Doody's Review Service

Reviewer:	Carl Balcom, DNP, MBA, RN, NEA-BC, FACHE (HCA Healthcare)

Description
The book provides an explanation of health systems design and delivery and then compares 30 different nations' healthcare systems. It provides a solid explanation of systems theory and the framework necessary to evaluate health system performance and then moves into detailing the health systems of the targeted countries. The previous second edition was published in 2017, so this updated version is needed and pertinent.

Purpose
The primary purpose of this book is to introduce American students -- mainly health and public administration -- to the way in which health systems in other countries function. The stated goals are to increase understanding of the global context of health and health care, and to demonstrate the impact of social, political, and economic factors on system performance. One of the expected outcomes identified is to demonstrate that there are opportunities for the US to learn from other countries' systems in terms of maximizing coverage, ensuring affordability of care, and achieving better health outcomes. These are all worthy objectives for American students given the current challenges in our healthcare system today and the need to increase capacity while reducing cost.

Audience
The authors' primary audience is health policy and health administration students in the United States of America. In addition to this intended audience, this book is beneficial to current healthcare leaders as it provides insights into systems and practices from other nations that are transferable, at least in some part, to the United States. The authors bring a vast amount of knowledge and experience in this field, and both are highly credible within the industry.

Features
The book comprises three main sections to provide a foundation of health system design and delivery, insight into the health systems of 30 different nations including the United States, and a discussion of ways to put the content together and what future directions in the United States could look like. The first part introduces the concept of health as well as system theory, key frameworks around global and international health, the impact of policy, politics, and economics on health system design and delivery, and the key role that international organizations play in health around the world. The second part of the book provides an overview and comparative analysis of 30 different countries. Each chapter details a specific country and provides background information (e.g., history, geography, demographics, political systems), history, and an overview of the nation's healthcare system including current state (e.g., workforce, systems of care), the impact and effects of the COVID-19 pandemic locally, and finally an evaluation of the country's system performance and outcomes. The third part of the book wraps up the content from the first two parts by exploring current challenges and opportunities presenting in the United States. It reviews disaster planning and management, future business and economic considerations within the U.S. and globally, and current challenges facing all nations right now (e.g., labor supply, aging population). The writing style throughout the book is clear and concise, and it uses figures and tables appropriately to facilitate understanding of the subject matter. The content is organized extremely well by setting the stage, providing details specific to each nation, and then concluding with content applicable to all nations and how opportunities and challenges can be considered and acted on from a global perspective.

Assessment
This book is extremely beneficial not only to the targeted audience but to other audiences (e.g., current health leaders and practitioners) because it is pertinent to how health systems are designed and care delivered. Moreover, the details of other nations' health systems are beneficial to U.S. readers because they provide insights and potential lessons learned beyond our borders. The third edition is an important update as there have been significant changes in health systems, both in the US and globally, since the second edition was published in 2017. In addition to the evolving socio-political environments, COVID-19 had significant and long-lasting impacts globally and the book does an exceptional job detailing and explaining this throughout. I strongly recommend this book not only as the text for a health administration or health policy graduate-level program, but to any health leaders or practitioners interested in expanding their knowledge on health system design and delivery.