This volume explores issues connected with quality, planning of services, access concerns especially as linked with providers of care, health care institutions, and patients. Changes have continued to occur with the field but led by overall marketplace trends. Papers are presented in four parts covering changing models of healthcare. In Part I topics come from a broad perspective to include: development of newer models of care, more traditional areas such as the medical profession and the patient or the hospital and the patient, the changes that alternative medicine brings to issues of quality of care and access and planning, and of citizen participation in health planning. Part II deals with federal programs such as Medicare and Medicaid and access and quality issues within those programs. Part III covers the challenges of planning for long-term care needs and services. And Part IV explores other aspects of the changing health care delivery system: changes in nursing, midwifery, and rural health care and provides linkages to quality, access, and planning issues. creatively about issues of quality of care, access to care, and planning for services.