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首页> 外文期刊>Israel Journal of Health Policy Research >Better together: a community- hospital integrative model of healthcare as a practical solution for providing excellence in endocrinology care in an era of limited resources
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Better together: a community- hospital integrative model of healthcare as a practical solution for providing excellence in endocrinology care in an era of limited resources

机译：更好的融合：在资源有限的时代，社区医院一体化医疗模式作为一种实用的解决方案，可提供出色的内分泌护理

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Background The demand for endocrinology services is growing worldwide, particularly among minority and underserved populations, mainly due to the rapid global increase of diabetes. The medical education of endocrinologists is a resource consuming process and is mainly hospital-based. Yet, given the chronic nature of endocrine morbidity, the greatest demand for endocrinology services is in the community. However, an isolated endocrinologist cannot cope with the rapid changes in the field. Limited funding of hospital facilities does not allow for the establishment of a freestanding endocrine-center; thus, the Community- Hospital Integrative Model of Healthcare (Co-HIMH) was developed and implemented in an Israeli government hospital and is presented as an approach for achieving excellence in endocrinology care. Aim To describe the design, function and challenges of the Co-HIMH. Model description Originally, three pillars: 1) the hospital unit as a regional expertise resource, 2) Co-HIMH endocrine providers participating in both community and hospital services, and 3) integrated information flow between health-care providers, supported the integration between hospital and community networks. Results The community and hospital endocrine human resources were increased to create attainable and accessible endocrine services in the community and hospital. Collaborative interaction between healthcare providers increased both continuity of care and efficient patient navigation. Endocrine hospital referrals for specialized procedures have grown. Within this area of low socioeconomic status, continued medical endocrine education was conducted introducing state-of-the-art treatments. The essence of these achievements was maintained by continuous training of fellows. During the years that the Co-HIMH operated, it certified 14 % of all endocrinology fellows in Israel. Unresolved issues regarding employee rights and formalization of the Co-HIMH status are significant challenges. Conclusions In the era of limited resources and increased healthcare demand, creative infrastructures are required. This article provides a successful example of a preliminary model and proposes future needed modifications.
机译：背景技术世界范围内对内分泌服务的需求正在增长，特别是在少数族裔和服务水平较低的人群中，这主要是由于全球糖尿病的快速增长。内分泌科医生的医学教育是一个资源消耗过程，主要是基于医院的。然而，考虑到内分泌发病的长期性，对内分泌服务的最大需求是社区。但是，孤立的内分泌专家无法应对该领域的快速变化。医院设施的资金有限，无法建立独立的内分泌中心;因此，在以色列政府医院中开发并实施了社区医院综合医疗保健模式（Co-HIMH），并提出了一种实现卓越内分泌护理的方法。目的描述协同HIMH的设计，功能和挑战。模型说明最初有三个支柱：1）作为区域专业知识资源的医院部门; 2）参与社区和医院服务的共同HIMH内分泌提供者; 3）卫生保健提供者之间的整合信息流，支持医院之间的整合和社区网络。结果增加了社区和医院的内分泌人力资源，以在社区和医院中创建可访问的内分泌服务。医疗保健提供者之间的协作互动既增加了护理的连续性，又提高了患者的导航效率。内分泌医院对专门程序的转诊越来越多。在这个社会经济地位低下的地区，进行了持续的医学内分泌教育，引入了最先进的治疗方法。这些成就的实质是通过不断培训同伴而保持的。在联合HIMH运作的几年中，它认证了以色列所有内分泌学研究人员的14％。与雇员权利有关的未解决问题以及共同HIMH身份的正式化是重大挑战。结论在资源有限和医疗需求增长的时代，需要创新的基础设施。本文提供了一个初步模型的成功示例，并提出了未来所需的修改。

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