Health Care USA: Understanding Its Organization and Delivery, 3rd ed. - book review

AORN Journal, May, 2003 by Laurie Saletnik

third ed By Harry A. Sultz and Kristina M. Young 2001, 461 pp $57 paperback

This book is written with the intent of presenting a comprehensive overview of the health care industry and the issues being confronted during this tumultuous time. It provides a historical perspective on health care that allows readers to gain a better understanding of where health care is today in relation to where it began. It also discusses the political and economic influences that have affected and continue to affect the health care industry. The content is not limited to a presentation of the strengths of the US health care system; it also points out the obvious weaknesses.

The book's intended audience is health care students and those in related professions, as well as current practitioners; however, it would be easy for a layperson to read. This third edition includes discussion of the effects of the Balanced Budget Act of 1997, managed care consolidation, and advances in technology and pharmaceuticals, among other topics.

The text is presented by taking a complex, trillion-dollar system and breaking it into parts, such as hospitals, ambulatory care facilities, long-term care facilities, and mental health services, which then are discussed in detailed overviews. There also are chapters that focus specifically on health care providers and the evolution of medical education. Chapters can be read individually to provide an overview of the designated subject matter, or they can be read sequentially to gain a more complete understanding of the total health care system. The expectation is that more detailed information on each subject can be obtained from books that deal specifically with that subject.

An extensive reference list is included after each chapter, as is a list of associated web sites. Both authors have extensive backgrounds in public health and preventive medicine, and their viewpoints are interjected throughout the text. This is not a distraction and often gives readers a different perspective.

The book ends with a chapter on the authors' predictions about the future of health care. A future that is not so bright for managed care organizations and in which the home care industry grows and demand for chronic care support increases are a few of their predictions. They recognize that the extraordinary progress of medical technology will transform medical practice in the future but warn of issues related to cost, training, and ethics.

I believe that this book achieved its goal of providing an overview of the US health care system. Although an easy read, it contains a wealth of information and takes time to complete. The health care system is changing dramatically and rapidly in this country, and this text provides information to help readers understand why these changes are happening and necessary. This is a must read for anyone in the health care profession who has not taken a recent course on health care organization. It will help readers, whether health care professionals or consumers, make knowledgeable decisions about selection of services. The book also aids in understanding the political influences that will determine the future of our health care system.

This book is available from Aspen Publishers, Inc, 200 Orchard Ridge Dr, Suite 200, Gaithersburg, MD 20878; http://www.aspenpublishers.com.

LAURIE SALETNIK
RN, BSN
ASSISTANT DIRECTOR OF NURSING
JOHNS HOPKINS HOSPITAL

BALTIMORE