Nursing home care in 2001

As we move toward the 21st century, nursing home care will become an increasingly important part of family practice. The number of nursing home residents will grow, their illnesses will become more acute, and the types of medical services provided by nursing homes will broaden. The fiscal difficulty of providing nursing home care will intensify, and a variety of innovative payment programs will be introduced in an attempt to control costs. The only way these will succeed is by a partial reallocation of health care dollars from expensive high-technology hospital care to less expensive low-technology care in nursing homes. As a result of these changes, hospitals will become more involved in the provision of what were traditionally nursing home services. Nursing homes will be used to a larger extent for medical education, and, under congressional pressure, a shrinking pool of federal research dollars will be more fairly allocated to clinical investigation in this setting.