Academic health centers: leading change in the 21st century by Institute of Medicine, Board on Health Care Services,

By Institute of Medicine, Board on Health Care Services, Committee on the Roles of Academic Health Centers in the 21st Century, Linda T. Kohn

Policymakers might want to create incentives to aid innovation and alter in AHCs. In reaction, AHCs might want to elevate the extent of co-ordination and integration throughout their roles and the person organisations that include the AHC in the event that they are to effectively adopt the categories of alterations wanted. "Academic future health facilities" lays out a technique to begin a continuous and long term technique of swap.

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2003). 2 trillion or 16 percent of gross domestic product (Blumenthal, 2001). The growth in spending on health care is being reflected in premium costs for health insurance and increased out-of-pocket spending by patients. 3 percent in the prior year (Kaiser Family Foundation and Health Research and Educational Trust, 2001). 2 percent for larger firms. This increase in premiums is the greatest since 1992, and the trend is expected to continue. In 2003, for example, the California Public Employees’ Retirement System is facing increases in excess of 20 percent (Consumer Reports, 2002).

The tables he provided to the committee during its deliberations are included in Appendix A. Copyright © National Academy of Sciences. All rights reserved. html 28 ACADEMIC HEALTH CENTERS The committee also received an analysis conducted by Bruce Steinwald3 on alternatives for financing the activities of AHCs. His analysis formed the basis for Chapter 6 of this report. Finally, the committee was able to take advantage of information produced by The Commonwealth Task Force on Academic Health Centers.

Just over half of AHCs are publicly sponsored organizations; the remainder are private (Osterweis, 1999). Most AHCs are located in urban areas, although a few are rural. AHCs vary in the emphasis placed on each of their roles (see Appendix A). The greatest variation among AHCs is in the size of their research endeavors, in particular, the amount of support they receive from NIH. AHCs also vary in how they combine their roles. One analysis examining the amount of overlap among the top 100 hospitals engaged in teaching, the top 100 hospitals engaged in research, and the top 100 hospitals serving low-income patients revealed that only 25 AHCs rank Copyright © National Academy of Sciences.

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