ABSTRACT
The diversification of major hospital chains—not-for-profit as well as proprietary-into such fields as medical supply, insurance, management information systems, long-term care, ambulatory care, managed care and home care has been well documented. American Medical International has the most extensive foreign operations of the major chain companies. Some smaller domestic hospital chains have also invested in foreign institutions. For many of the chains, contracts for building and later operating hospitals, particularly in the Middle East, were the starting point for their international operations. The movement from management contracts to hospital ownership was spurred on by several common factors based on the geographic location, nature of the health system, and the economy of the area involved. In Britain, the conservative government of Margaret Thatcher has been eager to introduce a private sector into the country to compete with the National Health Service, as part of its attempt to reprivatize the domestic economy.
