Reform is probably the most frequently used term when discussing healt
h care systems. The literature is broad and general, with topics rangi
ng From reasons fur carrying out reform, through discussion and the me
aning of the reform, to discussions of methods for reform in developin
g countries. Interest has been centered more on the definition of cont
ent and less on the processes of implementation. Implications in terms
of changes in the requirements of health facilities and human resourc
es have been only superficially addressed. This paper presents a conce
ptual framework to discuss the main issues involved in reform of the h
ealth care systems and the shifts in needs of human resources. Assessm
ent of the ways in which reform affects the medical labor market requi
re the application of a conceptual framework that enables us to focus
more on process than content. In the organizational change literature,
both in theory and practice, human resources have been found critical
for the institutionalization of organizational change. They are also
critical for assessing health care reform. Copyright (C) 1996 Publishe
d by Elsevier Science Ltd