Caplan P A, Lefkowitz B, Spector L
Bureau of Health Care Delivery and Assistance, Health Resources and Services Administration, Rockville, MD.
Henry Ford Hosp Med J. 1992;40(1-2):50-5.
In response to poor coordination among health and social service providers, health care consortia have emerged in many areas of the United States. Consortia link multiple providers in a common structure to create comprehensive systems of care. They can be formally structured or informal combinations of providers that engage in coordination but otherwise do not comprise an independent organization. The functions most common among all types of consortia are shared services and service coordination; however, a number of consortia also operate outreach/education programs. Consortia represent an innovative response to the need both for vertical integration--case management of all levels of care--and horizontal integration to prevent duplication among primary care providers. We outline the history of consortia in which federally-funded community health centers have participated. We also suggest an analytical framework for the various types of consortia; discuss lessons learned about building and maintaining consortia; and provide preliminary outcome data.
针对卫生与社会服务提供者之间协调不力的问题，美国许多地区出现了医疗保健联盟。联盟将多个提供者联系在一个共同的结构中，以创建综合护理系统。它们可以是正式组建的，也可以是提供者之间的非正式组合，这些组合进行协调，但除此之外并不构成一个独立的组织。所有类型的联盟中最常见的功能是共享服务和服务协调；然而，一些联盟也开展外展/教育项目。联盟是对纵向整合（各级护理的病例管理）和横向整合（以防止初级保健提供者之间的重复）需求的一种创新回应。我们概述了联邦资助的社区卫生中心所参与的联盟的历史。我们还提出了一个针对各类联盟的分析框架；讨论了在建立和维持联盟方面吸取的经验教训；并提供了初步的成果数据。
