Michener J Lloyd, Champagne Mary T, Yaggy Duncan, Yaggy Susan D, Krause Katrina M
Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27710, USA.
Acad Med. 2005 Jan;80(1):57-61. doi: 10.1097/00001888-200501000-00014.
Academic medical centers (AMCs) have traditionally provided primary care for low-income and other underserved populations. However, they have had difficulty developing lasting partnerships with other organizations serving the same populations. This article describes an exception to the rule, in which an academic division was created at Duke University Medical Center to develop effective collaborations with health care and social service providers in Durham, North Carolina, including both public agencies and private organizations. Together, the division and its partners have created and operate programs that improve health outcomes and access to care for those at risk. These programs share a number of characteristics: they are designed to meet the needs of the patient, not the provider; they are based in the community, not in the AMC; they bring services to people's homes, schools, and neighborhoods; they are multidisciplinary, combining health, social, and even mental health services; and, once established, they are revenue-generating and can be made self-supporting when grant funding ends. These programs are also innovative. They are designed to model and test new ways of organizing and delivering care. Preliminary indications suggest that they also strengthen the AMC's relationships with the surrounding community.
学术医疗中心（AMCs）传统上一直为低收入及其他服务欠缺人群提供初级医疗服务。然而，它们在与服务相同人群的其他组织建立持久合作关系方面存在困难。本文描述了一个例外情况，即在杜克大学医学中心设立了一个学术部门，以与北卡罗来纳州达勒姆的医疗保健和社会服务提供者（包括公共机构和私人组织）开展有效的合作。该部门及其合作伙伴共同创建并运营了一些项目，这些项目改善了健康状况，并为有风险的人群提供了医疗服务。这些项目具有一些共同特点：它们旨在满足患者而非提供者的需求；它们以社区为基础，而非设在学术医疗中心内；它们将服务送到人们的家中、学校和社区；它们是多学科的，融合了医疗、社会甚至心理健康服务；而且，一旦建立起来，它们就能产生收入，在赠款资金结束后可以实现自我维持。这些项目也具有创新性。它们旨在塑造和测试组织及提供医疗服务的新方式。初步迹象表明，它们还加强了学术医疗中心与周边社区的关系。
