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We publish The Milbank Quarterly, as well as reports and issues briefs on topics important to population health.
June 1994 (Volume 72)
June 1994 | James C. Robinson
The American hospital faces two different possible futures. In one, the hospital continues to expand into outpatient, home health, and long-term-care services and remains the center of the changing health care system. In the other, competition in each of these domains from independent health plans, which do not have to contend with the high wages, technological imperatives, and bureaucratic inertia of large hospital organizations, pushes the hospital to a peripheral role as provider of ever-diminishing acute inpatient services. The choice between these two futures will be made based on the efficiencies of vertical integration relative to market contracting. Transactions cost economics is used to analyze the changing boundaries of the hospital organization, particularly with respect to outpatient diagnostic and surgical clinics, home health agencies, and long-term-care facilities.
Author(s): James C. Robinson
Read on JSTOR
Volume 72, Issue 2 (pages 259–275)
Published in 1994
Privatization, System Membership, and Access to Home Health Care for the Elderly
Improving Health: Measuring Effects of Medical Care