Changing Patterns of Health Service: Their Dependence on a Changing World

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Abstract
The patterns of health service are becoming increasingly organized in all sectors: hospital care, ambulatory patient care, and public health. Developments in science and technology contribute to the enormous specialization which, in turn, has generated patterns, such as group practice, to in tegrate the specialties. Urbanization has produced great medical centers and has stimulated regionalized planning. Rising costs have led to the health-insurance movement in a dozen forms, which has affected the quantity and arrangements of medical care. Likewise, governmental and voluntary pro grams tackling specific diseases or services have developed because of high costs combined with other problems. The rise in proportion of the aged and chronically ill has changed the emphasis of public health, of hospitals, and of medical research. The growth of industry has stimulated special medical-care programs and has fortified the insurance movement. Trans portation and communication have changed the relationship of patients to doctors and hospitals. The over-all impact of democratic and humanistic principles has greatly extended the supervisory role of government over the medical-care system and has widened citizen participation in medical af fairs. The resultant organizational complexities have created a great new need for co-ordination of health services in communities.

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