在理论和实践中独立的实践协会. 从经验中吸取经验教训
1Bayside Pediatrics, Oakland, CA, USA.
JAMA
|June 28, 1995
概括
独立实践协会 (IPA) 承诺在管理护理中提供医生自主权,但往往优先考虑组织权威. 平衡这些对医疗行业的未来至关重要.
科学领域:
- 健康管理健康管理
- 医学经济学 医学经济学
- 组织行为 组织行为
背景情况:
- 管理护理给医疗行业带来了重大的组织挑战.
- 旧金山东湾区作为先进管理护理实施的案例研究.
研究的目的:
- 检查医生管理护理所带来的组织问题.
- 评估独立实践协会 (IPA) 模型的理论承诺和实际应用.
主要方法:
- 分析旧金山东湾区管理护理环境中的组织结构.
- 对IPA模型与综合健康计划和直接守门员模型进行比较评估.
主要成果:
- 独立实践协会 (IPA) 模式在理论上是保持医生实践自治的有希望的.
- 在实践中,东湾地区的大型IPA往往倾向于赞成组织权威,而不是治理,会员和管理方面的医生自主权.
- 在保持实践自主性和IPA组织权威之间存在着紧张关系.
结论:
- 在管理护理中,平衡医生自主权和IPA权威是关键的挑战.
- 需要具体的政策建议来弥补这种不平衡.
- 医疗领导者的积极行动至关重要,以防止医院和保险公司等传统机构的控制.
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