Peniston R L
J Natl Med Assoc. 1989 Jun;81(6):637-42.
The widespread prevalence of cardiovascular diseases does not spare poor or heterogeneous urban communities. Since the inflationary spiral of health care costs has continued unabated, it will require intentional and creative maneuvers to preserve and develop new or existing programs which do not deny ready access to quality care for all classes. It is the opinion of the author that the present health care system promotes indifference on the part of health care providers and the purveyors of technology. The traditions of altrusim in medicine should be extended to health systems planning at the institutional and regional level. Although preventive medicine is a vital public issue, it is not the only priority agenda for populations experiencing already existing cardiovascular derangements. The private practice paradigm is an obsolete and inflation promoting system for the delivery of complex tertiary care. Modern cardiovascular diagnostics and therapeutics require efficient and economical team efforts. If the few remaining historically black medical centers are to properly serve a heterogeneous base, innovation and reorganization are inevitable.
心血管疾病的广泛流行并未放过贫困或成分复杂的城市社区。由于医疗保健成本的通胀螺旋持续不减，要维护和发展新的或现有的项目，且不让所有阶层都难以获得优质医疗服务，就需要有针对性的创新举措。作者认为，当前的医疗保健系统助长了医疗服务提供者和技术供应商的冷漠态度。医学中的利他主义传统应延伸至机构和地区层面的卫生系统规划。尽管预防医学是一个至关重要的公共问题，但对于已经患有心血管疾病紊乱的人群来说，它并非唯一的优先议程。私人执业模式是提供复杂三级护理的过时且助长通胀的体系。现代心血管诊断和治疗需要高效且经济的团队协作。如果仅存的少数历史悠久的黑人医疗中心要妥善服务成分复杂的人群，创新和重组将不可避免。
