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Prologue: To compete effectively with emerging health care delivery systems for patients and their dollars, hospitals (once the traditional base for medical care) have begun to offer a wider range of services. As hospitals diversify, they also feel pressure, both from outside the system and within, to contain costs. How do these trends affect the number and variety of services available to consumers? Stephen Shortell and his colleagues examine the impact of today s environment on multihospital systems, publishing for the first time the results of an ongoing study comparing selected system-affiliated hospitals with their market area competitors. Shortell, who holds a doctorate in behavioral sciences from the University of Chicago, has been researching hospital behavior for the past twelve years. He is the A.C. Bueller Distinguished Professor of hospital and health services management and professor of organization behavior at Northwestern University's J. L. Kellogg Graduate School of Management, and directs the program in organization behavior in health at the university's Center for Health Services and Policy Research. Ellen M. Morrison serves as project director and holds a master's degree in sociology from the University of Chicago, where she is completing her doctorate. Susan L. Hughes, who holds a doctorate in social work from Columbia University, directs the center's gerontological health program and teaches in the department of community health and preventive medicine at Northwestern's School of Medicine. Bernard S. Friedman, a well-known health economist, is the center's associate director, as well as principal or senior investigator on several ongoing research projects at Northwestern and at Edward A. Hinesjr. Veterans Administration Hospital's Health Services Research and Development Division. He holds a doctorate in economics from Massachusetts Institute of Tech-nology, james E. Coverdill, who holds a master's degree in sociology, is a research fellow at Northwestern's Center for Urban Affairs. Lee Berg, who holds a master's degree in biochemistry, is a former senior programmer analyst at the center.
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