Nash D B, Veloski J J
Department of Health Policy and Clinical Outcomes, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA.
West J Med. 1998 May;168(5):319-27.
Medical schools, teaching hospitals, and managed care organizations have a vested interest in shaping the knowledge, skills, and attitudes of the next generation of physicians who must adapt to significant changes in the financing and delivery of health care. This article summarizes the rationale for educational partnerships between managed care and academic medicine based on a review of three decades of well-documented experimentation in the literature. Discussed are some of the most important characteristics of the successful partnerships being forged in the current healthcare environment based on new kinds of relationships between faculty and non-university clinician educators. What had been referred to in previous decades as the "teaching-HMO" is now being complemented by community-based links between academic health centers and managed care plans. Several public and private sources have been generous in providing venture capital to support many of these innovations. However, their continued operation will depend on models for health care networks that can identify and manage the revenue and costs associated with the missions of education, clinical services, and research.
医学院校、教学医院和管理式医疗组织在塑造下一代医生的知识、技能和态度方面有着既得利益，这些医生必须适应医疗保健融资和提供方式的重大变化。本文基于对文献中三十年来有充分记录的实验的回顾，总结了管理式医疗与学术医学之间建立教育伙伴关系的基本原理。文中讨论了在当前医疗环境中基于教师与非大学临床教育工作者之间的新型关系而形成的成功伙伴关系的一些最重要特征。前几十年被称为“教学型健康维护组织”的模式，如今正由学术健康中心与管理式医疗计划之间基于社区的联系加以补充。一些公共和私人来源慷慨地提供风险资本以支持其中许多创新。然而，它们的持续运营将取决于医疗保健网络模式，该模式能够识别和管理与教育、临床服务和研究使命相关的收入和成本。
