Corrigan J M, Thompson L M
Medical Directors Division, Group Health Association of America, Washington, DC 20036.
Acad Med. 1991 Nov;66(11):656-61. doi: 10.1097/00001888-199111000-00002.
Prepaid health care plans are likely to play an important part in the current transition from inpatient to ambulatory care training of physicians, because such plans enroll one in seven Americans. In the spring of 1990, the Group Health Association of America conducted a survey of health maintenance organizations (HMOs) to assess their level of involvement in graduate medical education (GME). A questionnaire was sent to the 481 HMOs in the United States that had been operational for at least four years; 58% responded. Fifteen percent (42 HMOs) indicated that they were directly involved in GME. The majority of these 42 indicated that they had an agreement with an academic medical center (AMC) or a teaching hospital to serve as an ambulatory care rotation site. About one-sixth of the 42 HMOs had been approved by the Accreditation Council for Graduate Medical Education to serve as a sponsoring organization. HMOs directly involved in GME were more likely to be staff model and group model HMOs; older plans with an enrollment of 50,000 or more; not-for-profit plans; and those owned or sponsored by an AMC.
预付式医疗保健计划很可能在当前医生从住院治疗培训向门诊治疗培训的转变过程中发挥重要作用，因为此类计划覆盖了七分之一的美国人。1990年春，美国团体健康协会对健康维护组织（HMO）进行了一项调查，以评估它们在毕业后医学教育（GME）中的参与程度。一份调查问卷被寄给了美国481家运营至少四年的健康维护组织；58%的组织进行了回复。15%（42家健康维护组织）表示它们直接参与毕业后医学教育。这42家组织中的大多数表示，它们与一家学术医疗中心（AMC）或教学医院达成了协议，作为门诊治疗轮转地点。这42家健康维护组织中约六分之一已获得毕业后医学教育认证委员会批准，可作为主办机构。直接参与毕业后医学教育的健康维护组织更有可能是员工型和团体型健康维护组织；参保人数达5万或更多的老计划；非营利性计划；以及由学术医疗中心拥有或赞助的组织。
