Weitekamp M R, Ziegenfuss J T
Milton S. Hershey Medical Center, Pennsylvania State University College of Medicine, Hershey 17033-2390.
Acad Med. 1995 Jan;70(1 Suppl):S47-53. doi: 10.1097/00001888-199501000-00025.
Academic health centers (AHCs) and health maintenance organizations (HMOs) often hold each other at arm's length because of fundamental organizational differences. AHCs view HMOs as too intrusive in the clinical management of patients and too concerned with the financial bottom line. HMOs view AHCs as organizationally fragmented and expensive in providing health care services. AHCs must expand their primary care networks and reassess their mission and public accountability in training a more balanced physician workforce. HMOs are growing rapidly and need well-trained generalist physicians to support that growth. This paper uses an organizational systems model in examining AHCs and HMOs to identify common needs, mutual interests, areas for potential collaboration, and bridging strategies. These include health care systems development, professional education, information management systems, and health services research. As the financing and delivery of health care continue to change and to become more integrated, both organizations have much to gain from collaboration.
学术医疗中心（AHCs）和健康维护组织（HMOs）常常因根本的组织差异而保持距离。学术医疗中心认为健康维护组织在患者临床管理方面过于侵扰，且过于关注财务底线。健康维护组织则认为学术医疗中心组织架构分散，提供医疗服务成本高昂。学术医疗中心必须扩大其初级保健网络，并重新评估其在培养更加均衡的医师队伍方面的使命和公共问责制。健康维护组织正在迅速发展，需要训练有素的全科医生来支持这种发展。本文运用组织系统模型来审视学术医疗中心和健康维护组织，以确定共同需求、共同利益、潜在合作领域及衔接策略。这些包括医疗系统发展、专业教育、信息管理系统和卫生服务研究。随着医疗保健的融资和提供方式不断变化并日益整合，两个组织都能从合作中获益良多。
