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Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.
In the World War I era, veterans fought for a unique right: access to government-sponsored health care. In the process, they built a pillar of American social policy. Burdens of War explores how the establishment of the veterans’ health system marked a reimagining of modern veterans’ benefits and signaled a pathbreaking validation of the power of professionalized institutional medical care. Adler reveals that a veterans’ health system came about incrementally, amid skepticism from legislators, doctors, and army officials concerned about the burden of long-term obligations, monetary or otherwise, to ex-service members. She shows how veterans’ welfare shifted from centering on pension and domicile care programs rooted in the nineteenth century to direct access to health services. She also traces the way that fluctuating ideals about hospitals and medical care influenced policy at the dusk of the Progressive Era; how race, class, and gender affected the health-related experiences of soldiers, veterans, and caregivers; and how interest groups capitalized on a tense political and social climate to bring about change. The book moves from the 1910s—when service members requested better treatment, Congress approved new facilities and increased funding, and elected officials expressed misgivings about who should have access to care—to the 1930s, when the economic crash prompted veterans to increasingly turn to hospitals for support while bureaucrats, politicians, and doctors attempted to rein in the system. By the eve of World War II, the roots of what would become the country’s largest integrated health care system were firmly planted and primed for growth. Drawing readers into a critical debate about the level of responsibility America bears for wounded service members, Burdens of War is a unique and moving case study. -- Jennifer D. Keene, Chapman University, author of Doughboys, the Great War, and the Remaking of America
Phillip Longman tells the amazing story of the turnaround of the Department of Veterans Affairs health-care system from a dysfunctional, scandal-prone bureaucracy into the benchmark for high-quality medicine in the United States. Best Care Anywhere shows that vast swaths of what we think we know about health, health care, and medical economics are just plain wrong. And the book demonstrates how this extraordinarily cost-effective model, which has proven to be highly popular with veterans, can be made available to everyone. New to this edition is an analysis of how the shortcomings of both so-called Obamacare and Republican plans to privatize Medicare reinforce the need for applying the lessons of the VA. Also included are completely updated statistics and research, as well as examples of how the private sector is already beginning to learn from the VA's example.
Nearly 1.9 million U.S. troops have been deployed to Afghanistan and Iraq since October 2001. Many service members and veterans face serious challenges in readjusting to normal life after returning home. This initial book presents findings on the most critical challenges, and lays out the blueprint for the second phase of the study to determine how best to meet the needs of returning troops and their families.
In The Battle for Veterans' Healthcare, award-winning author Suzanne Gordon takes us to the front lines of federal policymaking and healthcare delivery, as it affects eight million Americans whose military service makes them eligible for Veterans Health Administration (VHA) coverage. Gordon’s collected dispatches provide insight and information too often missing from mainstream media reporting on the VHA and from Capitol Hill debates about its future. Drawing on interviews with veterans and their families, VHA staff and administrators, health care policy experts and Congressional decision makers, Gordon describes a federal agency under siege that nevertheless accomplishes its difficult mission of serving men and women injured, in myriad ways, while on active duty. The Battle for Veterans’ Healthcare is an essential primer on VHA care and a call to action by veterans, their advocacy organizations, and political allies. Without lobbying efforts and broader public understanding of what’s at stake, a system now functioning far better than most private hospital systems may end up looking more like them, to the detriment of patients and providers alike.
U.S. military conflicts abroad have left nine million Americans dependent on the Veterans Health Administration (VHA) for medical care. Their "wounds of war" are treated by the largest hospital system in the country—one that has come under fire from critics in the White House, on Capitol Hill, and in the nation's media. In Wounds of War, Suzanne Gordon draws on five years of observational research to describe how the VHA does a better job than private sector institutions offering primary and geriatric care, mental health and home care services, and support for patients nearing the end of life. In the unusual culture of solidarity between patients and providers that the VHA has fostered, Gordon finds a working model for higher-quality health care and a much-needed alternative to the practice of for-profit medicine.
In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment.