但是诸如Kaiser Permanaente和Mayo诊所这样的整合系统则不受此规则所限。 英国的全国医疗服务制度也尝试采用一种与Kaiser Permanaente和Mayo诊所相类似的做法。

Integrated American systems such as Kaiser Permanente and the Mayo Clinic are exceptions to this rule, and Britain’s National Health Service (NHS) is trying to adopt a similar approach.

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