Academic Health Centers Leading Change in the 21st Century (2004) / Chapter Skim
Currently Skimming:
2 Forces for Change
2 Forces for Change
Pages 30-44
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 30... ...
AHCs face particularly intense scrutiny and high expectations for meeting these new and evolving demands because of their special roles in education, patient care, and research. As this chapter reveals, these trends necessitate a reexamination of how AHCs carry out those roles to meet the public's health needs.
|
From page 31... ...
Chronic conditions are now the leading cause of illness, disability, and death in the United States, affecting almost half of the U.S. population and accounting for the majority of health care resources used (Hoffman et al., 1996; Foundation for Accountability and The Robert Wood Johnson Foundation, 2002)
|
From page 32... ...
Such understanding is needed at the individual patient level, but stronger interventions are needed at the population level as well to achieve broader change. Other Demographic Shifts The population of the United States is slowly aging in both absolute and relative terms.
|
From page 33... ...
, with implications for funding levels for Social Security and Medicare. The shift in demographics will also result in an increasingly tight labor market that can be expected to exert upward pressure on the wages of health workers, increasing demand to improve productivity in health care (Davis, 2002)
|
From page 34... ...
. Public health agencies are unable to share critical information quickly or pool data for analysis; treatment advances take too long to reach people, while unproven procedures are widely used; variation in practice patterns means that the costs and outcomes of care that people experience depend on where they live rather than scientific evidence; and both patients and clinicians face conflicting and poor-quality information.
|
From page 35... ...
Information technology is also expected to support enhanced surveillance so that disease outbreaks and bioterrorism can be detected quickly, and to create the opportunity to link public health and acute care delivery systems for improved response (Salinksy, 2002; Agency for Healthcare Research and Quality, 2002)
|
From page 36... ...
Clinical imaging is another promising area on the long list of biomedical possibilities. Developments in established fields, such as light and electron microscopy, and in new fields, such as scanning probe and magnetic resonance imaging microscopy, combine advances in hardware and computer algorithms to improve resolution and structural detail at the molecular and cellular levels (Office of Extramural Research, 2002)
|
From page 37... ...
Between 2000 and 2001, monthly premiums for employer-sponsored health insurance rose 11 percent, up from an average increase of 8.3 percent in the prior year (Kaiser Family Foundation and Health Research and Educational Trust, 2001)
|
From page 38... ...
. About 24 percent of all small firms and 13 percent of all large firms say they are very or somewhat likely to switch to a defined contribution plan over the next 5 years, compared with 20 percent and 16 percent, respectively, in the prior year (Kaiser Family Foundation and Health Research and Educational Trust, 2001)
|
From page 39... ...
One study estimates that quality problems such as overuse, misuse, and waste represent 30 percent of the direct costs of health care, or about $390 billion in 2000, excluding the indirect costs of lost workdays (Midwest Business Group on Health et al., 2002)
|
From page 40... ...
views the paradigm shift in health care as the movement from a biomedical model to a model that employs a broader view of health. The biomedical model is characterized by a focus on the acute care episode, the individual patient and his or her disease, and the goal of curing the disease.
|
From page 41... ...
the participation of all health care delivery organizations in a community or region in efforts to advance health, with contributions by AHCs to an improved understanding of population health through their research and education; (5) the measurement of performance by all health care organizations and accountability within the organization and to the community for resource use; and (6)
|
From page 42... ...
. About 90 percent of total AHC revenues is derived from clinical care; these revenues are used to cross-subsidize activities in research and education (The Commonwealth Fund Task Force on Academic Health Centers, 1997b)
|
From page 43... ...
, which are estimated to represent 15 to 20 percent of a project's total expenses (The Commonwealth Fund Task Force on Academic Health Centers, 1999; Weissman, et al., 1999)
|
From page 44... ...
Thus, the whole health care system is influenced by the pace at which AHCs are able to adapt their roles to a changing set of demands and expectations placed on the nation's health care system. Certainly, the overall health system is affected by other factors in addition to the activities of AHCs, but the roles performed by AHCs are a major influence in building the health system's overall capacity to adapt to the changes that will affect health care in the coming decades.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.