Новый мир здравоохранения

НЬЮ-ЙОРК – Традиционные системы здравоохранения переживают не лучшие времена. В странах ОЭСР дорогостоящие больницы и клиники являются преобладающим видом медицинских услуг и на них приходится 97% расходов США на здравоохранение. Эти системы с трудом справляются с такими проблемами, как ценовые ограничения, спрос со стороны общества на более высокое качество, а также завышенные ожидания.

Но существует иная система, широко практикуемая в более бедных странах, которые не могут себе позволить больницы западного образца. Центром этой системы является местная сеть здравоохранения. Нам нужны оба подхода, и нам нужно сделать так, чтобы они работали вместе. Действительно, растущий разрыв между обещаниями и реальностью здравоохранения создал – как в развитых, так и в развивающихся странах – пространство для новых игроков, которых больше волнует социальное поведение, нежели биология.

В своей основополагающей статье за 1996 год, опубликованной в журнале Harvard Business Review, У. Брайан Артур сформулировал важные различия между системой здравоохранения, основанной на планировании, иерархии и контроле, и системой, для которой характерны наблюдение, позиционирование и равноправный статус организаций. Систему первого типа, утверждал он, интересуют материалы, процессы и оптимизация. В центре ее внимания – доступность медицинского обслуживания, и обычно она со временем приносит все меньшую отдачу.

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