ABSTRACT
Advances in medical knowledge, diagnostic capabilities, and therapeutics, combined with an increase in the percentage of elderly patients living with more complex chronic disease, has necessitated significant changes in the American health care delivery system. The increased complexity of health care prompted a shift from a siloed or isolated and fragmented health system to one that is more organized, integrated, and continually evolving to provide more coordinated, high-quality care. This chapter reviews the implementation of multiple systems of care in various dimensions of the health care delivery spectrum, providing an overview of these systems, their corresponding principles, and changes driving the evolving health care landscape. Topics reviewed include integration of care, disease prevention and population management, the concept of a health care team, the medical home model, subacute and long-term care, continuum of care, quality and safety, palliative care, and hospice. The chapter provides the reader with an understanding of the driving forces and major paradigm shifts shaping the evolving health care delivery system in the twenty-first century.
