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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.
First multi-year cumulation covers six years: 1965-70.
With sixteen hospitals and almost 10,500 beds, the New York City Health and Hospitals Corporation(HHC) is the largest municipal hospital system in the United States. With forty-seven hospitals and almost thirty-three thousand beds, the Paris Hospital Corporation, Assistance Publique-Hopitaux de Paris(AP), is three times as large, the biggest municipal hospital system in France. This book compares these two vast systems. It analyzes staffing, outpatient and inpatient care, the desirability of private faculty practice plans, budgeting, quality assurance, and the role of medical education in these two very different systems. In addition, it reviews how both HHC and AP plan to adapt their systems over the next decade and beyond. Aging populations, the development and diffusion of new medical technologies, and the growth of hospitals and physicians throughout the 1960s and 1970s have led to massive increases in health care costs in both the United States and in France. Both New York City and Paris have suffered the shock of the AIDS epidemic. Detailed, informed, and authoritative, this book will stand for years as the standard comparative study of two large municipal hospital systems.
Praise for Partners in Health "The combination of visionary leadership, knowledge, and superb timing makes this book a winner. Health care is evolving toward collaboration and integration, and this book is essential reading for anyone wishing to change the relationships between hospitals and physicians." Donald W. Fisher, PhD, president and CEO, the American Medical Group Association "This book is a must-read for anyone committed to a high-performance health system. It spells out the practical steps that will move us toward an accessible, coordinated, patient-centered system of care. Its recommendations for payment and regulatory reform underscore the urgency of comprehensive health reform if the current misaligned incentives are to be changed to support those on the frontlines in providing the best care with prudent stewardship of resources." Karen Davis, PhD, president, The Commonwealth Fund "Closer physician-hospital integration would lead to higher quality care at lower cost. Partners in Health is a masterful guide to past integration efforts, current models of success, and thoughtful recommendations for future progress." Victor R. Fuchs, PhD, Henry J. Kaiser Jr. Professor Emeritus, Stanford University "The working relationship of hospitals and physicians must be restructured for the United States to achieve more efficient, accountable care. But addressing our urgent challenges can't wait for all hospitals and physicians to join highly structured systems. Thankfully, the authors offer steps that all the major stakeholders can take today to spur new models and start the flywheel of trust spinning at new speeds." Richard Umbdenstock, president and CEO of the American Hospital Association "Transitioning U.S. health care from fragmentation to integration, in the context of a more rational payment system, is sure to be a long and tortuous journey. Partners in Health is a kind of Fodor's Guide to the voyage. No one committed to health reform should travel without it." Susan Dentzer, editor-in-chief, Health Affairs
Over 300 references to books, journal articles, Ph. D. dissertations, and proceedings published mostly during the 1970's, as well as unpublished reports and studies. Selection based on applicability to health planning, community mental health centers, cooperative health statistics system, nurse training grants, and the health program implementation process. Alphabetical arrangement by authors. Entry gives bibliographical information and lengthy annotation.