Creating organized delivery systems: the barriers and facilitators.
An organized delivery system is a network of organizations that provides or arranges to provide a coordinated continuum of services to a defined population and is willing to be held clinically and fiscally accountable for the outcomes and the health status of the population served. As such, organized delivery systems are at the center of efforts to implement health care reform. Based on analysis of 12 such systems, this article identifies key characteristics that influence what organized delivery systems are able to do, outlines the major obstacles or challenges to achieving greater levels of integration, and then discusses a number of approaches for effectively dealing with these obstacles.
Shortell
S M
SM
J.L. Kellogg Graduate School of Management, Northwestern University, Evanston, IL 60208.
Gillies
R R
RR
Anderson
D A
DA
Mitchell
J B
JB
Morgan
K L
KL
D000288:Administrative Personnel / Q000523:psychology; D001291:Attitude of Health Personnel; D003191:Comprehensive Health Care / Q000458:organization & administration* / Q000592:standards; D003266:Continuity of Patient Care / Q000458:organization & administration* / Q000592:standards; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards; D005069:Evaluation Studies as Topic; D006075:Governing Board / Q000458:organization & administration; D017408:Guidelines as Topic / Q000592:standards; D006754:Hospital Restructuring / Q000592:standards*; D007407:Interviews as Topic; D009936:Organizational Innovation; D010934:Planning Techniques; D011340:Problem Solving; D014481:United States