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This book examines the implementation of the prospective payment system (PPS) in the US for Medicare hospital reimbursement, which started in 1983. The authors discuss the impact of the PPS on health care provision and conclude that rather than improving conditions for the elderly in their transition from hospital to community and decreasing escalating health costs, the PPS has restructured the system with the result that the greater financial burden is placed on informal caregivers, community and home health care agencies and the elderly themselves.