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.

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.

How is health care understood and assessed in America? 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? This eighth edition discusses these and other core issues in the field.

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.