Staffing and training aspects of hospital management: some issues for research.

Julio Frenk, M.D., M.P.H., Ph.D. is Director-General, National Institute of Public Health of Mexico; Enrique Ruelas, M.D., M.P.A., M.Sc. is Dean, School of Public Health of Mexico, National Institute of Public Health; and Avedis Donabedian, M.D., M.P.H. is Nathan Sinai Distinguished Professor of Public Health, Department of Health Services Management and Policy, School of Public Health, The University of Michigan, Ann Arbor. Throughout the world, hospitals have come to epitomize modem medical care. For many years, a major health policy concern was to provide communities with enough hospitals. More recently, the focus of concern has shifted to what is now considered the overly dominant role of the hospital within the health system. In developed nations there