overview the primary care development corporation概述了初级卫生保健发展有限公司

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1、NationalHealthReform:ThePrimaryCareImperativesandStrategiesforAddressingThemPresentationtotheCenterforFamilyandCommunityMedicineColumbiaUniversityMedicalCenterRondaKotelchuck,ExecutiveDirectorPrimaryCareDevelopmentCorporationThursday,January21,2010Introduction:TheProblemsHealthCareReform:T

2、hePrimaryCareAgendaPrimaryCareExpansionPrimaryCareTransformationA.PracticeRedesignB.HealthInformationTechnologyLessonsandReflectionsOverview1.Introduction:TheProblemsRisingCostandtheRoleofChronicIllnessTherisingcostofhealthcareisunsustainableCostisdrivenbytherisingrateofchronicillness.It:Isthe

3、singlelargestcauseofmorbidityandmortalityIsthesinglelargestdriverofcost(accountsfor75%ofallhealthexpenses)HastheheaviestimpactonlowincomecommunitiesWillgrowmoresevereaspopulationagesChronicillnessisoverwhelminglypreventableorprimarycaremanageable.Preventionandmanagementrequirearobustmodelofpri

4、marycare.PrimaryCareToday:InsufficientandPoorlyOrganizedPrimarycarecapacityisinsufficient:60millionAmericanslackaccesstoprimarycareHalfofprimarycaredoctorsplantoreduceorendtheirpracticesOnly20percentofmedicalstudentsplantopracticeprimarycareU.S.isexpectedtoneed46,000primarycaredoctorsby2025Mo

5、stprimarycareispoorlyorganizedandstillpracticedinanoutdatedmode.Itis:ReactiveandepisodicSubjecttolongwaitsanddelaysUncoordinatedInefficientStudy:USLagsBehindotherCountriesinKeyPrimaryCareIndicatorsCommonwealthFundstudyof11countries(November2009)–Australia,Canada,France,Germany,Italy,Netherlan

6、ds,NewZealand,Norway,Sweden,UK,USUS10thoutof11inuseofElectronicMedicalRecords(46%-aheadofCanada)10thof11inuseofcareteams(aheadofFrance)Lastinaccesstoafter-hourscareLeastlikelytohavefinancialincentivesforclinicaloutcomes2.HealthCareReformThePrimaryCareAgendaHealthReformWillDrivetheNeedforExpand

7、edPrimaryCareCapacityExpandedinsurancecoveragewillputmillionsofnewcustomersintothehealthcaremarketPhysicianshortageswillincreaseby25%andworkloadby29%overthenext15years.TheMassachusettsexperience:97%coveragePatientswaitmonthsforappointme