PMID: 3746864Sep 1, 1986Paper

The changing medical care system: some implications for medical education

Journal of Medical Education
S Foreman

Abstract

In summary, the medical care system is undergoing the most widespread and significant changes in a generation. Individual hospitals, the basic delivery units of the past, may fast be disappearing as mergers, acquisitions, and a variety of multi-institutional arrangements become the dominant form and as a host of free-standing medical enterprises spread out into the community. Fee-for-service medicine and cost-based hospital reimbursement, each with its service-maximizing incentives, are being replaced--the former by prepaid capitation systems and the latter by discount pricing and all-inclusive admission charges. The hospital, until now a "farmer's market" of diverse programs and activities serving a broad patient population, increasingly has become a provider of intensive services to a narrowing and more ill patient base. The major teaching hospital, formerly a complete educational resource within itself, may soon become simply one of a number of educational settings, all of which are equally essential for providing a total medical education. Finally, after years of change driven by biomedical discoveries and centered in the academic medical centers, there is a new locus of innovation within the delivery system itself, and tho...Continue Reading

Citations

Mar 1, 1988·Journal of General Internal Medicine·R A Rosenblatt
Nov 1, 1990·Medical Education·M G Hewson, N M Jensen
Aug 7, 1989·Evaluation & the Health Professions·B Barzansky, J Perloff

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