Improving the effectiveness of health care and public health: A multiscale complex systems analysis
Improving the effectiveness of health care and public health: A multiscale complex systems analysis
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DOI：
10.2105/ajph.2005.064444
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发表时间：
2006-03-01
影响因子：
12.7
通讯作者：
Bar-Yam, Y
中科院分区：
文献类型：
--
作者：
Bar-Yam, Y
美国医疗保健系统正在努力解决庞大、简单（低信息）的资金流动与复杂（高信息）的个体患者治疗之间的不匹配问题。实施成本控制和工业效率的努力适用于重复性任务，但不适用于高度复杂的任务，导致护理质量差。多尺度复杂系统分析表明，缓解这一结构性问题的重要一步是将两种不同类型的任务的责任分离：个体患者的医疗保健和预防/人群健康。这些不同的任务需要不同性质的组织结构。目前将护理提供者和组织同时用于这两种目的会导致组织过程中的妥协，从而对卫生保健组织为单个患者提供服务的能力产生不利影响。
The US health care system is struggling with a mismatch between the large, simple (low-information) financial flow and the complex (high-information) treatment of individual patients. Efforts to implement cost controls and industrial efficiency that are appropriate for repetitive tasks but not high-complexity tasks lead to poor quality of care.Multiscale complex systems analysis suggests that an important step toward relieving this structural problem is a separation of responsibility for 2 distinct types of tasks: medical care of individual patients and prevention/population health. These distinct tasks require qualitatively different organizational structures. The current use of care providers an organizations for both purposes leads to compromises in organizational process that adversely affect the ability of health care organizations to provide either individual patients.