MMWR Recomm Rep. 1995 Nov 17;44 RR-14:1-12.
The rapid, extensive changes in the health-care system in the United States provide public health agencies with new opportunities for prevention-oriented relationships with the private health-care system. Managed care organizations (MCOs) are rapidly becoming a major source of health care for the beneficiaries of both employer-funded care and of the publicly funded programs, Medicaid and Medicare. In addition, MCOs represent organized care systems that often focus their efforts on defined populations and are accountable for desired outcomes, including prevention activities. In recognition of the potential role of managed care in prevention, in January 1995, CDC formed a Managed Care Working Group to develop recommendations for CDC for fostering the incorporation of prevention practices into managed care. This report presents these recommendations and approaches for their implementation, as well as background and case examples.
美国医疗保健系统迅速而广泛的变革为公共卫生机构提供了与私营医疗保健系统建立以预防为导向关系的新机遇。管理式医疗组织(MCOs)正迅速成为雇主资助医疗保健的受益者以及公共资助项目(医疗补助和医疗保险)受益者的主要医疗保健来源。此外,管理式医疗组织代表着有组织的医疗保健系统,这些系统通常将工作重点放在特定人群上,并对包括预防活动在内的预期成果负责。认识到管理式医疗在预防方面的潜在作用,疾病控制与预防中心(CDC)于1995年1月成立了一个管理式医疗工作组,以制定相关建议,帮助疾病控制与预防中心促进将预防措施纳入管理式医疗。本报告介绍了这些建议及其实施方法,以及相关背景和案例。