What triggered hospital downsizing in the United States in the 1980s?

Rationale:

A. Well-to-do, private-pay patients started using hospitals: This development is more characteristic of stage 1 of the evolution of hospitals, where hospitals primarily served the wealthy and were often charitable institutions.

B. Advanced sanitation, nursing, and medical services: Stage 2 of the evolution of hospitals saw significant improvements in sanitation practices, the professionalization of nursing, and advancements in medical services, contributing to the transformation of hospitals into more

modern healthcare institutions.

C. Transition from primarily government institutions to community institutions: While the role of hospitals expanded to serve broader community needs during this stage, it was not the defining characteristic of stage 2.

D. Medical discoveries transformed hospitals into institutions of medical: While medical discoveries certainly influenced the evolution of hospitals, they were not unique to stage 2 and were ongoing throughout the development of healthcare institutions.

Rationale:

A. Physicians are paid at higher rates than private organizations: This statement does not accurately describe the staff model of managed care. Compensation rates may vary but are not necessarily higher than in private organizations.

B. The health maintenance organization (HMO) employs its own fixed-salary physicians: In the staff model, physicians and other healthcare providers are directly employed by the HMO and receive fixed salaries rather than fee-for-service payments.

C. Meets the nutritional and therapeutic requirements of the patients: This statement relates more to the provision of healthcare services rather than the employment model within managed care.

D. Registered nurses are sponsored by agency staffing companies: This statement does not pertain to the staff model of managed care; it describes a different aspect of healthcare staffing and employment.