Health care in big cities--the McGill experience.

Big cities encounter problems which are peculiar to them: population mix, housing conditions, social structure, infrastructure including transport, etc, which manifest in hospitals. From the beginning of the 20th century, big cities have been served by many providers of hospital care. Common to most cities is the change in the principles and methods of care, e.g. home care, and the notion that traditional hospital services are no longer the only answer to the needs of the population of large cities. Over the last decade, plans and projects have been devised to address the problems of excessive bed capacity, insufficient and excessive specialised units and difficulties in administration of payment systems.