Division of Geriatric Medicine, Department of Family and Community Medicine, Jefferson Medical College/Thomas Jefferson University, Philadelphia, PA 19107, USA.
Cancer J. 2010 Nov-Dec;16(6):593-9. doi: 10.1097/PPO.0b013e3181feee9a.
The US health care system has become increasingly unsustainable, threatened by poor quality and spiraling costs. Many Americans are not receiving recommended preventive care, including cancer screening tests. Passage of the Affordable Care Act in March 2010 has the potential to reverse this course by increasing access to primary care providers, extending coverage and affordability of health insurance, and instituting proven quality measures. In order for health care reform to succeed, it will require a stronger primary care workforce, a new emphasis on patient-centered care, and payment incentives that reward quality over quantity. Innovations such as patient-centered medical homes, accountable care organizations, and improved quality reporting methods are central features of a redesigned health care delivery system and will ultimately change the face of cancer care in the United States.
美国的医疗保健系统已经变得越来越难以为继,其质量差且成本不断攀升。许多美国人没有得到推荐的预防保健,包括癌症筛查检测。2010 年 3 月《平价医疗法案》的通过有可能扭转这一局面,其方法是增加初级保健提供者的数量,扩大医疗保险的覆盖范围和可负担性,并实施经过验证的质量措施。为了使医疗改革取得成功,它将需要一支更强大的初级保健人员队伍,新的以患者为中心的护理重点,以及奖励质量而非数量的支付激励措施。以患者为中心的医疗之家、问责制医疗组织和改进的质量报告方法等创新是重新设计的医疗服务提供系统的核心特征,最终将改变美国癌症护理的面貌。