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The United States spends more than 17% of its gross domestic product (GDP) on health care, while other developed countries throughout the world average 8.7% of GDP on healthcare expenditures. By 2028, that percentage in the United States is projected to be 19.7% of GDP. Yet all this spending apparently doesn’t equate to value, quality, or performance. Among 11 high-income countries, the U.S. healthcare industry ranked last during the past seven years in four key performance categories: administrative efficiency, access to care, equity, and healthcare outcomes. This book centers on ways to bring down skyrocketing healthcare costs and improve comparatively low patient outcomes by focusing on the second-highest cost after staffing in U.S. healthcare: the supply chain. The authors present strategies for aligning the healthcare supply chain, leadership, physicians, and department budget owners to achieve evidence-based value analysis (EVA) and effective strategic sourcing. The key to bringing alignment to where it needs to be is understanding the art and science of EVA and strategic sourcing and reorienting the health systems toward productively and gainfully accomplishing them both. Within healthcare, the biggest opportunities for a quantum leap in affordability and quality directly tie to improving the product and service selection process through EVA and greatly advancing hospital and health system supply chain sourcing strategies. The book outlines what the authors call the Lacuna Triangle—three lacunas (or gaps) that occur in hospitals and health systems that prevent them from pursuing effective EVA and strategic sourcing. The authors explore the three effects of those gaps, which keep the Lacuna Triangle walls tightly closed so that the oligopolies, irrational markets, and irrational pricing that those gaps create can continue to thrive, and where many healthcare organizations remain trapped. The goal with this book is to pluck the supply chain and health system executive and clinical leadership out of the chaos and irrationality they are caught in and give them tactics and strategies for reengineering the alignment of these processes to serve their enterprises’ needs. The book does this by a deep exploration into strategic sourcing, a way of doing business that has been embraced and employed effectively for decades in supply chain management in various industries and in healthcare supply chain in other countries.
"Today Singapore ranks sixth in the world in healthcare outcomes well ahead of many developed countries, including the United States. The results are all the more significant as Singapore spends less on healthcare than any other high-income country, both as measured by fraction of the Gross Domestic Product spent on health and by costs per person. Singapore achieves these results at less than one-fourth the cost of healthcare in the United States and about half that of Western European countries. Government leaders, presidents and prime ministers, finance ministers and ministers of health, policymakers in congress and parliament, public health officials responsible for healthcare systems planning, finance and operations, as well as those working on healthcare issues in universities and think-tanks should know how this system works to achieve affordable excellence."--Publisher's website.
Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.
Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.
The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.
The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.
In an increasingly interconnected world, the landscape of international trade is evolving at an unprecedented pace. The complexities and nuances of global markets demand not only a deep understanding of traditional trade principles but also the agility to adapt to modern dynamics. "International Trade Dynamics: Advanced Strategies for Modern Markets" is crafted to bridge the gap between foundational trade theories and the advanced strategies necessary for navigating today’s volatile economic environment. This book aims to provide a comprehensive exploration of the multifaceted world of international trade. From the economic principles that underpin trade policies to the latest trends in global supply chain management, we delve into the critical factors shaping international commerce. Our goal is to equip readers with the knowledge and tools needed to formulate and implement effective trade strategies in a rapidly changing global market. We begin by revisiting the core concepts of international trade, setting the stage for a deeper dive into contemporary issues and advanced strategies. The chapters that follow cover a wide range of topics, including trade policy formulation, economic integration, digital trade, sustainability, and risk management. Each chapter is designed to offer a blend of theoretical insights and practical applications, supported by real-world case studies and empirical data. The emphasis on advanced strategies reflects the need for businesses and policymakers to think beyond traditional boundaries. In today’s markets, success hinges on the ability to leverage technological advancements, adapt to shifting geopolitical landscapes, and respond to the demands for sustainable and ethical trade practices. This book provides a roadmap for navigating these challenges, offering strategic guidance for stakeholders at all levels
Second Edition rewarded First Place AJN Award! The only policy text written specifically for APRN students, this preeminent resource delivers a sweeping examination of policy impact on the full implementation of the APRN role across all environments, including its effectiveness on specific patient populations. The expanded third edition—containing six new chapters—includes expanded information on policy analysis, nursing roles, and the impact of technology. It provides practical knowledge on developing policy to advocate for vulnerable populations—bolstered by case examples—and discusses how interprofessional education has changed and will continue to alter health policy in the United States and internationally. Additionally, the text discusses the evolving influence of the Patient Protection Affordable Care Act (PPACA) and the implications of current and future health policy changes as they affect APRN practice. New doctoral-level content adds to the book's relevance for DNP students. The text addresses the initiative within nursing for Full Practice Authority for all APRNs, which enables them to practice to the full extent of their educational preparation. Edited by experienced APRN leaders who have been closely involved with health policy development, the text meets the requirements of the IOM report on The Future of Nursing and the DNP criteria V for the inclusion of health policy and advocacy in the curriculum. This "call to action" for APRNs is specifically designed for courses serving a variety of APRN trajectories and includes content from all APRN role perspectives in every section. New to the Third Edition: Encompasses six completely new chapters covering Health Policy Effects on Health Systems, Telehealth, Pediatrics, Quality Initiatives, Patient Protection, and more! Expanded to include developing roles, environments, and populations pertinent to APRNs and DNP students Includes new information on policy development advocating for vulnerable populations Updated to reflect the latest national nursing policy initiatives Incorporates 2020 revised AACN Essentials and Future of Nursing Report 2030 Includes new case studies and more practical application of content Key Features: Chapters include Discussion Questions; Analysis, Synthesis, and Clinical Application; Exercises/Considerations; and Ethical Considerations Explains how and why APRNs can and should influence policy development Discusses implications of not participating in health policy decisions