With the growing trend of Managed Care slowly seeping into our Health Care system, there is still a large population who is uninsured and vulnerable. The escalating cost of health care was slowed down by Managed Care but the uninsured population seems to be growing. This was the main driving force behind the formation of Academic/Community Partnerships across the country.
The Health Resources and Services Administration (HRSA) has an Academic/Community
Partnership initiative. HRSA is an organization that promotes the expansion
of academic/community partnerships. Its mission is to improve the health
of all communities and eliminate disparity across communities.
Websites:
The American International Health Alliance
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The AIHA partnership is a program that establishes and manages partnerships among U.S. health care providers, U.S. academic institutions, and their counterparts abroad. Currently there are 42 AIHA partnerships operating in 9 countries of Central and Eastern Europe and 11 republics of the former Soviet Union. The partnerships focus on solutions to health care delivery problems in the host country that are economically and technologically sustainable.
This program is unique in that the partnerships are formed across seas.
The schools in the U.S. try to improve the health of the over seas communities
that are poverty stricken. The site contained a vast amount of information
about all the partnerships in the program. It was easy to navigate through
and very worth while to read.
Northern Virginia Community (NOVA) College Partnership
The Mobile Nurse- Managed Health Center Program (MNMHC)
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In 1993, a community assessment of northern Virginia was performed by the Health Department which identified a number of recurrent health problems such as lack of assess to immunizations, inadequate prenatal care, spousal abuse, high teen pregnancy, and various other problems. Division leaders of NOVA believed that a restructuring of the educational process of nursing students was necessary to fit the demands of the changing health care market. With the use of a van, they also made it a mobile health community outreach program to combat the issue of access.
The site contained information on the various partners and affiliations
of their network. It was user friendly and had many links to other network
sites. This site was unique because it was the first network I found that
had a mobile unit.
Alaska Public Health Improvement Process Partnership (APHIP)
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APHIP has a strong public health initiative. Its mission is to assess Alaska’s public health system, identify, and develop appropriate public health infrastructure for the 21st Century, and to create a performance measurement system for the new and improved public health system.
This partnership stands out because it addresses the need to develop
a public health infrastructure, which I believe is lacking in many states.
Without a proper network, providers of health care will always be behind
the needs of the community. It also is planning to develop a performance
measurement system, which is important to assess the effectiveness of the
program after implementation. This site is rich with information about
its network and was fairly easy to navigate through.
Center for Family and Community Health Partnership
Rating ***
The Center for Family and Community Health addresses health issues such as AIDS, cancer (breast, cervical, prostate), alcohol and tobacco abuse, and the geographic distribution of health related problems. The Center’s primary mission is to improve the health of communities, establish links among the University, government, and community-based organizations, and train their students in prevention and public health practice.
This partnership is unique in that it tries to empower its students
with the knowledge and skills to improve the welfare of the community.
The site was fairly easy to navigate through. There was not a vast amount
of links to other sites.
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Some of the health issues addressed by PPH are access to health care, tobacco abuse, substance abuse, poor nutrition, and diabetes. The main objectives of the PPH partnership are to develop and coordinate health interventions and prevention strategies, conduct community health assessments, and serve as a resource and link between the community and businesses involved in planning and implementing health related programs.
The one thing I like about this partnership is that it conducts community
health assessments. This is a very important step in trying to improve
the community because you must find out what are the concerns that are
troubling the community in order to address them. The site was easy to
navigate through and it contained various links to other sites that are
useful.
Source: JAMA. 282(11):1067-72, 1999 Sep 15.
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This article examines how health plans competing in a managed care system
may face serious financial consequences if they are disproportionately
selected by enrollees with expensive health conditions. This was an observational
study done to find out if academic medical centers are at high risk for
adverse selection. The prevalence of state specified high cost chronic
conditions was generally higher for academic managed care organizations
compared with other managed care organizations. This article was useful
because it showed that cherry picking by managed care organizations does
occur and adverse selection may present serious financial risk for Academic
Managed Care participating in managed care.
Source: JAMA.283 (1): 99-104, 2000 Jan. 5.
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Due to competition and market forces in health care, concern has arisen
that the classic principle of serving disadvantaged persons may not be
fulfilled due to pressures from managed care. This report describes the
Reach Out program, which was developed to recruit leaders from among practicing
physicians to organize projects to care for the uninsured and underserved.
This report was useful because it pointed out that programs such as Reach
Out can not solve the national problem of access to health care but it
can have a small and important impact on the number of uninsured and underserved
persons without access to health care.
Source: Academic Medicine. 74(11): 1193-201, 1999 Nov.
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This report addresses the question of what are the institutional strategies
used by academic health centers and other academic institutions to support
and maintain the infrastructure that promotes health services research.
This report is useful because it found out that there are a wide variety
of models of successful health services research centers with very different
missions, organizational and interdisciplinary configurations, research
and policy objectives, and collaborative relationships. The author concluded
that further research is needed to specify the infrastructure elements
that foster effective and productive health services research in academic
health centers and other university settings.
Source: Academic Medicine. 74(8 Suppl):S21-6, 1999 Aug.
Rating **
This article sheds some light on the issue of how academic health centers
must maintain a balance between their core mission and their responsiveness
to social trends. The author believes that if academic health centers are
too close in accommodating to such trends, it can endanger their core mission
as has occurred with regard to Managed Care. I never thought to apply this
theory to academic health centers until I read this report. The author
concluded that a task for the future is to discern how academic health
centers can be responsive to social needs without being totally subservient
to societal desires.
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In this article, the author reviews the growth of managed care and its
transforming effect on academic medical centers. He goes on to mention
that academic medical centers should not only attend to the organization
and financing of the clinical enterprise and the enhancement of biomedical
research capacity, but also address how it can live up to the responsibility
of improving the health of the public. This report was useful because it
contained a variety of statistics about the uninsured and their care.
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