ABSTRACT
This chapter focuses on four major issues-— the burden of responsibility for care, the models of care, the effects on providers of care, and finally the economics of care. Health and Hospitals Corporation (HHC) is a major provider of health services in New York City, handling half of all ambulatory and emergency room visits, half of all inpatient psychiatric services, and a third of all inpatient drug detoxification services as well as about 10-15 percent of outpatient drug treatment slots in the city. Public hospitals, especially those located in urban areas, are leaders in confronting Acquired Immune Deficiency Syndrome (AIDS) and increased drug abuse. HHC's patient population reflects this and tragic challenge. The tragedy of AIDS poses a particular set of challenges and problems for all hospital providers, public and private. The care for AIDS patients often requires the full resources of an acute care facility.
