The epigram introducing the first chapter of this book states: "The beginning of the 21st century beckons both with
challenge and opportunity for improved health of Americans." From now until then, and most likely well beyond,
health services managers will be confronted with change--a constant that will challenge them to improve the
organization, delivery, and financing of health services. Our purpose in preparing this book is to help managers
meet these demands and seize the opportunities; by doing so they will make a major contribution to improv-
ing health.
This book is most beneficial for two types of users: 1) students engaged in the formal study of health services
management, and 2) current managers who wish to supplement their experience and refresh their knowledge of
applied management theory. It is about managing organizations that deliver health services. Historically, hospitals
and nursing facilities have been the most prominent health services organizations (HSOs). Others that have become
important more recently include managed care organizations (including HMOs and PPOs), multiorganizational
systems, ambulatory care organizations, home health agencies, birth centers, and hospices. All face new environ-
ments--a mosaic of external forces including new rules and technologies; changing demography; increased com-
petition, public scrutiny, and expectations; greater accountability; and more constraints on resources. Managerial
excellence makes a difference in the efficient and effective delivery of health services. HSO managers must be
prepared if they are to respond to these and other challenges. We hope this book will aid in their preparation.
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