Get Academic health centers: leading change in the 21st century PDF

By Institute of Medicine, Board on Health Care Services, Committee on the Roles of Academic Health Centers in the 21st Century, Linda T. Kohn

ISBN-10: 0309088933

ISBN-13: 9780309088930

Policymakers might want to create incentives to help innovation and alter in AHCs. In reaction, AHCs might want to bring up the extent of co-ordination and integration throughout their roles and the person corporations that include the AHC in the event that they are to effectively adopt the kinds of alterations wanted. "Academic well-being facilities" lays out a technique to begin a continuous and long term strategy of swap.

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Third, the passage of Medicare and Medicaid in 1965 ensured revenues for a significant portion of patient care services that had historically been provided as charity care to patients who also helped students learn (Ludmerer, 1999). Significantly, the Medicare program also included support for graduate medical education (Korn, 1996). The result of these three events is that AHCs found a steady revenue stream for their primary activities and were able to grow their enterprise during the decades that followed (Korn, 1996).

These changing needs, expectations, and capabilities have their most direct impact on care delivery—what care is provided, how it is provided, by whom, and where. For example, services that used to be provided only in a hospital are now offered in ambulatory settings. Likewise, services that may have been provided only by a physician may now be provided by nurse practitioners or nurse anesthetists. The pressures on care delivery ultimately affect the AHC roles in education, research, and patient care.

The importance of these trends is that disparities in health remain for different population groups. For example, chronic conditions appear to differ in their prevalence among racial groups and low-income and disadvantaged populations (Foundation for Accountability and The Robert Wood Johnson Foundation, 2002; Wolf, 2001). These general demographic shifts have at least three major implications. First, the growing diversity of the population will result in increased variation in people’s expectations of the health care system, creating demands for greater cultural sensitivity and competency in the system’s design and from its practitioners.

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Academic health centers: leading change in the 21st century by Institute of Medicine, Board on Health Care Services, Committee on the Roles of Academic Health Centers in the 21st Century, Linda T. Kohn


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