A Revisionist View of the Integrated Academic Health Center

Academic Medicine

Volumn 79, Issue 2, 2004, Pages 171-178

  Rodin, Judith ^a  

^a UNIVERSITY OF PENNSYLVANIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

FINANCIAL MANAGEMENT; HEALTH CARE POLICY; HEALTH CARE QUALITY; HEALTH CARE SYSTEM; HEALTH CENTER; LEADERSHIP; MEDICAL EDUCATION; MEDICAL RESEARCH; PRIORITY JOURNAL; REVIEW; UNITED STATES; ARTICLE; HUMAN; INTEGRATED HEALTH CARE SYSTEM; NONBIOLOGICAL MODEL; ORGANIZATION; ORGANIZATION AND MANAGEMENT; UNIVERSITY HOSPITAL;

ACADEMIC MEDICAL CENTERS; DELIVERY OF HEALTH CARE, INTEGRATED; HUMANS; MODELS, ORGANIZATIONAL; ORGANIZATIONAL INNOVATION; PENNSYLVANIA;

EID: 1542378727     PISSN: 10402446     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001888-200402000-00014     Document Type: Review

References (45)

1. Task Force on Academic Health Centers, Commonwealth Fund. Envisioning the Future of Academic Health Centers: Final Report of the Commonwealth Fund's Task Force on Academic Health Centers 〈 http://www.cmwf.org/publist/publist2.asp?CategoryID=1〉. Accessed 3 October 2003. New York City: The Commonwealth Fund, February 2003.
2. Robinson LE (ed). Association of American Medical Colleges (AAMC) Data Book, Statistical Information Related to Medical Schools and Teaching Hospitals. Washington, DC: Association of American Medical Colleges, 2001:66-71.
3. The University of Pennsylvania Health System (UPHS) comprised four owned hospitals (Hospital of the University of Pennsylvania, Presbyterian Medical Center, Pennsylvania Hospital, and Phoenixville Hospital.) The health system also included two multispecialty medical facilities: Penn Medicine at Radnor and Penn Medicine at Limerick; a primary care provider network, Clinical Care Associates; a subspecialty network, Franklin Specialty Physicians; as well as home health care, hospice, and long-term care. UPHS, distinguished by its historical significance-the first hospital (1751), the first medical school (1765), and the first university teaching hospital (1874)-marked another first in 1993 when it created the first fully integrated academic health system.
4. Rodin J. The state of the university, 1999-2000. Almanac. 1999 November 23/30;46(13):4-5.
5. Rx for health system: keep hospitals and take a 501(c)(3). Pennsylvania Gazette. 2001 March/April;99(4):14.
6. Health system's bond-rating slips a notch. Pennsylvania Gazette. 1998 September/October;97(1):18.
7. Rodin J. The health system's road to recovery: improving financial performance and preserving medical excellence. Pennsylvania Gazette. 2000 January/February;98(3):10.
8. Strong medicine: health system cuts 1,700 after record deficit. Pennsylvania Gazette. 2000 January/February;98(3):13-6.
9. Iglehart JK. Academic medical centers enter the market: the case of Philadelphia. N Engl J Med. 1995 October 12;333(15):1019-23.
10. Shea J. Birth of a system. Penn Health Magazine. 1995 May;1(1):4-7.
11. Gathering momentum for the next century: our long-range strategic plan: 1994-99. PennPulse. 1994 May/June;(36):1-23.
12. U.S. News and World Report. 2002 April 15;132(12):70.
13. U.S. News and World Report. 2003 April 14;134(12):76.
14. U.S. News and World Report. 2002 July 22;133(3):45.
15. U.S. News and World Report. 2003 July 28-August 4;135(3):47.
16. National Institutes of Health (NIH) awards to medical schools by rank, FY1996 and NIH awards to medical schools by rank, FY2002. (Bethesda, MD: National Institutes of Health, Office of Extramural Research.) NIH award data for FY1996-2002 is available at: 〈 http://grants1.nih.gov/grants/award/award.htm#trends〉. Accessed 3 October 2003.
17. The Abramson vision: family-centered cancer care and research. Almanac. 1997 December 16/23;44(16):28. See also 〈http://oncolink.upenn.edu〉. Accessed 3 October 2003.
18. For an overview of the University of Pennsylvania School of Medicine's Curriculum 2000, see 〈http://www.med.upenn.edu/admiss/curriculum〉. Accessed 3 October 2003.
19. Morrison G. University of Pennsylvania School of Medicine. Acad Med. 2000;75(9 suppl):S316-S318.
20. Ledger, M. A. Heirs of Dr. Morgan. Penn Medicine. 1997 Fall;11(1):16-25.
21. Shea J. A blueprint for a new curriculum. Penn Health Magazine. 1996 May;2(5):4-6.
22. The region has six medical schools, over 100 hospitals, including numerous teaching hospitals, and 25,000 physicians. In the region, Penn Medicine competes not only with Temple, Jefferson, Hahnemann-MCP (Drexel), and Tenet hospitals, among others, but also with Johns Hopkins and the New York City medical centers, including Memorial Sloan-Kettering, New York University, and Columbia-Presbyterian.
23. Penn Medicine was the first academic health system to win the Excellence in Health Care Risk Management Award for the effectiveness of its physician-designed Health and Disease Management Program. (See 〈http://www.uphs.upenn.edu/news〉. Accessed 3 October 2003.) It is also the recipient of the 1998 Ernest A. Codman Award from the Joint Commission on Accreditation of Healthcare Organizations for its effective use of an innovative health and disease management program to increase patient satisfaction and improve clinical outcomes. (See 〈 http://www.uphs.upenn.edu/news/News_Releases/oct98/codman.shtml〉. Accessed 3 October 2003.)
24. Penn Medicine was the first academic health system to win the Excellence in Health Care Risk Management Award for the effectiveness of its physician-designed Health and Disease Management Program. (See 〈http://www.uphs.upenn.edu/news〉. Accessed 3 October 2003.) It is also the recipient of the 1998 Ernest A. Codman Award from the Joint Commission on Accreditation of Healthcare Organizations for its effective use of an innovative health and disease management program to increase patient satisfaction and improve clinical outcomes. (See 〈 http://www.uphs.upenn.edu/news/News_Releases/oct98/codman.shtml〉. Accessed 3 October 2003.)
25. Major expansion to Penn Medicine's facilities during this period included the construction of three biological research buildings, costing approximately $208 million, as well as many other upgrades and renovations of existing structures.
26. Van Der Werf M. Changing economics of health care are devastating academic medical centers. Chron High Educ. 1999 May;21:A38.
27. Mangan KS. Teaching hospitals face loss of $4.2-billion over 5 years in Medicare cuts Chron High Educ Daily Rep. 1 October 2002. 〈http://chronicle.com/daily/2002/10/2002100104n.htm〉. Accessed 3 October 2003.
28. Faculty Senate: Special Meeting Coverage. Almanac. 2000 March 7;46(24):2.
29. Wangensteen OH, Wangensteen SD. The Rise of Surgery: From Empiric Craft to Scientific Discipline. Minneapolis: University of Minnesota Press, 1978;255-68.
30. Flexner A. The Proper Basis of Medical Education. In: Medical Education in the United States and Canada. A Report to the Carnegie Foundation for the Advancement of Teaching. Bulletin No. Four. Boston: D. B. Updike, Merrymount Press, 1910;20-7.
31. In addition to the School of Medicine, the University of Pennsylvania consists of the Annenberg School for Communication, School of Arts and Sciences, School of Dental Medicine, School of Design, Graduate School of Edu cation, School of Engineering and Applied Science, Law School, School of Nursing, School of Social Work, School of Veterinary Medicine, and the Wharton School.
32. Franklin B. Proposals Relating to the Education of Youth in Pennsylvania. Philadelphia: B. Franklin, 1749.
33. As the Commonwealth Fund report on AHCs documents, the conduct of mission-related activities (i.e., educating medical students, performing clinical research, and providing indigent care) in AHCs and other health care institutions is often associated with extra expenses that are not compensated in competitive health care markets, and in FY1998, mission-related costs averaged 28% of total costs per case treated in AHC hospitals. This is two and a half times the 11% attributable to mission-related costs in other teaching hospitals. See also Table 1.
34. Rodin J. No better place than Penn. Almanac. 2001 January 9;47(17):1.
35. Kohn LT, Corrigan JM, Donaldson MS (eds.). Committee on Quality of Health Care in America, Institute of Medicine. To Err is Human: Building a Safer Health System. Washington DC: National Academies Press, 2000.
36. Campbell EG, et al. Understanding the relationship between market competition and students' ratings of the managed care content of their undergraduate medical education. Acad Med. 2001;76:51-9. The Commonwealth Fund Task Force on Academic Health Centers (1997, 1999). Committee on Quality of Health Care in America, Institute of Medicine. Crossing the Quality Chasm. Washington DC: National Academies Press, 2001:48.
37. Campbell EG, et al. Understanding the relationship between market competition and students' ratings of the managed care content of their undergraduate medical education. Acad Med. 2001;76:51-9. The Commonwealth Fund Task Force on Academic Health Centers (1997, 1999). Committee on Quality of Health Care in America, Institute of Medicine. Crossing the Quality Chasm. Washington DC: National Academies Press, 2001:48.
38. Change in governance. System News. 2002 January: 1-3 〈 http://www.uphs.upenn.edu/prnews/publications/System_News/system_news.01=02. pdf〉. Accessed 3 October 2003.
39. Leaving the negative behind. System News. 2002 January:1 〈http://www.uphs.upenn.edu/prnews/publications/system_news/system_news.01= 02.pdf〉. Accessed 3 October 2003.
40. An update on strategic planning. PennPulse. 2002 July;(91):2.
41. Plan for Penn Medicine. Unpublished strategic planning document. School of Medicine, University of Pennsylvania. Philadelphia, PA: University of Pennsylvania, 2003.
42. For current information on Penn's Institute for Strategic Threat Analysis and Response (l*STAR), see 〈http://www.istar.upenn.edu〉 . Accessed 3 October 2003.
43. Urbanism at Penn, a strategic approach to the "century of the city." Unpublished strategic planning document. Committee on the Urban Community, University of Pennsylvania. Philadelphia, PA: University of Pennsylvania, 2003.
44. For more information on Penn's Robert Wood Johnson Health & Society Scholars Program, see 〈http://www.upenn.edu/rwjhssp〉. Accessed 3 October 2003.
45. RWJF site for clinical scholars. Almanac. 2003 February 18;49(22):3 〈http://www.upenn.edu/almanac/v49/n22/rwjf.html〉. Accessed 3 October 2003.