Hospital costs and the fees for physicians who treat patients admitted for inpatient care currently account for about half of the annual health care spending in the United States (around one trillion dollars). This situation will soon change, however, as market forces necessitate the downsizing, merging, and closing of acute-care hospitals.

In this authoritative book, the dean of health care analysts discusses the future of the American hospital. Eli Ginzberg reviews the institutional structure, function, and operations of hospitals in the United States and explains the factors in the marketplace that are transforming the hospital sector. He assesses the different approaches that hospitals and their physician staffs have developed in order to become part of an integrated health network and provide a more efficient and effective system of health care delivery. And he explores such trends as the growth of managed-care plans; the development of alternative, lower-cost treatment sites for patients requiring prolonged care; efforts by community hospitals to cooperate rather than compete; and the management of each individual's health care services by a primary physician who will provide essential services at a competitive price.