Shortell S M, Gillies R R, Anderson D A, Mitchell J B, Morgan K L
J.L. Kellogg Graduate School of Management, Northwestern University, Evanston, IL 60208.
Hosp Health Serv Adm. 1993 Winter;38(4):447-66.
An organized delivery system is a network of organizations that provides or arranges to provide a coordinated continuum of services to a defined population and is willing to be held clinically and fiscally accountable for the outcomes and the health status of the population served. As such, organized delivery systems are at the center of efforts to implement health care reform. Based on analysis of 12 such systems, this article identifies key characteristics that influence what organized delivery systems are able to do, outlines the major obstacles or challenges to achieving greater levels of integration, and then discusses a number of approaches for effectively dealing with these obstacles.
一个有组织的医疗服务提供系统是一个组织网络,它为特定人群提供或安排提供一系列协调一致的服务,并愿意对所服务人群的结果和健康状况承担临床和财务责任。因此,有组织的医疗服务提供系统是实施医疗改革努力的核心。基于对12个这样的系统的分析,本文确定了影响有组织的医疗服务提供系统能力的关键特征,概述了实现更高程度整合的主要障碍或挑战,然后讨论了一些有效应对这些障碍的方法。