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A Changing Health Care Decision-Making Environment

The increasing pressure to contain costs is bringing a new member to the "traditional" health delivery team, the professionally(and nonmedically-) trained administrator. In this paper, we examine the root differences in attitudes of physicians and this emerging administrative group exhibited in response to simulated life-threatening scenarios. When cardiopulmonary resuscitation (CPR) is indicated, physicians in our sample focus on the future "worth" (or quality) of the patient's life; administrators, however, are more likely to focus on the existing "worthiness" of the patient. These differences lead us to conclude that equitable health care delivery programs in the United States, balancing quality, availabity, and cost efficiency, will require new broader-based management systems both at the macrosystem as well as at the single institution levels.