ABSTRACT
The evolution and emergence of managed health care in the United States have produced a flood of information concerning the quality of the health care delivery system. A moderate amount of this information is grounded in valid, scientific study. Other information, however, is speculative and often serves the interests of those who profit from the conclusions. This change in the health care system has primarily occurred because of the economic burden placed on those who pay for health care in this country (e.g., insurance companies, businesses, etc.). This chapter, however, is more concerned with: (a) how the emerging managed care environment changes the communicative roles of health care providers, (b) the definition of quality care as it relates to the interaction between providers and patients, and (c) most importantly, the older patient-health care provider relationship. This chapter organizes existing literature and attempts to expand the thinking of researchers, practitioners, and older patients who are concerned with how managed care influences the dynamics of the health care providerolder patient relationship so that the best quality of care may be attained.
