Int Nurs Rev. 1996 Jul-Aug;43(4):113-20, 126.
Health care is under scrutiny. Governments and regulators are examining the way in which health care is delivered within a framework of public accountability. Licensing authorities are faced with issues such as legislative reform, undefined scopes of practice, increased lay involvement in licensing, specialty licensing and the measurement of continuing competence. The protection of the public and preservation of the professionalism of self-regulation are the principles that should guide decision-making. While economics are behind much of the top-down initiatives to change, there is also a real grassroots demand for preventive services, choice of alternative therapies and increased responsiveness by healthcare providers to community needs for primary health care, which includes convenient times and locations, at costs affordable by everyone.
医疗保健正在接受审查。政府和监管机构正在审视在公共问责框架内提供医疗保健的方式。许可机构面临着诸如立法改革、业务范围不明确、外行参与许可的增加、专业许可以及持续能力的衡量等问题。保护公众和维护自我监管的专业性是指导决策的原则。虽然自上而下的变革举措大多背后有经济因素，但基层也确实存在对预防服务、替代疗法选择以及医疗服务提供者对社区初级医疗保健需求（包括便利的时间和地点，且人人都能负担得起费用）的更高响应度的需求。
