Thompson R S
Group Health Cooperative of Puget Sound, Seattle, USA.
Milbank Q. 1996;74(4):469-509.
Over the last 20 years, HMOs have begun to develop population- and evidence-based systems for their clinical prevention services. Because of their integrated information systems and staff communications, HMOs are uniquely positioned to help physicians to identify systematically the primary risk factors or secondary prevention needs of individuals and to provide specific referral or screening services and off-site telephone counseling services to effect seamless, organized intervention. A review of the relevant published literature was combined with the empirical experience of the Group Health Cooperative of Puget Sound in Seattle to illustrate the approach of one large staff-model HMO. Challenges for the future include creating clinical information systems, establishing adequate funding, instituting practitioner incentives, training practitioners for behavioral change, and developing and integrating patient self-care.
在过去20年里，健康维护组织（HMOs）已开始为其临床预防服务开发基于人群和证据的系统。由于其综合信息系统和员工沟通，健康维护组织具有独特的地位，能够帮助医生系统地识别个体的主要风险因素或二级预防需求，并提供特定的转诊或筛查服务以及非现场电话咨询服务，以实现无缝、有组织的干预。对相关已发表文献的回顾，结合了西雅图普吉特海湾集团健康合作社的经验，以说明一家大型员工模式健康维护组织的方法。未来的挑战包括创建临床信息系统、建立充足的资金、制定从业者激励措施、培训从业者以改变行为，以及开发和整合患者自我护理。
