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The American hospital is being reinvented to conform with the forces that are replacing the acute, inpatient-oriented illness model of health care with a disease-prevention, health-promotion, primary-care one. Although hospitals will no longer conduct the "core business" of American health care, they can play a key role by empowering others and facilitating the integration of health services across the continuum of care. New management and governance structures will be required, as will population-based health status needs assessments, new relations with physicians, re-engineering of the clinical processes, organization-wide commitment to improving quality, information systems that link patients and providers, and creation of an overall community care management system. Despite major barriers, there are examples of progress.
Shortell et al. (Sun,) studied this question.