The challenge of attribution: responsibility for population health in the context of accountable care.
The challenge of attribution: responsibility for population health in the context of accountable care.
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DOI：
10.1016/j.amepre.2012.03.012
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发表时间：
2012-06-01
影响因子：
5.5
通讯作者：
Summers, Cynthia
中科院分区：
文献类型：
--
作者：
Gourevitch, Marc N;Cannell, Thomas;Summers, Cynthia
负责任的护理组织的三个目标之一是改善人口健康。这将需要负责任的护理组织弥合临床护理和公共卫生之间的分歧。但是，卫生保健提供机构和公共卫生机构是否有相同的“人口”概念呢？我们不这么认为：提供服务的系统根据接受护理的人来定义人口，而公共卫生机构通常根据地理位置来衡量健康状况。这造成了归属问题，特别是在大城市中心，那里的多个医疗保健提供者经常为任何给定的社区提供服务。我们建议进行潜在的创新，使城市负责任的护理组织能够接受责任和奖励，以显著改善人口健康。
One of the 3 goals for accountable care organizations is to improve population health. This will require that accountable care organizations bridge the schism between clinical care and public health. But do health care delivery organizations and public health agencies share a concept of “population”? We think not: whereas delivery systems define populations in terms of persons receiving care, public health agencies typically measure health on the basis of geography. This creates an attribution problem, particularly in large urban centers, where multiple health care providers often serve any given neighborhood. We suggest potential innovations that could allow urban accountable care organizations to accept accountability, and rewards, for measurably improving population health.