The health care environment: issues and questions for nurses

We must understand today's health care environment to ensure that the future of health care accommodates the needs of patients as well as health care providers in general and nurses in particular. To that end, five concepts from the macroenvironment--awareness, cost, quality, access, and policymaking--and three concepts from the microenvironment--patients, clinicians, and administrators--are examined in this paper. Although the number of questions raised exceeds the number of answers posed, identifying critical questions is a necessary first step in searching for solutions to health care challenges.