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Old and Sick in AmericaThe Journey through the Health Care System$
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Muriel R. Gillick

Print publication date: 2017

Print ISBN-13: 9781469635248

Published to North Carolina Scholarship Online: May 2018

DOI: 10.5149/northcarolina/9781469635248.001.0001

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The Transformation of the American Hospital, 1965–2015

The Transformation of the American Hospital, 1965–2015

(p.133) Chapter Eight The Transformation of the American Hospital, 1965–2015
Old and Sick in America

Muriel R. Gillick M.D.

University of North Carolina Press

Over the last fifty years, the hospital has been technologized, corporatized, and bureaucratized due to demographic, political, economic, and scientific developments. The demographic shift has led to the greying of the population, with an associated increase in chronic disease, resulting in hospitalized patients becoming sicker and more complex. Legislative changes such as the introduction of Medicare led to a surge in the number of hospitalizations of older individuals; the subsequent move to prospective payment led to shorter hospital stays—and increased reliance on the skilled nursing facility. A change in the economic climate produced consolidation, with the resulting growth of hospital chains and hospital systems. Scientific advances, fuelled in many cases by generous research grants from the National Institutes of Health, led to new, non-invasive imaging techniques such as computerized tomography and magnetic resonance imaging. Advances in biology and epidemiology led to new approaches to the hospital’s management of diseases as disparate as heart attacks and cancer.

Keywords:   Hospital chains, Hospital systems, CT scans, MRI, Epidemiology

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