TABLE 12.2.

Transformation of Health Care Paradigms

Old Paradigm	New Paradigm
Emphasis on inpatient care	Emphasis on continuum of care
Emphasis on treating illness	Emphasis on maintaining and promoting wellness
Responsibility for the individual patient	Accountable for defined population
Specialists rewarded more than generalists	Greater economic parity between providers
Surgery rewarded more than medical services	Prevention rewarded versus surgery
Goal to fill beds	Provision of care at appropriate level of care
Separate organization, funding of hospital and other services	Integrate health delivery system
Managers run an organization or a department	Managers promote market share
Managers coordinate services	Managers promote intersectoral cooperation

Source: Adapted from Shortell SM, Kaluzny AD. Health care management, organization, design and behavior. 5th ed. Albany, NY: Delmar; 2005.