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REFERENCES 145 ------. 2002d. Commission on Collegiate Nursing Education Accreditation. Online. http:// www.aacn.nche.edu/Accrediation/index.htm. American Association of Colleges of Osteopathic Medicine. 2003. UME-21, Undergraduate Medical Education for the 21st Century: A National Demonstration of Curriculum Innovations to Keep Pace with a Changing Health Care Environment, 1997-2002. Online. www.aacom.org/ume/. American Health Care Association. 2002. AHCA/NCAL Put Forward Long Term Care Fi- nancing Reform Proposal. Online. www.ahca.org/brief/nr020602a.htm [accessed Au- gust 14, 2002]. Anderson, G. 2002. The Roles of Academic Health Centers in the 21st Century: A Workshop Summary. Washington, DC: The National Academies Press. Online. www.nap.edu/cata- log/10383.html. Anderson, G. F., and J. R. Knickman. 2001. Changing the chronic care system to meet people's needs. Health Affairs 20(6):146-160. Anderson, G. F., E. Steinberg, and R. Heyssel. 1994. The pivotal role of the academic health center. Health Affairs 13(3):146-158. Anderson, G. F., G. Greenberg, and C. K. Lisk. 1999. Academic health centers: Exploring a financial paradox. Health Affairs 18(2):156-167. Anderson, G. F., G. D. Greenberg, and B. O. Wynn. 2001. Graduate medical education: The policy debate. Annual Review of Public Health 22:35-147. Ashton, C. M., N. J. Petersen, J. Souchek, T. J. Menke, H. J. Yu, K. Pietz, M. L. Eigenbrodt, G. Barbour, K. W. Kizer, and N. P. Wray. 1999. Geographic variations in utilization rates in Veterans Affairs hospitals and clinics. New England Journal of Medicine 340(1):32-39. Association of Academic Health Centers. 2002a. Access to Health Care Initiative. Online. www.ahcnet.org/programs/delivery/access.php. ------. 2002b. Frequently Asked Questions. Online. www.ahcnet.org/newsroom [accessed June 21, 2002]. ------. 2002c. The Nursing Shortage and Academic Health Centers: Assessing Options for Remedy in a Complex System. Washington, DC: Association of Academic Health Centers. Association of American Medical Colleges. 1998. Maximizing the Investment: Principles to Guide the Federal-Academic Partnership in Biomedical and Health Sciences Research. Washington, DC. Online. www.aamc.org/research/dbr/maximize/contents.htm. ------. 2002. AAMC Supports National Quality Initiative for Patient Care. Washington, DC. Online. http://www.aamc.org/newsroom. ______. 2003a. Columbia University Researchers Receive $6 Million Grant to Establish Health Disparities Center. Online. www.aamc.org/newsroom/bulletin/columbia/030213. htm. ______. 2003b. New AAMC Institute to Examine Quality of U.S. Medical Education. Online. www.aamc.org/newsroom/pressrel/2003/030303.htm. Association of American Medical Colleges and the Milbank Memorial Fund. 2000. The Edu- cation of Medical Student: Ten Stories of Curriculum Change. New York, NY: Milbank Memorial Fund. Association of American Universities. 2000. Employment Impacts of Academic R&D, Fiscal Year 1999. Online. www.aau.edu/resuniv/FY97employ.html [accessed February 4, 2002]. Association of Schools of Public Health. 2001. Annual data report. Online. www.asph.org. Barry, M. J., F. J. Fowler Jr., A. G. Mulley Jr., J. V. Henderson Jr., and J. E. Wennberg. 1995. Patient reactions to a program designed to facilitate patient participation in treatment decisions for benign prostatic hyperplasia. Medical Care 33(8):771-782.

146 ACADEMIC HEALTH CENTERS Barzansky, B., and S. I. Etzel. 2001. Educational programs in U.S. medical schools, 2000- 2001. Journal of the American Medical Association 286(9):1049-1055. Batalden, P., D. Leach, S. Swing, H. Dreyfus, and S. Dreyfus. 2002. General competencies and accreditation in graduate medical education. Health Affairs 21(5):103-111. Becher, E. C., and M. R. Chassin. 2001. Improving the quality of health care: Who will lead? Health Affairs 20(5):164-179. Beller, G. A. 2000. President's page: ACC takes strategic steps to address members' needs. American College of Cardiology. Journal of the American College of Cardiology 35(7):1989-1992. Berenson, R. A., and J. Horvath. 2003. Confronting barriers to chronic care management in Medicare. Health Affairs, Web Exclusive. Online. www.healthaffairs.org/WebExclusives/ 2202Berenson.pdf. Biotechnology Industry Organization. 2003. Biotechnology: A Collection of Technologies. Online. www.bio.org/er/technology_collection.asp. Blendon, R. J., C. Schoen, K. Donelan, R. Osborn, C. M. DesRoches, K. Scoles, K. Davis, K. Binns, and K. Zapert. 2001. Physicians' views on quality of care: A five-country com- parison. Health Affairs 20(3):233-243. Blumenthal, D. 1994. The variation phenomenon in 1994. New England Journal of Medicine 331(15):1017-1018. ------. 2001. Controlling health care expenditures. New England Journal of Medicine 344(10):766-769. Blumenthal, D., and E. Bass. 2001. The need for data not dogma on the costs of graduate medical education. Journal of General Internal Medicine 16(1):66-67. Blumenthal, D., and M. B. Buntin. 1998. Carve outs: Definition, experience, and choice among candidate conditions. American Journal of Managed Care 4(Suppl):SP45-SP57. Blumenthal, D., and G. S. Meyer. 1996. Academic health centers in a changing environment. Health Affairs 15(2):200-215. Bodenheimer, T., E. H. Wagner, and K. Grumbach. 2002. Improving primary care for pa- tients with chronic illness. Journal of the American Medical Association 288(14):1775- 1779. Boufford, J. I. 2002. Leadership and Organizational Change. Presentation at IOM Annual Meeting. Online. www.iom.edu/IOM/IOMHome.nsf/Pages/2002+Annual+Meeting+ Agenda+leadership. Bowen, J. L., and D. M. Irby. 2002. Assessing quality and costs of education in the ambula- tory setting: A review of the literature. Academic Medicine 77(7):621-680. Boyd, E. A., and L. A. Bero. 2000. Assessing faculty financial relationships with industry: A case study. Journal of the American Medical Association 284(17):2209-2214. Boyle, L. D., and K. Fisher. 2002. Medicare Direct Graduate Medical Education (DGME) Payments. Online. www.aamc.org [accessed July 15, 2002]. Broder, S. 2002. The Roles of Academic Health Centers in the 21st Century: A Workshop Summary. Washington, DC: The National Academies Press. Online. www.nap.edu/cata- log/10383.html. Brook, R. H. 1997. Managed care is not the problem, quality is. Journal of the American Medical Association 278(19):1612-1614. Brotherton, S. E., F. A. Simon, and S. C. Tomany. 2000. U.S. graduate medical education, 1999-2000. Journal of the American Medical Association 284(9):1121-1126. Bulger, R. J. 1988. Medical education reform and departmental chairs. Health Affairs 7(4):185-187. ------. 2000. The quest for the therapeutic organization. Journal of the American Medical Association 283(18):2431-2433.

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Academic health centers are currently facing enormous changes that will impact their roles in education, research, and patient care. The aging and diversity of the population will create new health care needs and demands, while rapid advances in technology will fundamentally alter the health care systems’ capabilities. Pressures on health care costs, growth of the uninsured, and evidence of quality problems in health care will create a challenging environment that demands change.

Academic Health Centers explores how AHCs will need to consider how to redirect each of their roles so they are able to meet the burgeoning challenges of health care and improve the health of the people they serve. The methods and approaches used in preparing health professionals, the relationship among the variety of their research programs and the design of clinical care will all need examination if they are to meet the changing demands of the coming decades.

Policymakers will need to create incentives to support innovation and change in AHCs. In response, AHCs will need to increase the level of coordination and integration across their roles and the individual organizations that comprise the AHC if they are to successfully undertake the types of changes needed. Academic Health Centers lays out a strategy to start a continuing and long-term process of change.

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