Organization design of integrated delivery systems.

摘要: Healthcare integrated delivery systems (IDSs) evolve through four observed stages of development, with each successive stage having greater levels interdependence among facilities and between physicians. The cottage industry is characterized by competition hospitals little interdependence. organizations in the next stage, horizontally systems, have pooled interdependencies, third vertically predominately sequential reciprocal physicians hospitals. In fourth community healthcare, their other providing services along continuum care. This characteristic level integration that must be addressed for system effectiveness. Greater require stronger organizational integrating mechanisms processes. "Integrative management" or "service-line one vehicle this integration. Although few empirical studies are available, article relates available conceptual literature to analyze interdependencies at IDS as well design characteristics address those interdependencies. It then examines organization Veterans Health Administration (VHA) terms evolution, suggests designs VHA's increased needs