1 East Tennessee Children's Hospital, Knoxville, TN
Physicians are responsible for cost containment. Use of more expensive hospital services for which less expensive hospital or outpatient services can be substituted without significant threat to outcome of clinical care will no longer be tolerated. Every service traditionally provided to inpatients will be scrutinized for possible delivery in a less expensive manner. The sophistication of these services has progressed dramatically in recent years. It was progressive to allow children with chronic pulmonary disease to access self-administered
-adrenergic inhalation treatments at home; it is progressive to allow parents to care for respirator-dependent infants and children at home. It was progressive to sustain life by providing inpatient intravenous hyperalimentation; it is progressive to sustain life by providing intermittent home hyperalimentation.