当变大变得太大时：医疗保健系统增长面临的挑战。
When Getting Bigger is Too Big: Challenges of Growing Health Care Systems.
机构信息
Atlanta VA Health Care System, Surgery and Perioperative Care, Decatur, GA.
Department of Surgery, Division of Surgical Oncology, Emory University School of Medicine, Atlanta, GA.
出版信息
Ann Surg. 2024 Aug 1;280(2):190-192. doi: 10.1097/SLA.0000000000006286. Epub 2024 Mar 28.
Abstract
Nearly two hospital mergers occur per week and the majority of hospitals are now part of a larger health system. As health systems continue to grow in size and geographic coverage, these changes could have unintended consequences for many different healthcare stakeholders. This surgical perspective outlines emerging challenges associated with the growth of health systems and potential strategies to monitor and mitigate the potential adverse impact of these ongoing changes.
摘要
每周几乎都会发生两起医院合并事件，而且现在大多数医院都属于更大的医疗体系的一部分。随着医疗体系的规模和地理覆盖范围不断扩大，这些变化可能会给许多不同的医疗保健利益相关者带来意想不到的后果。本文从外科角度概述了与医疗体系发展相关的新出现的挑战，以及监测和减轻这些持续变化潜在不利影响的潜在策略。
相似文献
1
When Getting Bigger is Too Big: Challenges of Growing Health Care Systems.当变大变得太大时：医疗保健系统增长面临的挑战。
Ann Surg. 2024 Aug 1;280(2):190-192. doi: 10.1097/SLA.0000000000006286. Epub 2024 Mar 28.
2
Health care consolidation. Big and getting bigger.医疗保健行业合并。规模越来越大，且仍在不断扩大。
Minn Med. 2011 Feb;94(2):12-4.
3
The health economics of insulin therapy: How do we address the rising demands, costs, inequalities and barriers to achieving optimal outcomes.胰岛素治疗的卫生经济学：我们如何应对不断增长的需求、成本、不平等现象以及实现最佳治疗效果的障碍。
Diabetes Obes Metab. 2025 Jul;27 Suppl 5(Suppl 5):24-35. doi: 10.1111/dom.16488. Epub 2025 Jun 4.
4
The big keep getting bigger. IPO viewed as positive in long-term-care arena.大者愈大。首次公开募股在长期护理领域被视为积极因素。
Mod Healthc. 2009 Sep 21;39(38):13.
5
Is healthcare in the United States too big to fail?美国的医疗保健体系是否规模太大而不能倒？
Int J Clin Pract. 2008 Dec;62(12):1827-30. doi: 10.1111/j.1742-1241.2008.01949.x.
6
Delivery arrangements for health systems in low-income countries: an overview of systematic reviews.低收入国家卫生系统的交付安排：系统评价综述
Cochrane Database Syst Rev. 2017 Sep 13;9(9):CD011083. doi: 10.1002/14651858.CD011083.pub2.
7
The HMO industry: the big keep getting bigger.健康维护组织（HMO）行业：大者恒大。
Med Econ. 1995 Nov 27;72(22):26.
8
Reducing health inequalities through general practice: a realist review and action framework.通过全科医疗减少健康不平等：一个现实主义综述和行动框架。
Health Soc Care Deliv Res. 2024 Mar;12(7):1-104. doi: 10.3310/YTWW7032.
9
Health care challenges created by substance abuse: the whole is definitely bigger than the sum of its parts.药物滥用所带来的医疗保健挑战：整体绝对大于其各部分之和。
Health Soc Work. 2002 Aug;27(3):162-5. doi: 10.1093/hsw/27.3.162.
10
Municipal health services provision by local governments: a systematic review of experiences in decentralized Sub-Saharan African countries.地方政府提供城市卫生服务：分散的撒哈拉以南非洲国家经验的系统评价。
Health Policy Plan. 2017 Nov 1;32(9):1327-1336. doi: 10.1093/heapol/czx082.
本文引用的文献
1
Patterns in Physician Burnout in a Stable-Linked Cohort.稳定关联队列中医生倦怠的模式。
JAMA Netw Open. 2023 Oct 2;6(10):e2336745. doi: 10.1001/jamanetworkopen.2023.36745.
2
Organization and Performance of US Health Systems.美国卫生系统的组织和绩效。
JAMA. 2023 Jan 24;329(4):325-335. doi: 10.1001/jama.2022.24032.
3
Comparison of the Financial and Operational Characteristics of For-Profit and Nonprofit Hospitals Receiving Federal Graduate Medical Education Payments, 2011-2020.2011 - 2020年接受联邦毕业后医学教育支付的营利性和非营利性医院的财务与运营特征比较
JAMA. 2023 Jan 10;329(2):173-175. doi: 10.1001/jama.2022.21460.
4
Quality and Safety Outcomes of a Hospital Merger Following a Full Integration at a Safety Net Hospital.一家医疗保障机构医院在全面整合后合并的质量和安全结果。
JAMA Netw Open. 2022 Jan 4;5(1):e2142382. doi: 10.1001/jamanetworkopen.2021.42382.
5
Prevalence of Discrimination, Abuse, and Harassment in Emergency Medicine Residency Training in the US.美国急诊医学住院医师培训中歧视、虐待和骚扰的发生率。
JAMA Netw Open. 2021 Aug 2;4(8):e2121706. doi: 10.1001/jamanetworkopen.2021.21706.
6
Changes in Quality of Care after Hospital Mergers and Acquisitions.医院并购后的医疗质量变化。
N Engl J Med. 2020 Jan 2;382(1):51-59. doi: 10.1056/NEJMsa1901383.
7
An Empirical National Assessment of the Learning Environment and Factors Associated With Program Culture.实证性国家学习环境评估及与项目文化相关因素分析。
Ann Surg. 2019 Oct;270(4):585-592. doi: 10.1097/SLA.0000000000003545.
8
US Public Perceptions About Cancer Care Provided by Smaller Hospitals Associated With Large Hospitals Recognized for Specializing in Cancer Care.美国公众对与大型癌症专科医院有合作关系的小型医院提供的癌症护理的看法。
JAMA Oncol. 2018 Jul 1;4(7):1008-1009. doi: 10.1001/jamaoncol.2018.1400.
9
Health Care Market Concentration Trends In The United States: Evidence And Policy Responses.美国医疗保健市场集中趋势：证据与政策应对。
Health Aff (Millwood). 2017 Sep 1;36(9):1530-1538. doi: 10.1377/hlthaff.2017.0556.
10
Adequacy of Outpatient Specialty Care Access in Marketplace Plans Under the Affordable Care Act.《平价医疗法案》下医保市场计划中门诊专科护理可及性的充足性
JAMA. 2015 Oct 27;314(16):1749-50. doi: 10.1001/jama.2015.9375.
Zotero 插件