ABSTRACT
This chapter examines the experience of hospitals in computerizing their operations, to assess the pace at which these systems and their applications are being installed, and to analyze the impact of adaptation on work and career opportunities. It is based on interviews with executives of seven hospitals and the Hospital Corporation of America as well as with a number of individuals closely associated with the industry. The crisis facing US hospitals can only be understood by recognizing the decades of growth and rising medical costs that proceeded the mounting difficulties. Declining demand was at first largely incipient for most hospitals, but since 1981 there has been a continuous decline in inpatient census. Payment for both Medicare and Medicaid patients in hospitals has been significantly changed since 1981 when requirements for Medicaid were altered to permit states to reduce reimbursement.
