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Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge base--as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systems--important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.
Health care -- rather than sick care -- requires preventive and primary services. With more than half of New York City communities facing significant shortages of primary care physicians who serve low-income New Yorkers, those New Yorkers disproportionately rely on emergency room services for health care. Furthermore, 32% of the primary care physicians who serve low-income New Yorkers base their practices in hospitals. Faced with the hospital closures proposed in the Berger Commission report, many New Yorkers ... will lose a major source of primary care and will face increased barriers to accessing health care. Populations served by health centers show lower rates of costly health conditions and lower rates of preventable hospitalizations when compared to those who do not live within close proximity to a health center. Uninsured people living close to a community health center are less likely to postpone or delay seeking needed care, and less likely to have visited an emergency room, compared to other uninsured persons. The City's role should be to expand the primary health care infrastructure for our residents to access preventive medicine. Currently, about 62% of New York City zip codes have an inadequate number of primary care physicians. A ratio that represents adequate access is fewer than 2000 Medicaid enrollees per 1 full time equivalent (FTE) primary care physician, but more than 40% of New York City zip codes have more than 3000 Medicaid enrollees per 1 FTE.
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.
Praise for HANDBOOK of HEALTH SOCIAL WORK SECOND EDITION "Handbook of Health Social Work, Second Edition is a crucial addition for seasoned practitioners' libraries, as well as an essential foundation for fledgling social workers ready to enter health as a practice and research area." –From the Foreword by Suzanne Heurtin-Roberts, U.S. Department of Health and Human Services "The book's strengths include the high quality of writing and the expertise of its contributors. It covers the field of health social work in significant depth and is sure to leave readers well informed." –Mary Sormanti, PhD, MSW, Associate Professor of Professional Practice, Columbia University School of Social Work "Quite simply, this is the definitive volume for health and social work. In this second edition, Gehlert and Browne and their expert contributors have confidently managed to keep pace with current theory and empirical research across a wide range of subject matter that will be of interest to practitioners, educators, and researchers." –Michael Vaughn, PhD, Assistant Professor, School of Social Work, School of Public Health, and Department of Public Policy Studies, Saint Louis University Thoroughly revised and updated, the only comprehensive handbook of its kind covering the diverse field of health social work Now in its Second Edition, Handbook of Health Social Work provides a comprehensive and evidence-based overview of contemporary social work practice in health care. Written from a wellness perspective, the chapters cover practice and research areas ranging from chronic disorders to infectious disease, from physical to mental disorders, and all areas in between. An excellent resource preparing social workers for the present and future challenges of practice in the field of health care, the Handbook of Health Social Work, Second Edition features discussion on: New trends in social work and health care, including genetics, transdisciplinary care, as well as national and state changes in policy Health social work and children The wide array of roles performed by social workers in health-care settings Ethical issues and decision making in a variety of arenas Understanding of community factors in health social work Edited by two respected leaders in the field of health social work, this second edition includes contributions from a diverse team of notable experts, researchers, and scholars addressing multiple theoretical foundations, models, issues, and dilemmas for the social worker in health care. The resulting resource offers both a foundation for social work practice in health care and a guide for strategy, policy, and program development in proactive and actionable terms.