Issues facing American hospitals.

Major issues facing general hospitals today include the spiraling cost of health care and attempts by both the hospital industry and government to stem it. Although psychiatric care has not contributed substantially to the inflation in health care costs, the author predicts that psychiatric services would not escape public regulation of hospital costs. He urges psychiatrists to pay closer attention to the influential role of health systems agencies in determining health care needs.

Chinese health system gets down to basics.

Preventive medicine and primary health care, rather than advanced medical technology, appear to be the focus of health care delivery in China. In fact, the author says, one could imagine a decision being made not to install a CT scanner so that more physician extenders could be trained to improve nutritional standards, help eliminate infectious diseases, and provide health education information to people who would not otherwise be exposed to these services.

Doing more with less-gracefully.

A new challenge for hospital trustees is that of managing infinite demands with finite resources. Meeting the challenge will require educated decisions arrived at through a participatory process; a rethinking of the institution's goals; a structured evaluation procedure for deciding among alternatives; and a strong data base.