The emerging health care world: implications for social work practice and education.

Dramatic changes in patient care delivery have been stimulated by advances in technology and new approaches to the financing of health care. Traditionally, the American health care system has been based on a paradigm of unpredictable acute simple disease, a model that has become inappropriate as increasing numbers of patients are presenting with multiple, chronic health problems. Because chronic illnesses are determined by many factors, such as an individual's social, psychological, and physical environment; genetic makeup; and health care accessibility factors, the hospital, once the dominant organization in health care, must become part of a primary care network of community-oriented delivery systems focused on chronic disease management. In this model, the social worker treats the patient throughout the continuum of care. Therefore, dynamic training that addresses the changing health care environment will be needed. In addition, social workers will need to work as members of a team in addressing the needs of patients for preventive, curative, and rehabilitative services.