Drevdahl Denize
Nursing Program, University of Washington, Tacoma 98402-3100, USA.
Public Health Nurs. 2002 May-Jun;19(3):161-9. doi: 10.1046/j.0737-1209.2002.19313.x.
Public health is increasingly joining forces with managed care, yet the effect of this partnership on public health nursing (PHN) has received little scrutiny. The feasibility and consequences of a public-private alliance raise questions about whether the mission of public health can be sustained in a managed care system and whether managed care's approaches to health care are conducive to providing population-oriented care. Expanding the links between PHN and private organizations is both problematic and promising. Managed care organizations have much to offer, including coordination of services and comprehensive care. However, they may also restrict coverage and create bureaucratic obstacles to obtaining services. The growth of for-profit health care corporations evokes questions about ways in which concern for communities and populations collide with stockholder interests. The task for PHN is to recognize and to dialogue about these complexities so that nursing's voice can be heard as solutions to these dilemmas are created.
公共卫生领域正日益与管理式医疗携手合作，然而这种合作关系对公共卫生护理（PHN）的影响却很少受到审视。公私联盟的可行性及后果引发了诸多问题，比如公共卫生的使命在管理式医疗体系中能否得以维持，以及管理式医疗的医疗保健方式是否有利于提供以人群为导向的护理。扩大公共卫生护理与私人组织之间的联系既存在问题，也充满希望。管理式医疗组织能提供很多东西，包括服务协调和综合护理。然而，它们也可能限制保险范围，并在获取服务方面制造官僚主义障碍。营利性医疗保健公司的发展引发了关于社区和人群关怀与股东利益相冲突方式的问题。公共卫生护理的任务是认识到这些复杂性并就此展开对话，以便在创造解决这些困境的方案时能听到护理界的声音。
