Calman Neil S, Golub Maxine, Shuman Saskia
Department of Family Medicine and Community Health, Mount Sinai School of Medicine, The Institute for Family Health, New York, NY, USA.
Mt Sinai J Med. 2012 Sep-Oct;79(5):527-34. doi: 10.1002/msj.21335.
Skyrocketing health care costs are burdening our people and our economy, yet health care indicators show how little we are achieving with the money we spend. Federal and state governments, along with public-health experts and policymakers, are proposing a host of new initiatives to find solutions. The Patient Protection and Affordable Care Act is designed to address both the quality and accessibility of health care, while reducing its cost. This article provides an overview of models supported by the Affordable Care Act that address one or more goals of the "Triple Aim": better health care for individuals, better health outcomes in the community, and lower health care costs. The models described below rely on the core principles of primary care: comprehensive, coordinated and continuous primary care; preventive care; and the sophisticated implementation of health information technology designed to promote communication between health care providers, enhance coordination of care, minimize duplication of services, and permit reporting on quality. These models will support better health care and reduced costs for people who access health care services but will not address health outcomes in the community at large. Health care professionals, working in concert with community-based organizations and advocates, must also address conditions that influence health in the broadest sense to truly improve the health of our communities and reduce health care costs.
医疗保健成本的飙升正给我们的人民和经济带来沉重负担，然而医疗保健指标却显示出我们在医疗支出上收获寥寥。联邦和州政府，连同公共卫生专家及政策制定者，正在提出一系列新举措来寻求解决方案。《患者保护与平价医疗法案》旨在解决医疗保健的质量和可及性问题，同时降低其成本。本文概述了《平价医疗法案》所支持的一些模式，这些模式旨在实现“三重目标”中的一个或多个目标：为个人提供更好的医疗保健、在社区取得更好的健康成果以及降低医疗保健成本。以下所述模式依赖于初级保健的核心原则：全面、协调且持续的初级保健；预防性保健；以及复杂的健康信息技术实施，旨在促进医疗保健提供者之间的沟通、加强医疗协调、减少服务重复并允许进行质量报告。这些模式将为获得医疗保健服务的人们提供更好的医疗保健并降低成本，但不会解决整个社区的健康成果问题。医疗保健专业人员必须与社区组织及倡导者协同合作，还必须解决从最广泛意义上影响健康的各种状况，以真正改善我们社区的健康状况并降低医疗保健成本。
