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Cancer Care for the Whole Patient
Cancer care today often provides state-of-the-science biomedical treatment, but fails to address the psychological and social (psychosocial) problems associated with the illness. This failure can compromise the effectiveness of health care and thereby adversely affect the health of cancer patients. Psychological and social problems created or exacerbated by cancer-including depression and other emotional problems; lack of information or skills needed to manage the illness; lack of transportation or other resources; and disruptions in work, school, and family life-cause additional suffering, weaken adherence to prescribed treatments, and threaten patients' return to health.
Today, it is not possible to deliver high-quality cancer care without using existing approaches, tools, and resources to address patients' psychosocial health needs. All patients with cancer and their families should expect and receive cancer care that ensures the provision of appropriate psychosocial health services.
Cancer Care for the Whole Patient recommends actions that oncology providers, health policy makers, educators, health insurers, health planners, researchers and research sponsors, and consumer advocates should undertake to ensure that this standard is met.
eBook
Returning Home from Iraq and Afghanistan
Nearly 1.9 million U.S. troops have been deployed to Afghanistan and Iraq since October 2001. Many service members and veterans face serious challenges in readjusting to normal life after returning home. This initial book presents findings on the most critical challenges, and lays out the blueprint for the second phase of the study to determine how best to meet the needs of returning troops and their families.
eBook
Guidance for the National Healthcare Disparities Report
The Agency for Healthcare Research Quality commissioned the Institute of Medicine establish a committee to provide guidance on the National Healthcare Disparities Report is of access to health care, utilization of services, and the services received. The committee was asked to con population characteristics as race and ethnicity, society status, and geographic location. It was also asked to examine factors that included possible data sources and types of measures for the report.
eBook
Health Care System Transformation and Integration: A Call to Action for Public Health
Restructured health care reimbursement systems and new requirements for nonprofit hospitals are transforming the U.S. health system, creating opportunities for enhanced integration of public health and health care goals. This article explores the role of public health practitioners and lawyers in this moment of transformation. We argue that the population perspective and structural strategies that characterize public health can add value to the health care system but could get lost in translation as changes to tax requirements and payment systems are rapidly implemented. We urge public health leaders to take a more active role in hospital assessments of community health needs and evaluation of the patient outcomes for which providers are accountable.
Journal Article
Supporting a Movement for Health and Health Equity
Supporting a Movement for Health and Health Equity is the summary of a workshop convened in December 2013 by the Institute of Medicine Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities and the Roundtable on Population Health Improvement to explore the lessons that may be gleaned from social movements, both those that are health-related and those that are not primarily focused on health. Participants and presenters focused on elements identified from the history and sociology of social change movements and how such elements can be applied to present-day efforts nationally and across communities to improve the chances for long, healthy lives for all.
The idea of movements and movement building is inextricably linked with the history of public health. Historically, most movements - including, for example, those for safer working conditions, for clean water, and for safe food - have emerged from the sustained efforts of many different groups of individuals, which were often organized in order to protest and advocate for changes in the name of such values as fairness and human rights. The purpose of the workshop was to have a conversation about how to support the fragments of health movements that roundtable members believed they could see occurring in society and in the health field. Recent reports from the National Academies have highlighted evidence that the United States gets poor value on its extraordinary investments in health - in particular, on its investments in health care - as American life expectancy lags behind that of other wealthy nations. As a result, many individuals and organizations, including the Healthy People 2020 initiative, have called for better health and longer lives.
eBook
Beyond Payment and Delivery Reform: The Individual Mandate's Cost-Control Potential
In a symposium focused on healthcare cost control, most of our authors have unsurprisingly highlighted and assessed Obamacare’s payment and delivery reforms—the supply-side efforts to decrease costs of medical treatment. But there is another party in healthcare decision-making who is equally or even more important: the patient. The question we will tackle here is whether the individual mandate and its accompanying patient-centered insurance reforms might decrease costs for patients in ways that ought to matter in assessing Obamacare’s cost control provisions. The individual mandate’s cost control potential lies in its reduction or even elimination of patients’ decision costs. The mandate, together with its minimum coverage requirements and a handful of the statute’s substantive insurance reforms, combats demand-side inefficiencies that might arise from patients’ bounded rationality. Decisions about whether to buy commercial insurance, how much insurance to buy, whether to consume preventive care, and how much to pay for that care are all difficult decisions. In order to make optimal choices, patients need a lot of information that is costly to obtain and to evaluate.
Journal Article
Knowledge/Power Transforming the Social Landscape: The Case of the Consumer Health Information Movement
The consumer health information (CHI) movement is the result of various twentieth-century ideologies and is an outgrowth of the broader consumer movement. From a sociocultural and political perspective, the consumer, civil rights, and women’s movements and related societal shifts helped pave the way for the consumer health movement, which laid the foundation for the CHI movement. All are examples of freedom of choice expressed through action and mirror a growing societal determination to exert control over important areas of one’s life. The provision of consumer health information is a necessary support mechanism for that portion of health care focused on investing in risk reduction and shared decision making. As changes in the U.S. health-care system occur over time, access to CHI is likely to remain prominent and increasingly important to the ordinary person. Examining key components of the movement’s origins helps elucidate both present and future trends.
Journal Article
The potential imposition of wage controls on nurses: a threat to nurses, patients, and hospitals
When there are shortages of RNs, hospitals and health care organizations in competitive nurse labor markets respond by increasing wages: some hospitals will respond faster and some will offer higher wages than others. The wage increase brings about two important short and long-run outcomes that, together, will increase the supply of RNs in the labor market. Because wage controls prevent the flexibility of wages to adjust, they can cause a shortage to develop when the demand for RNs is increasing (as in the 1970s), and wage controls will lengthen the duration of a shortage once it has begun. The impacts of prolonged RN shortages are multifaceted and destructive to nurses, patients, and hospitals. Looking ahead over the next 15 years when the demand for RNs is expected to grow by roughly 3% per year and the supply of RNs by much less than that, a new nursing shortage is projected to develop and reach a deficit of 285,000 RNs by 2020. The worst thing that could happen to the nursing profession would be to impose wage controls on nurses as this would prevent the needed short and long-run labor supply responses from developing and thereby eliminate the shortage.
Journal Article