Creating accountable care organizations: The extended hospital medical staff

被引:253
作者
Fisher, Elliott S. [1 ]
Staiger, Douglas O.
Bynum, Julie P. W.
Gottlieb, Daniel J.
机构
[1] Dartmouth Coll Sch Med, Hanover, NH USA
[2] Ctr Evaluat Clin Sci, Hanover, NH USA
[3] White River Junct VA Hosp, Vet Affairs Outcomes Grp, White River Jct, VT USA
[4] Natl Bur Econ Res, Cambridge, MA 02138 USA
关键词
CHRONIC DISEASE; UNITED-STATES; QUALITY; COHORTS;
D O I
10.1377/hlthaff.26.1.w44
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Many current policies and approaches to performance measurement and payment reform focus on individual providers; they risk reinforcing the fragmented care and lack of coordination experienced by patients with serious illness. In this paper we show that Medicare beneficiaries receive most of their care from relatively coherent local delivery systems comprising physicians and the hospitals where they work or admit their patients. Efforts to create accountable care organizations at this level-the extended hospital medical staff-deserve consideration as a potential means of improving the quality and lowering the cost of care.
引用
收藏
页码:W44 / W57
页数:14
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