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Ellen Marszalek-Gaucher and Richard Coffey argue that in the past, U. S. health care providers reveled in cost-based reimbursement and generous government support. Physicians and hospitals prospered; medical technology proliferated; and patients received increasingly advanced, but increasingly costly, pharmaceuticals, tests, transplants, and other treatments. Physicians had little incentive to provide care efficiently, to eliminate costly errors, or to satisfy the needs of patients as "customers."
The environment for health care organizations has changed. They face increasingly stringent price constraints and strong competition in an industry with excess capacity. Operating margins are declining. Profitable organizations are becoming marginal, and actual hospital
Transforming Healthcare Organizations: How to Achieve and Sustain Organizational Excellence. Ann Intern Med. ;115:71. doi: 10.7326/0003-4819-115-1-71_2
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Published: Ann Intern Med. 1991;115(1):71.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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