Fox D M
Milbank Q. 1986;64(1):76-99.
For most of the twentieth century the central theme in the history of health policy in the United States was the elaboration and implementation of a consensus that health services should be organized in regional hierarchies. This consensus was based on shared beliefs about how medical advances were made and disseminated. Hierarchical regionalism became national health policy in several stages that culminated in the 1960s. Since the 1970s, however, the national policy of hierarchical regionalism has been eroded by the unexpected consequences of its success.
在20世纪的大部分时间里，美国卫生政策史上的核心主题是对一种共识的阐述与实施，即卫生服务应以区域层级体系进行组织。这一共识基于有关医学进步如何取得及传播的共同信念。层级区域主义在几个阶段中成为国家卫生政策，并在20世纪60年代达到顶峰。然而，自20世纪70年代以来，层级区域主义的国家政策因其成功带来的意外后果而受到侵蚀。
