What is the single most dominant force in U.S. health care delivery?

A. Pharmacy services available: While having pharmacy services available may be beneficial for patient care, it does not directly address the importance of organizational integration.

B. Provides food services to meet the nutritional and therapeutic requirements of the patients: While important for patient care, providing food services does not fully capture the importance of organizational integration.

C. There is maintenance of medical records on each patient: Maintaining medical records is essential for patient care but does not address the broader importance of organizational

integration.

D. It is necessary for economic reasons: Organizational integration refers to the coordination and alignment of different aspects of a healthcare organization, including clinical, administrative, and financial functions. Integration is crucial for optimizing efficiency, reducing duplication of services, improving communication, and ultimately achieving cost savings and better patient outcomes.

Rationale:

A. Wastage at clinics: While wastage at clinics may contribute to inefficiencies in the healthcare system, it is not a primary reason that cost-control efforts in the United States have not been successful.

B. Global healthcare issues: While global healthcare issues may impact the broader context of healthcare delivery, they are not a specific reason for the lack of success in cost-control efforts within the United States.

C. Poor patient outcomes: Poor patient outcomes may contribute to healthcare costs, but they are not the primary reason that cost-control efforts have not been successful.

D. Cost shifting: Cost shifting refers to the practice of shifting costs from one payer to another, such as from private insurers to public payers like Medicare and Medicaid. This practice can undermine efforts to control costs by redistributing financial burdens rather than addressing underlying cost drivers.