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Healthcare reform: past and future
1Memorial Sloan-Kettering Cancer Center, New York, NY.
Purpose:
To review changes in the healthcare delivery system and project the challenges that practitioners and consumers will face in a reformed environment.
Data Sources:
Professional journals and books, print media, and government releases.
Data Synthesis:
Analysis of projected reform plans, discussions of issues related to complex social, economic, and political factors, and considerations for practice changes for oncology nurses.
Conclusions:
The pending dominance of healthcare delivery through managed-care systems will challenge oncology care providers and consumers.
Implications For Nursing Practice:
Oncology nurses must identify the opportunities, master the challenges, and adapt to the trends of the reformed healthcare system. The delivery of long-term care to senior citizens, patients with AIDS, and individuals from diverse cultures will shift to more community, ambulatory, and rural managed-care settings. Oncology nursing practice in these environments raises questions about prevention and screening, diagnosis, treatment, follow-up, alternative care, and research. Oncology nurses, especially advanced practice nurses, will play a pivotal role in reshaping the delivery of patient care and in designing the future of their profession.