Myers J E, Pelteret R
Department of Community Health, University of Cape Town.
S Afr Med J. 1995 May;85(5):347-51.
The origin and characteristics of academic health complexes (AHCs) are briefly outlined, along with pressures for restructuring of health services towards primary levels of care within the primary health care (PHC) approach. Weaknesses and strengths of the AHCs together with imbalances in the overall health system of which they are part are discussed. The Cape Town AHC is used to exemplify a suggested framework for analysis and development of other AHCs in South Africa and their transformation in accordance with the PHC approach. A method of service mapping is employed to aid an appreciation of the complexity of AHC services. Planning for potential transformation may be facilitated by conceptualising services in two dimensions, viz. level and location of care. Two important additional dimensions of service component linkage are integration across levels of care along a vertical axis, and integration across different services at primary level along a horizontal axis (comprehensiveness). AHCs, however skewly developed in terms of level and location of care, are complex combinations of services. They encompass all levels of care provided both within and beyond the walls of multiple health care facilities which are located both centrally and peripherally. AHC services are managed by health professionals in specific academic disciplines. They include PHC functions at the interface between primary and specialist care provision, and community health functions which are principally located outside the health care facilities in the community.(ABSTRACT TRUNCATED AT 250 WORDS)
本文简要概述了学术健康中心（AHCs）的起源和特点，以及在初级卫生保健（PHC）方法下，卫生服务向初级保健层面重组的压力。讨论了AHCs的优缺点，以及它们所属的整体卫生系统中的不平衡之处。开普敦AHC被用作一个示例框架，用于分析和发展南非的其他AHCs，并使其按照PHC方法进行转型。采用了一种服务映射方法，以帮助理解AHC服务的复杂性。通过在两个维度上对服务进行概念化，即护理水平和护理地点，可能有助于规划潜在的转型。服务组件联系的另外两个重要维度是，沿垂直轴跨护理级别整合，以及沿水平轴在初级层面跨不同服务整合（全面性）。然而，就护理水平和地点而言，AHCs的发展并不均衡，它们是复杂的服务组合。它们涵盖了位于中心和周边的多个医疗保健设施内部和外部所提供的所有护理级别。AHC服务由特定学术学科的卫生专业人员管理。它们包括初级保健与专科护理提供之间接口处的初级卫生保健功能，以及主要位于社区医疗保健设施之外的社区卫生功能。（摘要截选于250字）
