Department of National Prevention Programs at the Federal Office of Public Health, Schwarztorstrasse 96, Bern, 3003 Switzerland; University of Zürich, Institute for Primary Care, Pestalozzistrasse 24, Zürich, 8091 Switzerland.
Center for Primary Care, Harvard Medical School, Boston, MA, USA; Institute for Healthcare Improvement, Cambridge, MA, 02139 USA; Cambridge Health Alliance, USA.
Healthc (Amst). 2016 Dec;4(4):291-297. doi: 10.1016/j.hjdsi.2016.06.007. Epub 2016 Sep 28.
Innovations in payment are encouraging clinical-community partnerships that address health determinants. However, little is known about how healthcare systems transform and partner to improve population health. We synthesized views of population health experts from nine organizations and illustrated the resulting model using examples from four health systems. The transformation requires a foundation of primary care, connectors and integrators that span the boundaries, sharing of goals among participants, aligned funding and incentives, and a supporting infrastructure, all leading to a virtuous cycle of collaboration. Policies are needed that will provide funding and incentives to encourage spread beyond early adopter organizations.
支付方式的创新正在鼓励针对健康决定因素的临床-社区伙伴关系。然而,对于医疗保健系统如何转变并合作以改善人口健康,人们知之甚少。我们综合了来自九个组织的人口健康专家的观点,并使用四个卫生系统的例子来说明由此产生的模式。这种转变需要以初级保健为基础,建立连接者和整合者,跨越界限,参与者之间有共同的目标,资金和激励措施相协调,并提供支持性基础设施,所有这些都将导致合作的良性循环。需要制定政策,提供资金和激励措施,鼓励这种模式在早期采用者组织之外得到推广。