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首页> 外文期刊>The American Journal of Surgery >Functional alignment, not structural integration, of medical schools and teaching hospitals is associated with high performance in academic health centers.
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Functional alignment, not structural integration, of medical schools and teaching hospitals is associated with high performance in academic health centers.

机译：医学院校和教学医院的功能一致性而不是结构整合与学术保健中心的高性能相关。

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BACKGROUND: Debates continue regarding optimal structures for governance and administration between medical schools and their teaching hospitals. METHODS: Structural integration (SI) for 85 academic health centers was characterized as high (single leader or fiduciary) or low (multiple leaders or fiduciaries). Functional alignment (FA) was estimated from questionnaire responses by teaching hospitals' chief executive officers, and an index was calculated quantifying organizational collaboration across several functional areas. SI and FA were examined for their association with global performance measures in teaching, research, clinical care, finance, and efficiency. RESULTS: AHCs with high SI had significantly higher FA, though overlap between high-SI and low-SI institutions was considerable. SI was not significantly associated with any performance measure. In contrast, FA was significantly associated with higher performance in teaching, research, and finance but not clinical care and efficiency. CONCLUSIONS: FA between medical schools and their primary teaching hospitals more strongly predicts academic health centers' performance than does SI. As demands for greater collaboration increase under health reform, emphasis should be placed on increasing FA rather than SI.
机译：背景：关于医学院校及其教学医院之间的治理和管理的最佳结构的争论仍在继续。方法：85个学术卫生中心的结构整合（SI）被定为高（单位领导者或受托人）或低（多位领导者或受托人）。通过教学医院的首席执行官从问卷调查中估计功能一致性（FA），并计算出一个指数来量化跨多个功能领域的组织协作。检验了SI和FA与教学，研究，临床护理，财务和效率方面的全球绩效指标的关联。结果：尽管高SI和低SI机构之间存在大量重叠，但具有高SI的AHC的FA明显较高。 SI与任何绩效指标均无显着关联。相反，FA与教学，研究和财务方面的较高绩效显着相关，而与临床护理和效率无关。结论：医学院和其主要教学医院之间的FA比SI更能强烈地预测学术保健中心的表现。随着卫生改革对加强合作的需求不断增加，应将重点放在增加FA而不是SI上。

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