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Preface | |
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List of Exhibits | |
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List of Figures | |
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List of Tables | |
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List of Abbreviations/Acronyms | |
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A Distinctive System of Health Care Delivery | |
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Introduction | |
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An Overview of the Scope and Size of the System | |
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A Broad Description of the System | |
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Basic Components of a Health Services Delivery System | |
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Uninsured Americans | |
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Transition from Traditional Insurance to Managed Care | |
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Primary Characteristics of the US Health Care System | |
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Trends and Directions | |
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Significance for Health Care Practitioners and Policymakers | |
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Significance for Health Care Managers | |
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Health Care Systems of Other Countries | |
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The Systems Framework | |
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Summary | |
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Test Your Understanding | |
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Review Questions | |
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System Foundations | |
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Beliefs, Values, and Health | |
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Introduction | |
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Significance for Managers and Policymakers | |
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Basic Concepts of Health | |
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Risk Factors and Disease | |
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Health Promotion and Disease Prevention | |
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Public Health | |
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Bioterrorism and Disaster Preparedness | |
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Determinants of Health | |
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Cultural Beliefs and Values | |
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Equitable Distribution of Health Care | |
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Justice in the US Health Delivery System | |
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Integration of Individual and Community Health | |
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Measures of Health Status | |
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Summary | |
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Test Your Understanding | |
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Review Questions | |
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The Evolution of Health Services in the United States | |
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Introduction | |
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Medical Services in Preindustrial America | |
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Medical Services in Postindustrial America | |
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Medical Care in the Corporate Era | |
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Has the Era of Socialized Medicine Arrived? | |
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Summary | |
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Test Your Understanding | |
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Review Questions | |
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System Resources | |
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Health Services Professionals | |
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Introduction | |
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Physicians | |
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Issues in Medical Practice, Training, and Supply | |
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International Medical Graduates | |
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Dentists | |
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Pharmacists | |
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Other Doctoral-Level Health Professionals | |
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Nurses | |
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Nonphysician Practitioners | |
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Allied Health Professionals | |
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Health Services Administrators | |
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Summary | |
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Test Your Understanding | |
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Review Questions | |
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Appendix 4-A List of Professional Associations | |
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Medical Technology | |
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Introduction | |
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What Is Medical Technology? | |
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Information Technology and Informatics | |
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Innovation, Diffusion, and Utilization of Medical Technology | |
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Managed Care and Technology Diffusion | |
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The Government's Role in Technology Diffusion | |
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The Impact of Medical Technology | |
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The Assessment of Medical Technology | |
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Current and Future Directions in Health Technology Assessment | |
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Summary | |
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Test Your Understanding | |
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Review Questions | |
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Health Services Financing | |
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Introduction | |
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The Role and Scope of Health Services Financing | |
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Financing and Cost Control | |
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The Insurance Function | |
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Private Financing | |
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Public Financing | |
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Miscellaneous Private and Public Programs | |
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The Payment Function | |
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National Health Care Expenditures | |
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Trends, Problems, and Issues in Insurance and Financing | |
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Summary | |
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Test Your Understanding | |
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Review Questions | |
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System Processes | |
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Outpatient and Primary Care Services | |
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Introduction | |
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What Is Outpatient Care? | |
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The Scope of Outpatient Services | |
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Primary Care | |
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Models of Patient-Centered Primary Care | |
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Primary Care Providers | |
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Growth in Outpatient Services | |
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Reasons for the Growth in Outpatient Services | |
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Types of Outpatient Care Settings and Methods of Delivery | |
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Complementary and Alternative Medicine | |
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Utilization of Outpatient Services | |
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Summary | |
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Test Your Understanding | |
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Review Questions | |
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Inpatient Facilities and Services | |
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Introduction | |
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Hospital Transformation in the United States | |
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The Expansion Phase: Late 1800s to Mid-1980s | |
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The Downsizing Phase: Mid-1980s Onward | |
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Some Key Utilization Measures and Operational Concepts | |
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Hospital Employment | |
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Types of Hospitals | |
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Expectations from Nonprofit Hospitals | |
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Some Management Concepts | |
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Licensure, Certification, and Accreditation | |
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The Magnet Recognition Program� | |
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Ethical and Legal Issues in Patient Care | |
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Summary | |
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Test Your Understanding | |
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Review Questions | |
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Managed Care and Integrated Organizations | |
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Introduction | |
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What Is Managed Care? | |
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Evolution of Managed Care | |
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Growth of Managed Care | |
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Efficiencies and Inefficiencies in Managed Care | |
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Cost Control Methods in Managed Care | |
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Types of Managed Care Organizations | |
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Trends in Managed Care | |
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Impact on Cost, Access, and Quality | |
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Managed Care Backlash, Regulation, and the Aftermath | |
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Consolidation, Expansion, Diversification, and Integration | |
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Integrated Delivery Systems | |
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Accountable Care Organizations | |
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Types of Integration | |
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Pros and Cons of Integration | |
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Summary | |
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Test Your Understanding | |
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Review Questions | |
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Long-Term Care | |
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Introduction | |
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The Nature of Long-Term Care | |
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Long-Term Care Services | |
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The Clients of Long-Term Care | |
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Level of Care Continuum | |
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Types of Community-Based Long-Term Care Services | |
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Institutional Long-Term Care Continuum | |
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Specialized Facilities | |
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Nursing Home Industry and Patient Demographics | |
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Summary | |
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Test Your Understanding | |
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Review Questions | |
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Health Services for Special Populations | |
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Introduction | |
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Framework to Study Vulnerable Populations | |
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Racial/Ethnic Minorities | |
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The Uninsured | |
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Children | |
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Women | |
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Rural Health | |
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The Homeless | |
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Mental Health | |
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The Chronically Ill and Disabled | |
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HI/AIDS | |
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Summary | |
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Test Your Understanding | |
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Review Questions | |
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System Outcomes | |
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Cost, Access, and Quality | |
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Introduction | |
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Cost of Health Care | |
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Reasons for Cost Escalation | |
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Cost Containment-Regulatory Approaches | |
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Cost Containment-Competitive Approaches | |
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Access to Care | |
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Quality of Care | |
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Dimensions of Quality | |
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Quality Assurance | |
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Quality Assessment | |
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Public Reporting of Quality | |
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Summary | |
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Test Your Understanding | |
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Review Questions | |
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Health Policy | |
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Introduction | |
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What Is Health Policy? | |
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Principal Features of US Health Policy | |
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The Development of Legislative Health Policy | |
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Policy Implementation | |
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Critical Policy Issues | |
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Summary | |
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Test Your Understanding | |
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Review Questions | |
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System Outlook | |
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The Future of Health Services Delivery | |
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Introduction | |
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Forces of Change | |
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Precedents of Health Reform | |
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The Future of Health Reform | |
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Delivery Infrastructure of the Future | |
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Future Workforce Challenges | |
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The Future of Long-Term Care | |
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Global Threats and International Cooperation | |
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New Frontiers in Clinical Technology | |
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Evidence-Based Health Care and Beyond | |
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Summary | |
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Test Your Understanding | |
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Review Questions | |
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Glossary | |
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Index | |