全球合作医疗:评估一家顶尖学术医疗中心的资源需求。
Global collaborative healthcare: assessing the resource requirements at a leading Academic Medical Center.
作者信息
Rosson Nicole J, Hassoun Heitham T
机构信息
Johns Hopkins Medicine International, Baltimore, MD, USA.
Department of Surgery, Johns Hopkins University School of Medicine, 1300 Thames Street, Suite 200, Baltimore, MD, 21231, USA.
出版信息
Global Health. 2017 Sep 20;13(1):76. doi: 10.1186/s12992-017-0298-5.
INTRODUCTION
Academic Medical Centers ("AMCs") have served as a hub of the United States ("US") health system and represented the state-of-the art in American health care for well over a century. Currently, the global healthcare market is both massive and expanding and is being altered by the unprecedented impact of technological advances and globalization. This provides AMCs a platform to enter into trans-national collaborative partnerships with healthcare organizations around the world, thus providing a means to deliver on its promise globally while also expanding and diversifying its resources. A number of leading US AMCs have engaged in global collaborative healthcare, employing different models based on services offered, global distribution, and inclination to assume risk. Engaging in these collaborations requires significant effort from across the health system, and an understanding of the resources required is paramount for effective delivery and to avoid overextension and diversion from the primary mission of these organizations. The goal of this paper is to discuss the role of US AMCs in this current global healthcare landscape and to also investigate our institutional faculty and staff resource requirements to support the operating model.
METHODOLOGY
We extracted and retrospectively analyzed data from the JHI Global Services database for a 3-year period (Jan, 2013-Dec, 2015) to determine total utilization (hours and full time equivalent (FTE)), utilization by profession, and clinical and non-clinical areas of expertise.
RESULTS
JHI utilized on average 21,940 h annually, or 10.55 FTEs of faculty and staff subject matter experts. The majority of the hours are for work performed by physician faculty members from 23 departments within the School of Medicine, representing 77% percent or on average 16,894 h annually. Clinical and allied health departments had an average annual utilization of 17,642 h or 7.8 FTEs, while non-clinical departments, schools and institutes averaged 4298 h or 1.9 FTEs, representing 80.4% and 19.6% respectively.
CONCLUSION
We found that significant human resources are required within a broad range of AMC subject matter expertise across multiple disciplines, and that with adequate forecasting AMCs can successfully engage in these collaborations while continuing to fulfill their core mission.
引言
学术医疗中心(“AMC”)一直是美国医疗体系的核心,在一个多世纪以来代表着美国医疗保健的最高水平。目前,全球医疗市场规模庞大且不断扩张,正受到技术进步和全球化带来的前所未有的影响而发生改变。这为学术医疗中心提供了一个平台,使其能够与世界各地的医疗保健组织建立跨国合作伙伴关系,从而提供一种在全球范围内兑现其承诺的方式,同时也拓展和丰富其资源。一些美国领先的学术医疗中心已参与全球合作医疗,根据提供的服务、全球分布以及承担风险的意愿采用不同模式。参与这些合作需要整个医疗体系付出巨大努力,而了解所需资源对于有效开展合作以及避免这些组织过度扩张和偏离其主要使命至关重要。本文的目的是讨论美国学术医疗中心在当前全球医疗格局中的作用,并研究我们机构的教职员工资源需求以支持运营模式。
方法
我们从JHI全球服务数据库中提取并回顾性分析了三年(2013年1月 - 2015年12月)的数据,以确定总利用率(小时数和全职等效人员(FTE))、按专业划分的利用率以及临床和非临床专业领域的情况。
结果
JHI每年平均使用21,940小时,即10.55个全职等效人员的教职员工和主题专家。大部分时间用于医学院23个部门的医师教职员工工作,占77%,即每年平均16,894小时。临床和相关健康部门的年平均利用率为17,642小时或7.8个全职等效人员,而非临床部门、学院和机构平均为4298小时或1.9个全职等效人员,分别占80.4%和19.6%。
结论
我们发现,在多个学科的广泛学术医疗中心主题专业领域内需要大量人力资源,并且通过充分的预测,学术医疗中心能够在继续履行其核心使命的同时成功参与这些合作。