Managing Health Care Demand.

Managing Health Care Demand MacStravic S, Montrose G. Gaithersburg, MD 20878, Aspen Publishers Inc, 1998, hardcover, 556 pp, $65.

The primary objective of this book is to present a detailed approach to the management of consumer health care needs that is based on the economic principle of "demand management." The authors have based this book on the premise that health care consumers and physicians and health care professionals have become frustrated with the inability of the current health care system to respond appropriately to their needs despite the introduction of managed care.

For health care purposes, demand management is defined as anticipating what the individual consumer needs to know in order to make decisions to achieve optimal health. The basic premise of this approach is that the consumer can act as the primary decision maker for personal or family health and is capable of making the correct decision and taking the right action if provided with adequate information, advice, and support. The authors envision the potential for an industry-wide transformation, and they arranged their chapters in a way that will allow an organization to address needed changes in a structured manner. The structured change includes a focus on improving health care quality and demand by exerting a positive influence on consumer behavior.

The book consists of 25 chapters that have been broken into 5 sections covering well-defined topics. Part I introduces demand improvement concepts and includes definitions of the key concepts used in the remainder of the text. Part II presents the fundamentals for conceptual development and the preparation of strategic and program planning. Part III provides information on specific demand tactics that are available to an organization. Part IV addresses planning initiatives and community-based initiatives and includes recommendations for evaluating results. Part V includes initiatives such as health and decision improvement and disease and disability management. The text is well indexed and includes references from a number of recent publications.

The primary market for this text would not be the clinic-based therapist, but people in health care management positions or in the field of education. For those in management, the text will provide useful information on the many avenues that may be pursued as an organization goes through the process of change. For educational purposes, the text may be beneficial to students in graduate business administration or health care administration programs. Before reading this text, however, the reader should have a basic understanding of supply-and-demand economics as well as a familiarity with marketing and strategic planning.

Mark A Brimer, PhD, PT Holmes Regional Medical Center Melbourne, Fla.

Dr Brimer works in the Department of Rehabilitative Services. His research interests include health care management and administration.