According to Shi and Singh "Essentials of the U.S. Healthcare System," what percentage of the healthcare workforce do hospitals employ?

Rationale:

A. Technology: While technological advancements may have influenced healthcare delivery, they did not directly trigger hospital downsizing in the 1980s.

B. Hill-Burton Act (1946): The Hill-Burton Act provided federal funding for hospital construction and modernization, which typically led to expansion rather than downsizing of hospitals.

C. Covid-19: Covid-19 emerged long after the 1980s and is not related to the hospital downsizing trends of that decade.

D. Prospective Payment System (PPS): The implementation of the Prospective Payment System (PPS) in the 1980s, particularly for Medicare reimbursements, shifted hospital reimbursement from fee-for-service to a predetermined payment based on diagnosis-related groups (DRGs).

This change incentivized hospitals to become more efficient and led to downsizing, closure of underutilized facilities, and consolidation of services.

Rationale:

A. Right to make an informed choice regarding medical treatment, including the right to refuse

treatment: Informed consent refers to the ethical and legal principle that ensures patients have the right to make informed decisions about their medical care, including the risks, benefits, and

alternatives to treatment. It requires healthcare providers to provide patients with relevant information to enable them to make decisions consistent with their preferences and values.

B. Allows a hospital to participate in Medicare and Medicaid: This option describes a hospital's eligibility to participate in government healthcare programs and is not related to informed consent.

C. Value-based care that needs to go beyond the assessment of safety and effectiveness: This option describes the concept of value-based care, which emphasizes improving patient outcomes and experiences while controlling costs. It is not directly related to informed consent.

D. Differences of opinion on what constitutes extraordinary or heroic measures to sustain a person's life: This describes ethical considerations in end-of-life care and is not specifically related to the concept of informed consent.