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This volume reports on a study with two parts. The first part focuses on the patient's experience of acute hospital care and the second part examines the factors which influence the use of social work resources in providing services to acute hospital patients. The study explores the patients' views about the decision-making environment in an American acute care hospital. The context is the speedy treatment processes and early discharge of patients in the health care system under a managed care regime. Patients were asked about the treatment and discharge decisions made, the disagreements that occured and the problems they experienced while they were in the hospital and after discharge. The patients reported little difficulty with the decision-making environment, although it was evident that many experienced a high level of difficulty once discharged. The second part of the study focuses on the utilization of social work resources for these patients. It uses an activity-based framework to examine the cost drivers for social work intervention.