Jones and Bartlett Publishers. NOT FOR SALE OR DISTRIBUTION. Preface

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1 Preface Before embarking on the Fourth Edition, we surveyed instructors who use this book in courses at pharmacy schools throughout the country and incorporated their suggestions to make this text more useful for pharmacy students and their instructors. Based on the suggestions received, we have made several significant changes to the fourth edition including: 1. The revised edition has been shortened by consolidating some chapters and deleting others (a chapter on ethics and a chapter on public health). Deleting these chapters was not an easy decision, but necessary to keep the book a reasonable length. These two chapters were chosen partly because there are textbooks available on both of these topics, including a new book from Jones and Bartlett, Introduction to Public Health for Pharmacists by Levin, Hurd, and Hanson. We recommend these books for students and instructors who want to cover these topics in-depth. For those instructors who are looking for single chapters on public health or health care ethics, the chapters on these topics from the Third Edition are available on the book s Web site at These chapters may be reproduced for students who are using this textbook. 2. A comprehensive new glossary. 3. We also reorganized the chapters to more closely reflect how instructors are using the book in their courses. The chapters are still grouped into three parts: Part 1, The Social Aspects of Health Care Delivery (Chapters 1 5), Part 2, Organizational Aspects of Health Care Delivery (Chapters 6 11), and Part 3, The Economic Aspects of Health Care Delivery (Chapters 12 20). OVERVIEW OF CHAPTERS: Chapter 1 Health Care Delivery in America: Historical and Policy Perspectives includes new information about factors that make our health care system unique. Additional material discusses why the U.S. health care system can simultaneously be praised by some as superior, yet criticized by others as too costly, ineffective, of insufficient quality, and inaccessible to many of our citizens. xxi

2 xxii PREFACE Chapter 2 Health Care Professionals and Interdisciplinary Care, includes updated data on the various health care professions, as well as a brief description of the concept of pay for performance. Chapter 3 The Pharmacist and the Pharmacy Profession, provides new information about the Medicare Modernization Act of 2003 and supplements new material regarding Web-based pharmacy and e-technology as it relates to health and pharmacy care. Chapter 4 The Patient, includes updated information on patients, their environment, their expectations, and their access to health care information. Chapter 5 Drug Use, Access, the Pharmaceutical Industry, and Supply Chain in the United States, has been significantly revised, reflected by the new chapter title. In addition to updated data, the chapter includes new information about drug distribution, both licit and illicit. Chapter 6 Hospitals, contains up-to-date data on the state of American hospitals, as well as the continued impact of technology on hospital pharmacy practice. Chapter 7 Ambulatory Care, provides updated data on ambulatory care practice, including information about collaborations between schools and colleges of pharmacy, as well as community health centers and the establishment of mini-clinics in community pharmacies. Chapter 8 Long-Term Care, includes the latest information about the growing delivery segment of extended care, including the impact of Medicare Part D and the growing interest in LTC insurance. Chapter 9 Mental Health Services Delivery, contains an update of legislative and regulatory action related to mental health and trends in diagnosis and treatment. Chapter 10 Home Care, provides the latest information about available services, financing, and delivery options related to health services in the home. Chapter 11 Informatics in Health Care, reviews current technology trends that facilitate and enhance the delivery of contemporary health care services. Chapter 12 Basic Economic Principles Affecting Health Care, provides background on important economic concepts that are vital to understanding our health care system.

3 Preface xxiii Chapter 13 Unique Aspects of Health Economics, describes the challenges associated with allocating health care services and controlling costs. Chapter 14 Private Health Insurance, covers the basic principals of health insurance and provides new information on the uninsured and much more detail about insurance programs reimbursement for prescription drugs. Chapter 15 Government Involvement in Health Care, updates information explaining the influence that federal, state, and local governments have with regard to the financing, delivery, and regulation of health care services. Chapter 16 Managed Health Care, provides updated information of managed health care in general and prescription drugs in particular. Chapter 17 Medicare and Medicaid, is an updated consolidation of two separate chapters from the Third Edition and includes a new section on Medicare Part D. Chapter 18 Pharmacoeconomics, contains updated information about the rationale and methods for determining the cost-effectiveness, cost benefit, and cost utility of health care services and provides more details about pharmacoeconomic modeling. The chapter also demonstrates how this information is used in health care decision making. Chapter 19 International Health Care Services, has been extensively revised once again with updated information and a new emphasis on illustrating lessons from other health systems that could be applied to the U.S. health care system. Chapter 20 Health Care Reform, describes the changes that have occurred in the delivery, financing, and regulation of health care since publication of the third edition, including medical savings accounts, health savings accounts, and various state initiatives to increase patients access to health care. With changes in health care occurring at an ever increasing pace, a health care systems textbook must be revised frequently. Since the First Edition, we have tried to ensure that this book has the latest and most accurate information possible and are pleased that our publisher shares this goal. We are also appreciative of the feedback we receive from users. Your comments and our aggressive revision schedule helps to ensure the utility of this book for both you and

4 xxiv PREFACE your students. Please continue to offer your comments and suggestions as we continue to meet our goal of offering a book that provides a comprehensive overview of the American health care delivery system from a pharmacist s unique perspective. Robert L. McCarthy Storrs, Connecticut Kenneth W. Schafermeyer St. Louis, Missouri

5 Acknowledgments It is hard for us to believe that this is the Fourth Edition of our book. A text does not reach a Fourth Edition without the commitment and dedication of many people. Beyond our students who have inspired us for a combined nearly fifty years and to whom this edition is dedicated we are most grateful to our contributors, many of whom have been with us from the start. Their commitment to quality is largely responsible for any success this book has enjoyed. They are indeed special colleagues and friends. We are equally grateful to the many instructors who have adopted our book and provided us with thoughtful and important feedback. Their suggestions have enhanced its value as we developed this fourth iteration. We have also enjoyed strong support from the staff at Jones & Bartlett, especially David Cella, Lisa Gordon, and Jamie Chase. We are deeply grateful for their advice, encouragement, and, most of all, patience. Robert L. McCarthy Kenneth W. Schafermeyer xxv

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