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    1. Identify the major factors that have resulted in the shift in utilization from inpatient hospitalization to ambulatory care services. Describe the implications of this shift for hospitals consumers and the health care delivery system as a whole.
    2. In what ways have private practice physicians responded to the expansion of hospital health plans and other organization-sponsored ambulatory services? What are the implications of those responses for the patient for the consumer and for the health care industry as a whole?
    3. Hospital emergency departments continue to be used as an ever more important source of primary medical care by large numbers of the communitys medically underserved population. What are the implications of this practice for the patients and on health care costs and quality of care? What would you propose as a means to change this situation?
    4. Almost two-thirds of all surgical procedures are now performed in ambulatory surgery facilities. Discuss the reasons for this shift of surgery from the inpatient setting and its effect on hospitals and consumers.
    5. Some people support the role of public health departments in providing preventive and treatment services as necessary to fill gaps in the system for the medically needy. Others believe these services are more efficiently and effectively provided through private organizations. What is your position on this issue and why?

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