefan Gre, Felix Gurtner, Anthony Harris, Timothy Stoltzfus Jost, Eric Nauenberg, Christopher Newdick, Dea Niebuhr, Guillaume Roduit, Heinz Rothgang, Frans F.H. Rutten, Dominique Sprumont, Juergen Wasem.

Care Without Coverage

Care Without Coverage
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 213
Release: 2002-06-20
Genre: Medical
ISBN: 0309083435

Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

EBOOK: Health Care Coverage Determinations: An International Comparative Study

EBOOK: Health Care Coverage Determinations: An International Comparative Study
Author: Timothy Jost
Publisher: McGraw-Hill Education (UK)
Total Pages: 295
Release: 2004-12-16
Genre: Medical
ISBN: 0335225993

"A ground breaking set of case studies about how [health care] coverage decisions are made" Robert A. Berenson M.D. Senior Fellow at the Urban Institute, Washington D.C. and former Director of the Center for Health Plans and Providers of the Medicare program Developed countries are facing rapidly rising health care costs and one of the major factors driving health care cost growth is the continual development and diffusion of new, generally more expensive, health care technologies. This book contains: * A description of the institutions, procedures and criteria used by eight countries for assessing technologies for public insurance coverage * An analysis of the role of interest groups, and of the public interest, in these decision making processes * An examination of how particular technologies are treated differently by different countries, and why Based upon research from Australia, Canada, Germany, The Netherlands, Spain, Switzerland, the United States of America and the United Kingdom, the contributors argue that although each of these countries is committed to evidence-based scientific assessment of technologies, in fact adoption of technologies is significantly affected by political considerations, and in particular by the influence of interest groups. Moreover, it offers recommendations as to how technology assessment for coverage policy can be improved to serve better the public interest. Health Care Coverage Determinations is essential reading for health policy makers, managers, researchers and students with an interest in health economics, health care provision and the politics affecting health care legislation. Contributors: Liliana Bulfone, Tanisha Carino, Peter C. Coyte, Anna García-Altés, Colleen M. Flood, Stefan Greß, Felix Gurtner, Anthony Harris, Timothy Stoltzfus Jost, Eric Nauenberg, Christopher Newdick, Dea Niebuhr, Guillaume Roduit, Heinz Rothgang, Frans F.H. Rutten, Dominique Sprumont, Juergen Wasem.

Health-Care Utilization as a Proxy in Disability Determination

Health-Care Utilization as a Proxy in Disability Determination
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 161
Release: 2018-04-02
Genre: Medical
ISBN: 030946921X

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.

Finding What Works in Health Care

Finding What Works in Health Care
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 267
Release: 2011-07-20
Genre: Medical
ISBN: 0309164257

Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.

Explaining Divergent Levels of Longevity in High-Income Countries

Explaining Divergent Levels of Longevity in High-Income Countries
Author: National Research Council
Publisher: National Academies Press
Total Pages: 200
Release: 2011-06-27
Genre: Social Science
ISBN: 0309217105

During the last 25 years, life expectancy at age 50 in the United States has been rising, but at a slower pace than in many other high-income countries, such as Japan and Australia. This difference is particularly notable given that the United States spends more on health care than any other nation. Concerned about this divergence, the National Institute on Aging asked the National Research Council to examine evidence on its possible causes. According to Explaining Divergent Levels of Longevity in High-Income Countries, the nation's history of heavy smoking is a major reason why lifespans in the United States fall short of those in many other high-income nations. Evidence suggests that current obesity levels play a substantial part as well. The book reports that lack of universal access to health care in the U.S. also has increased mortality and reduced life expectancy, though this is a less significant factor for those over age 65 because of Medicare access. For the main causes of death at older ages-cancer and cardiovascular disease-available indicators do not suggest that the U.S. health care system is failing to prevent deaths that would be averted elsewhere. In fact, cancer detection and survival appear to be better in the U.S. than in most other high-income nations, and survival rates following a heart attack also are favorable. Explaining Divergent Levels of Longevity in High-Income Countries identifies many gaps in research. For instance, while lung cancer deaths are a reliable marker of the damage from smoking, no clear-cut marker exists for obesity, physical inactivity, social integration, or other risks considered in this book. Moreover, evaluation of these risk factors is based on observational studies, which-unlike randomized controlled trials-are subject to many biases.

The Law of Health Care Finance and Regulation

The Law of Health Care Finance and Regulation
Author: Mark A. Hall
Publisher: Aspen Publishing
Total Pages: 907
Release: 2018-05-11
Genre: Law
ISBN: 154380473X

The Law of Health Care Finance and Regulation is based on Part III, “Institutions, Providers, and the State,” of parent book Health Care Law and Ethics and adds additional coverage of a variety of issues that have shaped health care finance law. Integrating public health, financial and ethical issues, this casebook uses compelling case law, clear notes and comprehensive background information to illuminate the complex and dynamic field of health care law. Key Features: Based on material in Part III of the popular parent book, “Institutions, Providers, and the State,” along with coverage of duty to treat, hospital liability, managed care liability, and regulating access to drugs. Includes cases and material not found in the parent book on: • Judicial and administrative review of Medicare decisions. Certificate of need laws. Review immunity. Integrates public health and ethics issues and features clear notes that provide context, smooth transitions between cases, and background information. Website provides background materials, updates of important events, additional relevant topics and links to other resources on the Internet.

The State and Healthcare

The State and Healthcare
Author: H. Rothgang
Publisher: Springer
Total Pages: 292
Release: 2010-09-17
Genre: Political Science
ISBN: 0230292348

Describes developments in healthcare systems over nearly four decades. Combining cross-sectional studies on healthcare financing, provision and policy values with in-depth country studies of Britain, Germany and the USA, this volume is a thorough examination of the convergence toward hybrid forms of healthcare systems.

The Oxford Handbook of the Welfare State

The Oxford Handbook of the Welfare State
Author: Daniel B?land
Publisher: Oxford University Press
Total Pages: 1090
Release: 2021-10-27
Genre: Political Science
ISBN: 0192563475

This is the comprehensively-revised second edition of a volume that was welcomed at its first appearance as 'the most authoritative survey and critique of the welfare state yet published'. Its fifty-one chapters have been written by acknowledged experts in the field from across Europe, Australia, and North America. Some chapters are brand new; all have been systematically revised, and they are right up to date. The first seven sections of the book cover the themes of Ethics, History, Approaches, Inputs and Actors, Policies, Policy Outcomes, and Worlds of Welfare. A final chapter is devoted to the future of welfare and well-being under the imperatives of climate change. Every chapter is written in a way that is both comprehensive and succinct, introducing the novice reader to the essentials of what is going on while providing new insights for the more experienced researcher. Wherever appropriate, the handbook brings the very latest empirical evidence to bear. It is a book that is thoroughly comparative in every way. The Oxford Handbook of the Welfare State, second edition, is a comprehensible and comprehensive survey of everything that it is important to know about the welfare state in these troubled times. It is an indispensable source for everyone who wants to know what is really going on now, and what is likely to happen next.