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整合的概念化与衡量:卫生系统整合研究的结果

Conceptualizing and measuring integration: findings from the health systems integration study.

作者信息

Gillies R R, Shortell S M, Anderson D A, Mitchell J B, Morgan K L

机构信息

J.L. Kellogg Graduate School of Management, Northwestern University, Evanston, IL 60208.

出版信息

Hosp Health Serv Adm. 1993 Winter;38(4):467-89.

Abstract

Given the pressures for health care reform, interest in the concept of integrated or organized delivery systems as a means to offer more coordinated cost-effective care is growing. This article has two primary objectives: (1) to clarify the different types of integration associated with the notion of an organized delivery system, and (2) to share the results from an ongoing study of 12 organized delivery systems. The findings indicate a moderate level of integration overall, particularly in the areas of culture, financial planning, and strategic planning. The study found that corporate staff respondents perceive their systems to be more integrated and effective than do operating unit managers, and that some functional integration areas are positively associated with both physician-system and clinical integration that, in turn, are positively related to each other. Overall, perceived integration was found to be positively associated with perceived effectiveness.

摘要

鉴于医疗保健改革的压力,人们对整合式或有组织的医疗服务体系概念的兴趣与日俱增,认为这是提供更具协调性且成本效益更高的医疗服务的一种方式。本文有两个主要目标:(1)阐明与有组织的医疗服务体系概念相关的不同类型的整合,以及(2)分享一项正在进行的对12个有组织的医疗服务体系的研究结果。研究结果表明总体整合程度适中,尤其是在文化、财务规划和战略规划领域。该研究发现,企业员工受访者认为他们所在的体系比运营部门经理所认为的更具整合性和有效性,并且一些功能整合领域与医师-体系整合和临床整合均呈正相关,而医师-体系整合和临床整合又相互呈正相关。总体而言,感知到的整合与感知到的有效性呈正相关。

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