title: History of ambulatory care facilities from a roving hospital administrator's point of view.
abstract: Over the past four decades, the delivery of health care services has seen dramatic changes. Medicare coverage in 1966 expanded the ability of the health care industry to treat a growing segment of the population. Technology improvements have made great strides in the treatment of disease. Public policy decisions expanded health care coverage from an employee benefit to entitlement for large segments of the population. Managed care growth has reorganized the basic health care delivery system. The aggregate effect of all these items was a dramatic increase in the cost of providing health care in the United States. Beginning in the late 1960s, and escalating in the 1970s and 1980s, the increase of the cost of care was the primary issue for the industry. Only in the 1990s has the rate of increase modified through the impact of managed care, and now there is significant competition for the health care dollar among many competing providers.
authors.affiliation: Hunter Group, St. Petersburg, FL, USA.
authors.forename: A T
authors.initials: AT
authors.lastname: Dunn
mesh_terms: D003258:Consumer Behavior; D003363:Cost Control; D003695:Delivery of Health Care / Q000266:history / Q000458:organization & administration; D004465:Economic Competition; D006297:Health Services Accessibility; D049673:History, 20th Century; D006740:Hospital Administrators; D009936:Organizational Innovation; D010044:Outpatient Clinics, Hospital / Q000191:economics / Q000266:history / Q000458:organization & administration*; D010564:Personnel, Hospital; D012922:Social Change; D014481:United States