Academic Health Centers Leading Change in the 21st Century (2004) / Chapter Skim
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1 Introduction
1 Introduction
Pages 19-29
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Rather than starting with the AHCs themselves, this committee began with the developments and trends occurring in the external environment, focusing on the roles and activities 1 The term health is used broadly here to include both health and health care. 2 Patient care includes care for all people, including the poor and uninsured and other vulnerable groups.
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That task force defined an AHC as the medical school and its affiliated or owned clinical facilities (The Commonwealth Fund Task Force on Academic Health Centers, 2002)
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. During the same period, the number of medical school graduates grew by about 120 percent, the number of basic science faculty grew by more than 330 percent, and the number of clinical faculty grew by more than 1,000 percent (The Commonwealth Fund Task Force on Academic Health Centers, 1997b, 2002)
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. · Account for almost one-third of national health-related research and development funds (The Commonwealth Fund Task Force on Academic Health Centers, 1999)
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First, all AHCs have a medical school, at a minimum. For some AHCs, that is the only professional school they sponsor; however, the majority of medical schools are located on campuses that have multiple health professions schools and also train nurses, public health or allied health professionals.
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For most AHCs, revenues from patient care activities subsidize activities in research and education (The Commonwealth Fund Task Force on Academic Health Centers, 1997b)
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25 patients Roles for populations AHC Education Care and Research is is care the care care provides care provided Care Delivery What provided How provided Who the Where is people system Needs preferences System the expectations offer Public and Capabilities Services need; and What can AHCs. of Roles are and Changing and changing is advances care costs The burden of concerns are uninsured of 1-1 Environmental Changes People Disease· Demographics· labor Technology advancing Biomedical· Information· technology Organization financing evolving Increasing· Quality· Size· population FIGURE
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The pressures on care delivery ultimately affect the AHC roles in education, research, and patient care. The care provided by AHCs also changes, and as that happens, health professionals must be prepared differently, and research inevitably seeks to answer new questions.
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vice president, University of Virginia; and Stephen Joel Trachtenberg, president, George Washington University. Bill Gradison, vice chair of The Commonwealth Fund Task Force on Academic Health Centers, provided his perspective on the policy issues facing AHCs in the future.
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The work of this committee was funded through the generous support of The Rockefeller Brothers Fund, with additional support from The Commonwealth Fund, the Institute of Medicine, and the National Research Council. ORGANIZATION OF THE REPORT As noted earlier, this report starts not with the AHCs themselves, but with the trends and developments in health care that will affect AHCs in the years ahead.
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The goal of this committee was to synthesize across these major issues and develop a broad future vision and direction for the roles of AHCs in the 21st century. The challenges are complex; thus it is inevitable that some issues will remain unaddressed in any single report.
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