Health Care USA: Understanding Its Organization and Delivery

American Journal of Pharmaceutical Education, Fall 2001 by Amonkar, Mayur M

HARRY A. SULTZ AND KRISTINA M. YOUNG. Health Care USA: Understanding Its Organization and Delivery. Third Edition. Gaithersburg AM: Aspen Publishers, Inc, 2001. xviii 461 pp., 45 figs., 17 tbls., $52.00.

The objective of the third edition of the book, Health Care USA: Understanding Its Organization and Delivery, as stated by the authors, is to "provide an introduction to the U.S. health care system and an overview of the professional, political, social, and economic forces that have shaped it and will continue to do so." This book has accomplished this objective beautifully.

This paperback edition contains 13 chapters. Chapter 1 does an excellent job of setting up the content of subsequent chapters and the need for understanding the complexities and dynamic nature of the US health care system. Chapter 2 provides readers with a snapshot of the evolution of health care in the U.S. from a simple to a complex system, as a result of various legislative, political, economic, organizational and professional influences.

The next nine chapters covers topics such as hospitals and their origin, organization and performance, ambulatory care, medical education, health care personnel, financing health care, managed care, long-term care, mental health, and public health. Chapter 12 on "Research: How Health Care Advances" is an appropriate chapter in a book of this nature, which I have seen lacking in several introductor ry books on health care delivery in the U.S. Given the importance and capability that scientific research has in demonstrating the successes and failures of basic science, clinical and technological advances, this chapter does an excellent job of introducing novice researchers to the various types of research and the challenges associated with conducting such research. The book concludes with a chapter on the future of health care, which summarizes how the health care system has evolved, identifies major challenges affecting the system, and makes predictions for the future. At the beginning of each chapter, a brief description of the contents of that chapter is helpful. An appendix containing a listing of web site addresses of important health care organizations is useful for readers who may want to seek in-depth information about a particular organization or topic.

Overall, I liked the book and believe the authors achieve their goal of bringing together a diverse array of issues and provide a good starting point for someone who needs to achieve an understanding of the organization, complexities and dynamic nature of the U.S. health care system. An advantage of this book lies in the breadth of material that is presented. It is easy to read and presents the various topics in a well-structured manner. This book can serve as a valuable resource for an introductory course in health care systems. The only limitation that I see of this book is the lack of a strong emphasis on the pharmacy perspective, which is acknowledged by the authors. They justify this by indicating that such information would probably be included in the curricula of the various health professions. Pharmacy students will be unable to get an appreciation of topics such as the history and growth of the profession, the impact of managed care on pharmacy, an overview of the pharmaceutical industry, evolution of pharmaceutical care etc. For obtaining information about the pharmacy perspective, Robert L. McCarthy and Kenneth W. Schafermeyer's Introduction to Health Care Delivery: A Primer for Pharmacists (An Aspen Publication, 2001, 599 pp.) may be more useful.

Mayor M. Amonkar

West Virginia University