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November 21, 1977

Health Care Delivery in the United States

Author Affiliations

University of Chicago Chicago

JAMA. 1977;238(21):2309. doi:10.1001/jama.1977.03280220077035

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This book is intended as a textbook on the problems of health service provision in the United States, for use in schools of public health and medical schools, or courses in medical sociology, medical economics, and social work. Despite having eight contributors, the book is well integrated. All the major parts of the health service provision system are covered, as are the chief problems, such as cost and quality controls, maldistribution, overutilization, and the like. It successfully avoids polemics and extreme partisan observations, but the underlying presupposition is the self-evident truth that the health care provision system, to serve known populations, must have more organized group practice, planning, coordination, boundaries, and budgets. All systems are converging in this direction.

Koran writes: "The pluralistic nature of the service delivery system creates certain problems: inequitable access based on geography, class, and diagnosis, inadequate coordination." Abel-Smith, a prominent British health economist, is quoted