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"No one is rich enough to do without a neighbor." Traditional Danish Proverb This bit of Danish folk wisdom expresses an idea underlying much of the current thinking about social support. While the clinical literature has for a long time recognized the deleterious effects of unwholesome social relationships, only more recently has the focus broadened to include the positive side of social interaction, those interpersonal ties that are desired, rewarding, and protective. This book contains theoretical and research contributions by a group of scholars who are charting this side of the social spectrum. Evidence is increasing that maladaptive ways of thinking and behaving occur disproportionately among people with few social supports. Rather than sapping self-reliance, strong ties with others particularly family members seem to encourage it. Reliance on others and self-reliance are not only compatible but complementary to one another. While the mechanism by which an intimate relationship is protective has yet to be worked out, the following factors seem to be involved: intimacy, social integration through shared concerns, reassurance of worth, the opportunity to be nurtured by others, a sense of reliable alliance, and guidance. The major advance that is taking place in the literature on social support is that reliance is being -placed less on anecdotal and clinical evidence and more on empirical inquiry. The chapters of this book reflect this important development and identify the frontiers that are currently being explored.
America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.
How does caregiving affect health and well-being and what resources help caregivers? This book provides a synthesis of psychological research on caregiver stress and brings attention to the personal, social and structural factors that affect caregivers' well-being and as well as recent behavioral interventions to enhance health.
Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.
Sleeplessness, depression, anxiety... these are common symptoms of the burnout that often accompanies living with a loved one who has experienced some kind of traumatic stress. It's well known that the loss of a child, a life-threatening injury, sexual assault or combat experience can affect the victim in traumatic ways, but what's often overlooked is how this trauma affects those closest to the victim - the family. Burnout in Families focuses on the emotional vulnerability of families exposed to the chronic or acute stress of one of its members. Editor Charles R. Figley brings together seven psychologists from around the United States to take a closer look at what's now known as secondary traumatic stress disorder - the burnout that occurs when family members care for or just live with other family members who have undergone a traumatic life event. The authors provide a comprehensive review of the available literature and offer solutions for treating and preventing family burnout and the marital and family discord that inevitably follows. Burnout in Families is an ideal text for university-level psychology, family therapy and social work courses.
First published in 1985, this book considers the financial consequences of parents and other relatives caring for severely disabled children at home. At the time of publication little reliable information was available on the costs incurred by ‘informal carers’, which this book set to rectify. The volume interweaves hard statistical material about money with the detailed personal responses of parents. It examines the claim that disablement in a child reduces parents’ earnings while simultaneously creating an extra expense. The author compares the incomes and expenditure patterns of more than 500 families with disabled children and 700 control families of the time showing that the financial effects of disablement in a child can be far-reaching and pervasive. This book discusses contemporary policy implications of these findings in a chapter dealing with the rational for compensating families with disabled children, and in the final chapter. Although the book was original published in 1985, it references issues that are still important today and, whilst its main concern is families with disabled children, it will also be useful to anyone caring for other kinds of dependent people, such as the elderly.
Cracking Health Costs reveals the best ways for companies and small businesses to fight back, right now, against rising health care costs. This book proposes multiple, practical steps that you can take to control costs and increase the effectiveness of the health benefit. The book is all about rolling back health care costs to save companies and employees money. Working hand-in-hand with their employees, businesses need to ensure that, whenever feasible, employees with the most expensive diagnoses get optimal treatment at hospitals not practicing “volume-driven” medicine for higher profits. Less than 10% of employees incur 80% of costs. About 20% of patients have been completely misdiagnosed, while many others are simply the victims of surgeons who are either practicing bad medicine or overtreating for profit. For example, some companies, such as Walmart and Lowe’s, are turning to the “Centers of Excellence” approach author Tom Emerick helped to pioneer while running benefits for Walmart. By determining which hospitals are adopting the highest standards of care, benefits managers can reduce the number of unnecessary high-cost surgeries and improve employees’ overall health. The solution-based approach offered by the book is unique, because it can be implemented by businesses today.
New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.
Utilization management (UM) has become a strong trend in health care cost containment. Under UM, some decisions are not strictly made by the doctor and patient alone. Instead, they are now checked by a reviewer reporting to an employer or other paying party who asks whether or not the proposed type or location of care is medically necessary or appropriate. This book presents current findings about how UM is faring in practice and how it compares with other cost containment approaches, with recommendations for improving UM program administration and clinical protocols and for conducting further research.
"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.