Bosch S J, Merino R, Daniels M S, Fischer E P, Rosenthal M
J Community Health. 1979 Summer;4(4):302-11. doi: 10.1007/BF01319024.
There is today both a need and an opportunity to develop and test a variety of models--organizational and financial--for improving the delivery of health care services. This article describes the structure and functioning of one such model and highlights the organizational problems expected to arise during its implementation. The proposed health plan is intended to facilitate the access of Medicaid-eligible, inner-city families to already available health services. The central hypothesis is that in low-income urban areas the elementary schools offer an organizational focus for the development of a health plan. As a prepaid, community-based model, this plan is designed to address the issues of accessibility, equity, accountability, continuity of care, and consumer participation, primarily through the development of a coordinating agency, the health plan office (HPO), which assures the linking of consumers and providers of health care. Adapted from the Kaiser-Permanente model, the HPO also assumes responsibility for marketing, enrollment, coordination of services, consumer advocacy, and quality surveillance.
如今，开发和测试各种模式——组织模式和财务模式——以改善医疗服务的提供既有需求也有机会。本文描述了其中一种模式的结构和运作，并突出了在其实施过程中预计会出现的组织问题。拟议的健康计划旨在促进符合医疗补助条件的市中心家庭获得现有的医疗服务。核心假设是，在低收入城市地区，小学为健康计划的制定提供了一个组织焦点。作为一种预付的、基于社区的模式，该计划旨在主要通过建立一个协调机构——健康计划办公室（HPO）来解决可及性、公平性、问责制、医疗连续性和消费者参与等问题，该办公室确保医疗服务消费者与提供者之间的联系。HPO借鉴了凯撒医疗集团（Kaiser-Permanente）的模式，还负责营销、注册、服务协调、消费者权益倡导和质量监督。
