Essentials of Health Services or Fourth Generation Evaluation

Essentials of Health Services

Author: Stephen J Williams

A book of interest to those working with the Health Care System.

Doody Review Services

Reviewer: Anita Finkelman, MSN, RN (Orbis Education Services)
Description: This book attempts to provide an overview of the healthcare delivery system in the U.S. It does cover the critical broad areas of concern related to structure, organization, providers, and reimbursement.
Purpose: The major purpose is to provide a direct resource of current information about the healthcare delivery system:scope and functions. This is a worthy objective, but the result is that it lacks depth.
Audience: According to the editor, this book is written for undergraduate students, clinicians, and those who have an interest in healthcare delivery. This is a broad group from perspective of education and experience. The editor and authors of chapters have the expertise to write about this subject.
Features: The book covers access to care, settings in which care is provided, reimbursement, and quality care issues. The content is highly relevant but poorly presented and too simplistic. The goal was to have a short, to the point discussion but the book seems to lack depth when some is needed. Chapter objectives and study questions are included, but no other additional learning strategies. There are no references for any of the chapters. Some of the areas of weakness are the limited content on nursing when nurses provide most of the acute care, and limited discussion about the major workforce shortage. Quality and safety are other critical issues that receive superficial attention.
Assessment: I would not purchase this book or use it as a reference or in teaching because it is too superficial.

Booknews

Explains the structure and functions of the nation's health care system. Emphasis is placed on describing and explaining the components of the health care system and on presenting information in an easily readable format. Material draws on, but simplifies, presentation available in the publisher's , fifth edition, edited by Stephen J. Williams and Paul R. Torrens. Designed for graduate students in public health, health services administration, and related health professions. The author teaches public health and heads the Division of Health Services Administration at San Diego State University. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Rating

2 Stars from Doody

Table of Contents:

PART ONE AN OVERVIEW OF HEALTH CARE IN THE UNITED STATES: The Big Picture. The Underlying Basis of Health Services Utilization. Access to Health Care Services. PART TWO THE RESOURCES FOR PROVIDING CARE: Ambulatory Health Services: Backbone of the System. Public Health Services. Hospitals and Health Systems. Mental and Behavioral Health Services. Long-Term Care Services. The People Who Provide Health Care Services. The Pharmaceutical Industry. PART THREE PAYING FOR, MANAGING, CONTROLLING, AND EVALUATING THE SYSTEM: Paying for Health Care. Managed Care and the Reorganization of Health Services. Regulating and Planning for the System. Quality of Care. National Health Policy. Index.

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Fourth Generation Evaluation

Author: Yvonna S Lincoln

"In Fourth Generation Evaluation, Guba and Lincoln present a strong, unequivocal argument for the epistemological, methodological, and ethical superiority of their refined constructivist inquiry paradigm for the political and practical demands of program evaluation."

--Jennifer Greene, Cornell University

"I would warmly recommend it as stimulating and challenging reading."

--Systems Practice

"I consider Fourth Generation Evaluation to be an exceptionally daring and insightful book. It has done more than most books to further loosen the grip of liberal, instrumental "common sense" (i.e., ideology) that has constricted the field of evaluation for the past 30 years. The book's idealism is energizing and must only be matched, as the authors certainly know, by yet more hard-headed analysis. Its radical ambitions are inspiring if not always apparently achievable. However, fair is fair: radical ends demand radical means."

--Evaluation Practice

Fourth Generation Evaluation represents a monumental shift in evaluation practice. Guba and Lincoln point to the inherent problems faced by previous generations of evaluators--politics, ethical dilemmas, imperfections and gaps, inconclusive deductions--and lay the blame for failure and nonutilization at the feet of the unquestioned reliance on the scientific/positivist paradigm of research. Fourth Generation Evaluation, a more informed and sophisticated approach, moves beyond science to include the myriad human, political, social, cultural, and contextual elements that are involved. Based upon relativism, a unity between knower and known, and a subjective epistemology, theauthors show how fourth generation evaluation unites the evaluator and the stakeholders in an interaction that creates the product of the evaluation. Differing from previously existing generations, this new approach moves evaluation to a new level, whose key dynamic is negotiation. The constructivist paradigm is espoused by the authors and shown to offer multiple advantages, including empowerment and enfranchisement of stakeholders, as well as an action orientation that defines a course to be followed. Not merely a treatise on evaluation theory, Guba and Lincoln also comprehensively describe the differences between the positivist and constructivist paradigms of research, and provide a practical plan of the steps and processes in conducting a fourth generation evaluation.

This is a book that no evaluator can afford to ignore and an important advance in the study of applied research.