bulatory health care delivery is oriented toward the delivery of relatively sophisticated health care services on what is, essentially, an outpatient basis (Wolper, 1983; Burn, 1979). Ambulatory health care delivery centers provide a variety of health care services ranging from emergency room services to treatments which have traditionally required hospitalization including some types of surgery (Stein, 1986; Williams, 1983; Wolper, 1983). The two major reasons for the development of the ambulatory health care delivery centers were (1) costs of services and (2) quality of care, as care quality was associated with receiving acceptable care without admittance to a hospital (Stein, 1986). If alternative delivery systems do not perform in these two areas at superior levels to traditional hospitals, they fail in their promise. Outpatient surgery, thus, must ultimately be evaluated on the bases of cost effectiveness and quality of care (Stein, 1986).
Ambulatory health care centers were introduced in the 1970s to provide uncomplicated surgery and other care, which required hospital quality facilities, but did not require an overnight hospital stay (Williams, 1983). The services provided by many of these centers were rather quickly expanded to include emergency room services (Stein, 1986; Williams, 1983).
Ambulatory health care centers hold attractions for both patients and providers (Shannon, 1985b). "With health care costs rising and reimbursements becoming less, health care professionals are developing strategies for ambulatory care" (Wolper, 1983, p. 13). Ambulatory care centers are viewed as a means of (1) coping with restricted reimbursements by health care funders, (2) reducing the costs of services delivery, and (3) attracting health care consumers (Stein, 1986; Shannon, 1985b; Wolper, 1983). The attractions of ambulatory health care facilities for the health care consumer ar...