Ford D E, Kissick J F
ETHIX Northwest, Seattle, WA, USA.
Aust Health Rev. 1995;18(1):61-81.
The paper discusses the practical structural aspects required for implementing 'managed competition' reform policy which are often overlooked by policy designers of change. Namely, without fundamentally new organisational structures to mediate among the parties of interest, the policies for change will not be sufficient to meet the future. The paper discusses in some detail an organisational mediating structure called the Community Equity Model which organises care at the local neighbourhood or community level using the community as actual fundsholder. This puts the critical stakeholders in a practical mutual ownership relationship by making allocation, services and resource accountability a local act. The paper briefly discusses the organisational and information technology for this type of health care system redesign.
本文讨论了实施“管理式竞争”改革政策所需的实际结构方面，而这些方面往往被改革政策设计者所忽视。也就是说，如果没有全新的组织结构在利益相关方之间进行协调，改革政策将不足以应对未来的需求。本文详细讨论了一种名为“社区公平模式”的组织协调结构，该结构以社区为实际资金持有者，在当地邻里或社区层面组织医疗服务。通过将分配、服务和资源问责制变为地方行为，这使关键利益相关者形成了切实的共同所有权关系。本文简要讨论了这种类型的医疗保健系统重新设计所需的组织架构和信息技术。
