This volume explores issues connected with quality, planning of services, access concerns especially as linked with providers of care, health care institutions, and patients. Changes have continued to occur with the field but led by overall marketplace trends. <BR>Papers are presented in four parts covering changing models of healthcare. In Part I topics come from a broad perspective to include: development of newer models of care, more traditional areas such as the medical profession and the patient or the hospital and the patient, the changes that alternative medicine brings to issues of quality of care and access and planning, and of citizen participation in health planning. Part II deals with federal programs such as Medicare and Medicaid and access and quality issues within those programs. Part III covers the challenges of planning for long-term care needs and services. And Part IV explores other aspects of the changing health care delivery system: changes in nursing, midwifery, and rural health care and provides linkages to quality, access, and planning issues. <BR>This excellent work helps the reader to think more carefully and more creatively about issues of quality of care, access to care, and planning for services.

List of contributors. Introduction (J.J. Kronenfeld). Changing Models of Health Care: Impact on Quality, Planning and Access Concerns. Medical uncertainty, medical collegiality, and improving quality of care (M. Rosenthal). Developing a patient-responsive model of hospital care (E. Kahana et al.). How alternative medicine is changing the way consumers and practitioners look at quality, planning of services, and access in the United States (M. Gouldner). Citizen participation in health planning: a case study of changing delivery systems (H. Perlstadt et al.). Medicare, Medicaid, and Planning: Quality and Access Issues. Using a model to evaluate the impact of managed care on Medicaid-eligible moms and their children in a rural population (R. Riportella-Muller). Is the content of parental care for teens less adequate in Medicaid managed care settings? (B.D. Gifford). Financial incentives under Medicare's prospective payment system: a study of readmissions (E.G. Gay et al.). Challenges of Planning for Long-Term Care. Preparing for an uncertain future: assessing the service environment and the challenges of providing long-term care (D. Zablotsky et al.). Long-term care and "managed" Aids: the challenge we face (R.D. Moremen). Changing in Nursing, Midwifery, and Rural Health Care: Examples of Linkages to Quality, Access, and Planning. The profession of nursing as a complex, adaptive system: strategies for change (J.W. Begun, K.R. White). Access to the new midwifery in Ontario: integrating midwifery versus integrating midwives (I.L. Bourgeault). Rural hospital survival: a case study of the shaping and effect of community perceptions (W.A. McIntosh et al.).