Scutchfield et al. Respond
Dados Bibliográficos
We appreciate the letter by Plochg et al. It makes the important point that our reflections on primary care and public health are focused on the United States, and that there is a very active movement in population health occurring internationally. The long-standing efforts of international colleagues in public health and primary care to integrate the two disciplines might offer lessons for us as well. However, the payment system, which we point to as a major barrier to previous US efforts at integration, is substantially different from our own in most international settings. Many countries enjoy a national health system that has the better potential for integration because there is one final governing authority for both public health and medical services. And, most notably, the funding for both comes from the same source, again not the case in the United States. As we pointed out, we are optimistic that the United States will now take a similar path as new forms of care delivery, such as accountable care organizations, require a focus on the health of the population they serve, whether it is a community or its enrollees. We would be well served to continue looking to international efforts at integration and alignment across the components of health care systems. It is likely that we can learn from the successes and mistakes of their efforts as we proceed in the United States
Environmental health · Family medicine · Global Health Workforce Issues · Medicine · Primary Care and Health Outcomes · Public Health Policies and Education
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