A CONFERENCE ON THE 'CRISIS' OF ACADEMIC MEDICAL CENTERS

学术医疗中心将三个关键功能联系起来：培训医生和其他卫生专业人员;提供最先进的医疗保健;开展实验室和临床研究。这三种职能的联系加强了每一种职能。现在，许多资产管理公司报告了严重的财务困境。一些人声称，这种痛苦是从一个急剧恶化的金融环境，管理式医疗计划，减少医疗保险和医疗补助，减少了对住院服务的需求技术变革，增加了市场力量。其他人则认为，这些问题更多是资产管理公司自己造成的，原因是多年来相对不受限制的偿付导致了管理不善，以及为应对竞争日益激烈的环境和产能过剩而做出的不明智的商业决策。这次会议的目的是审查现有的证据，并听取与会者的第一手资料。由于数据收集的滞后性，从战壕里的人那里获得哪怕是粗略的情报也很重要。这些观点中哪一个更接近事实，应该对公共政策产生重要影响。这次会议的成果将采取两种形式：与会者直接交换意见，以及布鲁金斯将在会后不久发表的会议讨论文件和会议摘要。

Academic medical centers link three critical functions: training physicians and other health professionals; delivering state-of-the-art medical care; and Carrying out laboratory and clinical research. The linkage of these three functions has enhanced each. Now, many AMCs report severe financial distress. Some allege that this distress is from a dramatically worsened financial environment-increased market power by managed care plans, reduced reimbursements by Medicare and Medicaid, and technological change that has reduced demand for in-patient hospital services. Others claim that the problems are more of the AMCs' own making, arising from sloppy administration sanctioned by years of relatively unconstrained reimbursements and from unwise business decisions made in response to an increasingly competitive environment and excess capacity. The purpose of this conference is to review available evidence and hear first hand from participants. Because of lags in data collection, it is important to get even rough intelligence from those who are in the trenches. Which of these views is nearer to the truth should have an important bearing on public policy. The product of this conference will take two forms: the direct exchange of views by those who attend, and a conference discussion paper and conference summary that Brookings will publish shortly after the conference.