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Jonas and Kovner's Health Care Delivery in the United States.

Jonas and Kovner's Health Care Delivery in the United States edited by Anthony R. Kovner, PhD, and James R. Knickman, PhD; New York: Springer Publishing, 2005; 753 pages, $74.95 hardcover, $48.95 softcover

Health care delivery in the United States is a complex enterprise built on business processes and dependent on rapidly changing medical science, coexisting professional and hierarchical organizational structures, and complex--and often unresolved--ethical and social issues. Government regulation of public sector reimbursement for health care, concerns for cost of care and profit margins by health care administrators, responsibility for ensuring care quality and access, and the development, acquisition, and management of scarce resources are all issues in building and supporting systems of care.

Jonas and Kovner's Health Care Delivery in the United States addresses this dynamic field by carefully exploring the health care sector of our economy, the settings in which health care is provided, measurements of system performance, and strategic planning and forecasting. Readers are led through a detailed examination of what makes the US health care delivery system what it is and how its successes and failures compare to those of other developed countries. With contributions from well-known experts in their fields, the editors identify key challenges of health care delivery while offering resource information important to the design and management of future systems.

The book details contextual issues that are often overlooked in similar discussions: health-related behaviors and preventive health measures centered in public health. It also explains the realities of health care resources such as research and regulations that impact the availability of medical interventions, including new pharmaceuticals, medical devices, and biological approaches such as those offered through genomics. The critical need for well-prepared health care workers and the growing disparity in the labor force relative to an increasingly diverse population are also explored.

Content on increasingly sophisticated information management systems and their impact on clinical quality, service, and cost offers a glimpse into the future, raising questions regarding how technology can be used to support health care quality and the evaluation of care. A discussion of the methods by which population-based health status is measured and the need for care is identified is very useful. Readers are confronted with the dilemma of how to provide access to care while containing costs, maintaining quality, and ensuring that systems are able to provide for the continued development of advanced treatment interventions and options.

What first seemed daunting both in the book's volume and expected complexity turns out to be an intelligent, realistic, thoughtful, and thought-provoking approach to the subject of health care delivery. Extensive reference lists, a guide to sources for data, and a valuable list of websites supplement the content. Current, easy to understand, and informative, this book provides clear learning objectives, topical outlines, discussion questions, and a case study for each chapter, making it a good resource for both professionals in the field and for students. Content is supported by well-developed, illustrative charts, tables, and graphs, features that faculty will find useful in directing and engaging students. An instructor's manual can be obtained from the publisher.

reviewed by Mary Etta Mills, ScD, RN, CNAA, FAAN, associate dean for academic affairs and professor, University of Maryland, Baltimore, School of Nursing
COPYRIGHT 2006 National League for Nursing, Inc.
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2006 Gale, Cengage Learning. All rights reserved.

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Author:Mills, Mary Etta
Publication:Nursing Education Perspectives
Date:Sep 1, 2006
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