With sixteen hospitals and almost 10,500 beds, the New York City Health and Hospitals Corporation(HHC) is the largest municipal hospital system in the United States. With forty-seven hospitals and almost thirty-three thousand beds, the Paris Hospital Corporation, Assistance Publique-Hopitaux de Paris(AP), is three times as large, the biggest municipal hospital system in France. This book compares these two vast systems. It analyzes staffing, outpatient and inpatient care, the desirability of private faculty practice plans, budgeting, quality assurance, and the role of medical education in these two very different systems. In addition, it reviews how both HHC and AP plan to adapt their systems over the next decade and beyond. Aging populations, the development and diffusion of new medical technologies, and the growth of hospitals and physicians throughout the 1960s and 1970s have led to massive increases in health care costs in both the United States and in France. Both New York City and Paris have suffered the shock of the AIDS epidemic. Detailed, informed, and authoritative, this book will stand for years as the standard comparative study of two large municipal hospital systems.

No One Was Turned Away is a book about the importance of public hospitals to New York City. At a time when less and less value seems to be placed on public institutions, argues author Sandra Opdycke, it is both useful and prudent to consider what this particular set of public institutions has meant to this particular city over the last hundred years, and to ponder what its loss might mean as well. Opdycke suggests that if these public hospitals close or convert to private management--as is currently being discussed--then a vital element of the civic life of New York City will be irretrievably lost. The story is told primarily through the history of Bellevue Hospital, the largest public hospital in the city and the oldest in the nation. Following Bellevue through the twentieth century, Opdycke meticulously charts the fluctuating fortunes of the city's public hospital system. Readers will learn how medical technology, urban politics, changing immigration patterns, economic booms and busts, labor unions, health insurance, Medicaid, and managed care have interacted to shape both the social and professional environments of New York's public hospitals. Having entered the twentieth century with high hopes for a grand expansion, Bellevue now faces financial and political pressures so acute that its very future is in doubt. In order to give context to the Bellevue experience, Opdycke also tracks the history of a private facility over the same century: New York Hospital. By noting the points at which the paths of these two mighty institutions have overlapped--as well as the ways in which they have diverged--this book clearly and persuasively highlights the significance of public hospitals to the city. No One Was Turned Away shows that private facilities like New York Hospital have generally provided superb care for their patients, but that in every era they have also excluded certain groups. This exclusion has occurred for various reasons, such as patients' diagnoses, their social characteristics, behavior, or financial status--or simply because of a lack of unoccupied beds. Fortunately, however, year in and year out, Bellevue and its fellow public facilities have acted as the city's medical safety net. Opdycke's book maintains that public hospitals will be as essential in the future as they have been in the past. This is a thoughtful and well-written study that will appeal to anyone interested in the history of medicine, public policy, urban affairs, or the City of New York.

New York. London. Paris. Although these cities have similar sociodemographic characteristics, including income inequalities and ethnic diversity, they have vastly different health systems and services. This book compares the three and considers lessons that can be applied to current and future debates about urban health care. Highlighting the importance of a national policy for city health systems, the authors use well-established indicators and comparable data sources to shed light on urban health policy and practice. Their detailed comparison of the three city health systems and the national policy regimes in which they function provides information about access to health care in the developed world’s largest cities. The authors first review the current literature on comparative analysis of health systems and offer a brief overview of the public health infrastructure in each city. Later chapters illustrate how timely and appropriate disease prevention, primary care, and specialty health care services can help cities control such problems as premature mortality and heart disease. In providing empirical comparisons of access to care in these three health systems, the authors refute inaccurate claims about health care outside of the United States.

First multi-year cumulation covers six years: 1965-70.

How do we understand and also assess the health care of America? Where is health care provided? What are the characteristics of those institutions which provide it? Over the short term, how are changes in health care provisions affecting the health of the population, the cost of care, and access to care?. Health Care Delivery in the United States, now in a thoroughly updated and revised 9th edition, discusses these and other core issues in the field. Under the editorship of Dr. Kovner and with the addition of Dr. James Knickman, Senior VP of Evaluation, Robert Wood Johnson Foundation, leading thinkers and practitioners in the field examine how medical knowledge creates new healthcare services. Emerging and recurrent issues from wide perspectives of health policy and public health are also discussed. With an easy to understand format and a focus on the major core challenges of the delivery of health care, this is the textbook of choice for course work in health care, the reference for administrators and policy makers, and the standard for in-service training programs.;chapter

In By the Bedside of the Patient, Nortin Hadler places current efforts to reform medical education--from the undergraduate level through residency programs and on to continuing medical education--in historical context. In doing so, he traces the evolution of medical school curricula, residency and fellowship programs, and the clinical practices they promoted. Hadler examines crucial junctures in history to locate the seeds for reform. Some believe that medical education and training should highlight literature, ethics, and culture, while others emphasize science and efficiency to abbreviate the time from entry to licensure. Neither of these approaches, Hadler argues, maintains or improves patient care, which should be at the core of medical education and practice. Hadler contends that most reform attempted thus far constitutes, at best, little more than a reshuffling of the basic curriculum and, at worst, an augmenting of medicine's predilection to measure, grade, and record. Examining generational changes in medical education, Hadler mines sixty years of training and practice to identify mistaken approaches and best practices. Ultimately, in the contemporary era of managed care, Hadler argues for a clinical practice that draws on the best available scientific knowledge, transmits the wisdom of experienced clinicians, reforges an empathetic relationship between physician and patient, and treats each patient as an individual--all centered on restoring the mandate to care.

What are public health services? Countries across Europe understand what they are or what they should include differently. This study describes the experiences of nine countries detailing the ways they have opted to organize and finance public health services and train and employ their public health workforce. It covers England France Germany Italy the Netherlands Slovenia Sweden Poland and the Republic of Moldova and aims to give insights into current practice that will support decision-makers in their efforts to strengthen public health capacities and services. Each country chapter captures the historical background of public health services and the context in which they operate; sets out the main organizational structures; assesses the sources of public health financing and how it is allocated; explains the training and employment of the public health workforce; and analyses existing frameworks for quality and performance assessment. The study reveals a wide range of experience and variation across Europe and clearly illustrates two fundamentally different approaches to public health services: integration with curative health services (as in Slovenia or Sweden) or organization and provision through a separate parallel structure (Republic of Moldova). The case studies explore the context that explain this divergence and its implications. This study is the result of close collaboration between the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe Division of Health Systems and Public Health. It accompanies two other Observatory publications Organization and financing of public health services in Europe and The role of public health organizations in addressing public health problems in Europe: the case of obesity alcohol and antimicrobial resistance (both forthcoming).