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Academic Medical Centers
An academic medical center (AMC) is an organization whose mission encompasses emphases on clinical care, research, and education. Typically, it includes the following elements: an accredited medical school, one or more affiliated hospitals in which a majority of the medical staff are physician-faculty members, hospital admissions that are primarily made by physician-faculty members, and an affiliated faculty practice plan that is tax-exempt under federal law or is part of an exempt organization under an umbrella designation.
Background
The modern structure of the AMC has its roots in the highly critical Flexner Report of 1910, which criticized medical education for its lack of an evidence-based approach and paved the way for the modern, more allopathic approach. There was also a concomitant migration from the “commercial” medical school of the time to formalized programs of medical education. Subsequently, the medical education model was characterized by an academic venue, staffed by scientifically rooted faculty practicing in an associated teaching hospital. The ensuing leap in the caliber of medical education has seen highly complex organizational models and intricate connectivity through the multifaceted mission that characterizes today's academic medical centers.
Distinguishing Features
AMCs are differentiated from public health systems, community hospitals, and safety net healthcare complexes in large measure due to distinct characteristics that came about with the advent of the AMC model of the 20th century. Additional distinguishing features, combined with the multifaceted mission of the AMC organization, go well beyond the purely academic elements that serve to differentiate AMC. These include the following.
Technology
AMCs are on front lines of emerging technology. They are the environment in which new clinical treatment methods and scientific advances are typically developed. The nature of translational research efforts and the setting in which tertiary and quaternary care is delivered embolden providers to make critical advancements in care; as such, AMCs are the setting where these advances can most efficiently occur. These advances take many forms, including new device development and testing, as well as diagnostic and treatment protocols and surgical techniques. With the scientific rigor and evidence-based discipline present in this setting, promising clinical developments occur. An example is the discovery of the prostate-specific antigen (PSA), which led to a test that helps detect prostate cancer in men of age 50 and older. AMCs also often curtail the introduction of techniques that are unsafe or lack efficacy. One such example is the Jarvik artificial heart, which was banned when practitioners found that most of the recipients could not live more than half a year.
Prestige
The output of AMCs significantly contributes to the United States' international presence and prestige. Healthcare is often a source of national pride and economic benefit; thus, advances in science and medicine represent a significant portion of a nation's economic and political agenda.
Physician Scientists
AMCs are essential to the development of the United States' base of young scientists. Federally funded programs such as the National Science Foundation's Science, Technology, Engineering and Mathematics (STEM) program leverage AMCs to encourage the study of science, making these centers important settings for training physician scientists.
Preparedness
Along with federal and local government agencies, AMCs play an integral role in the United States' preparedness infrastructure for national emergency and terrorism response. Routinely seen as the tertiary- and quaternary-care centers for the country in the event of any number of national health scenarios (e.g., terrorism attacks, epidemics, bioscientific responses), AMCs play key roles in drill scenarios. Without the involvement of AMCs, the nation's response armamentarium would be substantially less robust.
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- Access to Care
- Access to Healthcare
- Access, Models of
- Critical Access Hospitals (CAHs)
- Cultural Competency
- Direct-to-Consumer Advertising (DTCA)
- E-Health
- E-Prescribing
- Ethnic and Racial Barriers to Healthcare
- Geographic Barriers to Healthcare
- Health Communication
- Health Literacy
- Health Professional Shortage Areas (HPSAs)
- Healthcare Web Sites
- Hospital Closures
- Inner-City Healthcare
- Medical Travel
- National Health Service Corps (NHSC)
- Patient Dumping
- Patient Transfers
- Rural Health
- Safety Net
- Telemedicine
- Transportation
- Accreditation, Associations, Foundations, and Research Organizations
- Accreditation
- Associations
- AARP
- AcademyHealth
- America's Health Insurance Plans (AHIP)
- American Academy of Family Physicians (AAFP)
- American Academy of Pediatrics (AAP)
- American Association of Colleges of Nursing (AACN)
- American Association of Preferred Provider Organizations (AAPPO)
- American College of Healthcare Executives (ACHE)
- American Health Care Association (AHCA)
- American Health Planning Association (AHPA)
- American Hospital Association (AHA)
- American Medical Association (AMA)
- American Nurses Association (ANA)
- American Osteopathic Association (AOA)
- American Public Health Association (APHA)
- American Society of Health Economics (ASHE)
- Association of American Medical Colleges (AAMC)
- Association of University Programs in Health Administration (AUPHA)
- Healthcare Financial Management Association (HFMA)
- Institute for Healthcare Improvement (IHI)
- International Health Economics Association (IHEA)
- National Alliance for the Mentally Ill (NAMI)
- National Association of Health Data Organizations (NAHDO)
- National Association of State Medicaid Directors (NASMD)
- National Center for Assisted Living (NCAL)
- National Citizens' Coalition for Nursing Home Reform (NCCNHR)
- National Coalition on Health Care (NCHC)
- National Commission for Quality Long-Term Care (NCQLTC)
- National Health Policy Forum (NHPF)
- National Medical Association (NMA)
- National Quality Forum (NQF)
- University HealthSystem Consortium (UHC)
- Business Coalitions
- Foundations
- Research Organizations
- Biographies of Current and Past Leaders - Current Leaders
- Current Leaders
- Aday, Lu Ann
- Aiken, Linda H.
- Altman, Drew E.
- Andersen, Ronald M.
- Arrow, Kenneth J.
- Berwick, Donald M.
- Brook, Robert H.
- Chassin, Mark R.
- Clancy, Carolyn M.
- Culyer, Anthony J.
- Davis, Karen
- Drummond, Michael
- Ellwood, Paul M.
- Enthoven, Alain C.
- Evans, Robert G.
- Feder, Judith
- Fuchs, Victor R.
- Ginsburg, Paul B.
- Grossman, Michael
- Kane, Robert L.
- Katz, Sidney
- Lee, Philip R.
- Lomas, Jonathan
- Luft, Harold S.
- Marmor, Theodore R.
- Maynard, Alan
- Mechanic, David
- Naylor, C. David
- Newhouse, Joseph P.
- O'Leary, Dennis S.
- Pauly, Mark V.
- Reinhardt, Uwe E.
- Relman, Arnold S.
- Rice, Dorothy P.
- Roos, Leslie L.
- Roos, Noralou P.
- Rosenbaum, Sara
- Sackett, David L.
- Scott, W. Richard
- Shortell, Stephen M.
- Starfield, Barbara
- Starr, Paul
- Stevens, Rosemary A.
- Tarlov, Alvin R.
- Ware, John E.
- Wennberg, John E.
- White, Kerr L.
- Wilensky, Gail R.
- Past Leaders
- Anderson, Odin W.
- Cochrane, Archibald L.
- Codman, Ernest Amory
- Cohen, Wilbur J.
- Davis, Michael M.
- Donabedian, Avedis
- Eisenberg, John M.
- Farr, William
- Flexner, Abraham
- Ginzberg, Eli
- Kimball, Justin Ford
- McNerney, Walter J.
- Nightingale, Florence
- Roemer, Milton I.
- Rorem, C. Rufus
- Shapiro, Sam
- Sheps, Cecil G.
- Thompson, John Devereaux
- Williams, Alan H.
- Current Leaders
- Cost of Care, Economics, Finance, and Payment Mechanisms
- Administrative Costs
- Capitation
- Charity Care
- Committee on the Costs of Medical Care (CCMC)
- Compensation Differentials
- Cost Containment Strategies
- Cost of Healthcare
- Cost Shifting
- Cost-Benefit and Cost-Effectiveness Analyses
- Current Procedural Terminology (CPT)
- Diagnosis Related Groups (DRGs)
- Economic Barriers to Healthcare
- Economic Recessions
- Economic Spillover
- Economies of Scale
- Fee-for-Service
- Flat-of-the-Curve Medicine
- Health Economics
- Healthcare Financial Management
- Healthcare Markets
- Inflation in Healthcare
- Long-Term Care Costs in the United States
- Market Failure
- Pay-for-Performance
- Payment Mechanisms
- Pharmacoeconomics
- Prospective Payment
- Resource-Based Relative Value Scale (RBRVS)
- Supplier-Induced Demand
- U.S. National Health Expenditures
- Uncompensated Healthcare
- Disease, Disability, Health, and Health Behavior
- Activities of Daily Living (ADL)
- Acute and Chronic Diseases
- Adverse Drug Events
- Chronic-Care Model
- Diabetes
- Disability
- Disease
- Emerging Diseases
- Genetics
- Health
- Health Indicators, Leading
- Iatrogenic Disease
- Infectious Diseases
- International Classification of Diseases (ICD)
- Life Expectancy
- Medical Sociology
- Medicalization
- Mental Health
- Morbidity
- Mortality
- Mortality, Major Causes in the United States
- Obesity
- Pain
- Prescription and Generic Drug Use
- Tobacco Use
- Government and International Healthcare Organizations
- International Organizations
- Canadian Association for Health Services and Policy Research (CAHSPR)
- Canadian Health Services Research Foundation (CHSRF)
- Canadian Institute of Health Services and Policy Research (IHSPR)
- Pan American Health Organization (PAHO)
- United Kingdom's National Health Service (NHS)
- United Kingdom's National Institute for Health and Clinical Excellence (NICE)
- World Health Organization (WHO)
- U.S. Government Organizations
- Agency for Healthcare Research and Quality (AHRQ)
- Centers for Disease Control and Prevention (CDC)
- Centers for Medicare and Medicaid Services (CMS)
- Congressional Budget Office (CBO)
- Health Resources and Services Administration (HRSA)
- Indian Health Service (IHS)
- Medicare Payment Advisory Commission (MedPAC)
- National Center for Health Statistics (NCHS)
- National Guideline Clearinghouse (NGC)
- National Information Center on Health Services Research and Health Care Technology (NICHSR)
- National Institutes of Health (NIH)
- Substance Abuse and Mental Health Services Administration (SAMHSA)
- TRICARE, Military Health System
- U.S. Department of Veterans Affairs (VA)
- U.S. Food and Drug Administration (FDA)
- U.S. Government Accountability Office (GAO)
- International Organizations
- Health Insurance
- Adverse Selection
- Blue Cross and Blue Shield
- Carve-Outs
- Coinsurance, Copays, and Deductibles
- Consumer-Directed Health Plans (CDHPs)
- Crowd-Out
- Employee Health Benefits
- Flexible Spending Accounts (FSAs)
- Health Insurance
- Health Insurance Coverage
- Health Savings Accounts (HSAs)
- Medicaid
- Medicare
- Medicare Part D Prescription Drug Benefit
- Moral Hazard
- RAND Health Insurance Experiment
- Selective Contracting
- Single-Payer System
- State Children's Health Insurance Program (SCHIP)
- State-Based Health Insurance Initiatives
- Tax Subsidy of Employer-Sponsored Health Insurance
- Health Professionals and Healthcare Organizations
- Academic Medical Centers
- Allied Health Professionals
- Ambulatory Care
- Case Management
- Chiropractors
- Community Health Centers (CHCs)
- Community Mental Health Centers (CMHCs)
- Complementary and Alternative Medicine
- Dentists and Dental Care
- Disease Management
- Diversity in Healthcare Management
- Emergency Medical Services (EMS)
- Eye Care Services
- Federally Qualified Health Centers (FQHCs)
- Free Clinics
- General Practice
- Health Maintenance Organizations (HMOs)
- Health Systems Agencies (HSAs)
- Health Workforce
- Healthcare Organization Theory
- Home Health Care
- Hospice
- Hospital Emergency Departments
- Hospitalists
- Hospitals
- Intensive-Care Units
- Intermediate-Care Facilities (ICFs)
- Long-Term Care
- Managed Care
- Medical Group Practice
- Multihospital Healthcare Systems
- Nonprofit Healthcare Organizations
- Nurse Practitioners (NPs)
- Nurses
- Nursing Homes
- Pharmaceutical Industry
- Pharmacy
- Physician Assistants
- Physician Workforce Issues
- Physicians
- Physicians, Osteopathic
- Preferred Provider Organizations (PPOs)
- Primary Care
- Primary-Care Case Management (PCCM)
- Primary-Care Physicians
- Skilled-Nursing Facilities
- Health Services Research
- Data Sources in Conducting Health Services Research
- Health Services Research at the Veterans Health Administration (VHA)
- Health Services Research in Australia
- Health Services Research in Canada
- Health Services Research in Dentistry and Oral Health
- Health Services Research in Eastern Europe
- Health Services Research in Germany
- Health Services Research in Sub-Saharan Africa
- Health Services Research in the People's Republic of China
- Health Services Research in the United Kingdom
- Health Services Research Journals
- Health Services Research, Definition
- Health Services Research, Origins
- Laws, Regulations, and Ethics
- Measurement, Data Sources and Coding, and Research Methods
- Case-Mix Adjustment
- Causal Analysis
- Clinical Decision Support
- Cohort Studies
- Community-Based Participatory Research (CBPR)
- Computers
- Cross-Sectional Studies
- Data Privacy
- Data Security
- Diagnostic and Statistical Manual of Mental Disorders (DSM)
- Electronic Clinical Records
- Evidence-Based Medicine (EBM)
- General Health Questionnaire
- Geographic Information Systems (GIS)
- Health Informatics
- Health Surveys
- Healthcare Cost and Utilization Project (HCUP)
- Healthcare Effectiveness Data and Information Set (HEDIS)
- Healthcare Informatics Research
- Measurement in Health Services Research
- Meta-Analysis
- Minimum Data Set (MDS) for Nursing Home Resident Assessment
- National Practitioner Data Bank (NPDB)
- ORYX Performance Measurement System
- Provider-Based Research Networks (PBRNs)
- Quality of Well-Being Scale (QWB)
- Randomized Controlled Trials (RCTs)
- Satisfaction Surveys
- Severity Adjustment
- Short-Form Health Surveys (SF-36, -12, -8)
- Outcomes of Care
- Policy Issues, Healthcare Reform, and International Comparisons
- Comparing Health Systems
- Competition in Healthcare
- Equity, Efficiency, and Effectiveness in Healthcare
- Focused Factories
- For-Profit Versus Not-for-Profit Healthcare
- Forces Changing Healthcare
- Health Disparities
- Healthcare Reform
- International Health Systems
- National Health Insurance
- National Healthcare Disparities Report (NHDR)
- Public Policy
- Rationing Healthcare
- Technology Assessment
- Public Health
- Quality and Safety of Care
- Accreditation
- Benchmarking
- Clinical Practice Guidelines
- Continuum of Care
- Credentialing
- Geographic Variations in Healthcare
- International Classification for Patient Safety (ICPS)
- Malpractice
- Medical Errors
- National Healthcare Quality Report (NHQR)
- National Patient Safety Goals (NPSG)
- Nursing Home Quality
- Patient Safety
- Patient-Centered Care
- Quality Enhancement Research Initiative (QUERI) of the Veterans Health Administration (VHA)
- Quality Improvement Organizations (QIOs)
- Quality Indicators
- Quality Management
- Quality of Healthcare
- Quality of Life, Health-Related (HRQOL)
- Quality-Adjusted Life Years (QALYs)
- Structure-Process-Outcome Quality Measures
- Timeliness of Healthcare
- Special and Vulnerable Groups
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