Perspectives From the Assistant Secretary for Preparedness and Response.

With each disaster, whether an infectious disease outbreak or a natural disaster, we are reminded of the importance of having a health care system that is prepared to efficiently and effectively care for large numbers of sick or injured people. We’ve been building our national preparedness system for well over a decade and have seen significant progress, particularly in hospital preparedness. But our populations are changing, as is our health care system. People are living longer, and with advances in technology and modern medical care, are more able to live independently. By 2050, the number of individuals using paid long-term care services in any setting (eg, at home, residential care such as assisted living, or skilled nursing facilities) will likely double to 27 million people. Care is increasingly shifting from the acute care hospital to ambulatory settings—surgicenters, urgent care centers, dialysis facilities, and ambulatory care sites are all more prevalent than a decade ago. The Affordable Care Act has accelerated transformation of the delivery system; new models of care are emerging throughout the country. Health care facilities are consolidating and integrating, both horizontally and vertically, and networks of care for any given individual involve multiple kinds of facilities and health care professionals.