TY - CHAP M1 - Book, Section TI - How Health Care Is Organized—I: Primary, Secondary, and Tertiary Care A1 - Bodenheimer, Thomas A1 - Grumbach, Kevin PY - 2016 T2 - Understanding Health Policy: A Clinical Approach, 7e AB - Frank Hope has walked with a limp since contracting polio in 1950. When he watches his daughter run after her young toddler, he feels a sense of gratitude that the era of vaccination has protected his child and grandchild from such a disabling infection. He recalls the excitement that gripped the nation as the Salk polio vaccine was first tested and then adopted into widespread use. In Frank’s mind, these types of scientific breakthroughs attest to the wonders of the US health care system.Frank’s grandson attends a day care program. Ruby, a 3-year-old girl in the program, was recently hospitalized for a severe asthma attack complicated by pneumococcal pneumonia. She spent 2 weeks in a pediatric intensive care unit, including several days on a respirator. Ruby’s mother works full time as a bus driver while raising three children. She has comprehensive private health insurance through her job but finds it difficult to keep track of all her children’s immunization schedules and to find a physician’s office that offers convenient appointment times. She takes Ruby to an evening-hours urgent care center when Ruby has some wheezing but never sees the same physician twice. Ruby never received all her pneumococcal vaccinations or consistent prescription of a steroid inhaler to prevent a severe asthma attack. Ruby’s mother blames herself for her child’s hospitalization. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1126405059 ER -