decisions about the health of the nation into the next century. While markets will adjust to supply and demand conditions over the long-term, it is possible for policy to influence these demand and supply conditions. Incentives to invest in new technologies, for example, may result in an increased demand for new technical skills by nurses or, possibly, a substitute for those skills. Policies can range from laissez faire (do nothing) to active intervention in demand and supply conditions such as education, research, regulation, taxation, and information. Then it is important to ask the question what the effect will likely be on the quality of patient care and on the nursing staff providing the care. This then leads to the question of appropriate policy responses.

Finally, the committee's work on several of the issues it was asked to examine was impeded by the spotty availability of timely, reliable, and valid data with uniform definitions and classification. Thus, committee members expressed a common concern about the lack of sufficient data to address the questions they were charged to address. Insights gleaned from public testimony, site visits, and similar activities cumulatively added to the understanding of today's health care system, nursing services, and the quality of patient care. These issues will continue to represent major concerns in the years ahead. Adequate funding is essential for research and evaluation to help ensure that efforts to constrain the costs of nursing do not, in fact, result in serious consequences for the health of our citizens.



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