"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.

Managed care has produced dramatic changes in the treatment of mental health and substance abuse problems, known as behavioral health. Managing Managed Care offers an urgently needed assessment of managed care for behavioral health and a framework for purchasing, delivering, and ensuring the quality of behavioral health care. It presents the first objective analysis of the powerful multimillion-dollar accreditation industry and the key accrediting organizations. Managing Managed Care draws evidence-based conclusions about the effectiveness of behavioral health treatments and makes recommendations that address consumer protections, quality improvements, structure and financing, roles of public and private participants, inclusion of special populations, and ethical issues. The volume discusses trends in managed behavioral health care, highlighting the emerging role of the purchaser. The committee explores problems of overlap and fragmentation in the delivery of behavioral health care and discusses the issue of access, a special concern when private systems are restricted and public systems overburdened. Highly applicable to the larger health care system, this volume will be of particular interest to all stakeholders in behavioral healthâ€"federal and state policymakers, public and private purchasers, health care providers and administrators, consumers and consumer advocates, accrediting organizations, and health services researchers.

This imaginative book is a fictionalized account of clinician Dr. Evelyn Bloom and businessman Adam Wilder who attempt to run a start-up managed behavioral healthcare company in a highly ethical manner. Each example in the book offers an understanding of the complex legal and ethical challenges that are inherent in the managed behavioral health care environment.

The ethical aspects of the operation of healthcare organizations (HCOs) are central to the delivery of health care. Organization Ethics in Health Care begins by assessing the shortcomings of clinical ethics, business ethics, and professional ethics as a basis for solving problems that have emerged in healthcare delivery systems since the advent of managed care. The text focuses on the meaning of the developent of the HCO in our society and what its present status is. The authors point out that moral parameters endorsed by society have guided previous shifts in the relationships among important HCO stakeholders, but that these parameters have been unclear or missing altogether during the past tumultous decade. Finally, they describe the key elements for the successful implementation of a fully functioning healthcare organization ethics program and what it can mean to the institution, its associated clinicians and employees, its patients, and its community. Moving from theory to practical application, this book will serve as an excellent student text, a professional guide, and a reference work.

Marc A. Rodwin draws on his own experience as a health lawyer--and his research in health ethics, law, and policy--to reveal how financial conflicts of interest can and do negatively affect the quality of patient care. He shows that the problem has become worse over the last century and provides many actual examples of how doctors' decisions are influenced by financial considerations. We learn how two California physicians, for example, resumed referrals to Pasadena General Hospital only after the hospital started paying $70 per patient (their referrals grew from 14 in one month to 82 in the next). As Rodwin writes, incentives such as this can inhibit a doctor from taking action when a hospital fails to provide proper service, and may also lead to the unnecessary hospitalization of patients. We also learn of a Wyeth-Ayerst Labs promotion in which physicians who started patients on INDERAL (a drug for high blood pressure, angina, and migraines) received 1000 mileage points on American Airlines for each patient (studies show that promotions such as this have a direct effect on a doctor's choice of drug). Rodwin reveals why the medical community has failed to regulate conflicts of interest: peer review has little authority, state licensing boards are usually ignorant of abuses, and the AMA code of ethics has historically been recommended rather than required. He examines what can be learned from the way society has coped with the conflicts of interest of other professionals --lawyers, government officials, and businessmen--all of which are held to higher standards of accountability than doctors. And he recommends that efforts be made to prohibit and regulate certain kinds of activity (such as kickbacks and self-referrals), to monitor and regulate conduct, and to provide penalties for improper conduct. Our failure to face physicians' conflicts of interest has distorted the way medicine is practiced, compromised the loyalty of doctors to patients, and harmed society, the integrity of the medical profession, and patients. For those concerned with the quality of health care or medical ethics, Medicine, Money and Morals is a provocative look into the current health care crisis and a powerful prescription for change.

Ethics in Health Services Management provides a decision-making framework that clarifies ethical issues and points the way toward the best course of action for organizations as well as individual healthcare leadersan indispensable resource for healthcare executives as well as those preparing to enter the field. With more material than in any previous edition, the fifth edition of Ethics in Health Services Management addresses such critical contemporary issues as patient autonomy, end-of-life decisions, consent for treatment, appropriate resource allocation, whistle blowing, and confidentiality. An added focus on public health issues expands this new edition's already far-reaching scope. More than 80 incisive case studies and vignettes from a full range of care delivery settings demonstrate how to use various ethical constructs to analyze situations and subsequently make more organized, defensible decisions. Offering a framework for identifying and solving ethical dilemmas, this acclaimed text reveals how to understand and apply ethical principles; approach ethical paradoxes with sound problem-solving methodology; formulate personal and professional codes of ethics; identify, link, and integrate values, vision, and mission statements; develop and use institutional review boards and ethics committees; resolve conflicts of interest and avoid self-dealing; and maximize community benefit while protecting and enhancing organization assets.

Reference for clinicians and healthcare information management professionals, addressing the multifaceted ethical challenges of working with sensitive health information in an ethical way. Features Web site addresses for additional resources, real-life scenarios, and a consistent structure that reinforces the material.

This comprehensive and much-needed resource helps health care ethicists to meet the demand of challenges such as managed care, medical technology, and patient activism. Through a review of core principles and a rich selection of cases, practitioners and students will learn to apply ethics in the day-to-day administration of health care organizations. The authors are from the Park Ridge Center, the nationally acclaimed consulting and research firm.

This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.