Patients and community together - A family medicine community-oriented primary care project in an urban private practice
Patients and community together - A family medicine community-oriented primary care project in an urban private practice
复制标题
DOI：
10.1001/archfami.8.6.546
复制
发表时间：
1999-11-01
期刊：
影响因子：
--
通讯作者：
Fiscella, K
中科院分区：
文献类型：
--
作者：
Bayer, WH;Fiscella, K
背景资料：有相当多的讨论，在文献中关于社区为导向的初级保健（COPC）的价值和可行性，但相对较少发表的真实世界的examples.Objective：探讨的效果，一个实践为基础的COPC项目的预防性健康干预率在内城家庭医学实践。一个新成立的社区咨询委员会称为病人和社区在一起（PACT）和医疗主任的做法在罗切斯特，纽约州，合作的所有阶段的COPC项目。巴氏涂片和乳房X光检查、儿童免疫接种、糖尿病控制和戒烟是干预的目标。开展了一场实践/社区宣传运动，并制定了个人和团体奖励措施。结果：每年巴氏涂片率从46%增加到71%，每年乳房X光检查年龄大于50岁的妇女，从56%增加到86%，完成儿童免疫接种时，年龄小于6岁，从78%增加到97%。和半年糖化血红蛋白的表现，从85%到92%。糖化血红蛋白值低于10%的患者比例从56%提高到77%。有5吸烟者成功戒烟。结论：这个项目说明了如何实践为基础的COPC可以成功地实施在私人执业环境。它还显示了COPC原则如何可以用来实现健康的人2000年内城市的做法的目标。
Background: There has been considerable discussion in the literature regarding the value and feasibility of community-oriented primary care (COPC), but relatively few published real-world examples.Objective: To examine the effect of a practice-based COPC project on rates of preventive health interventions within an inner-city family medicine practice.Methods: A newly created community advisory board called Patients and Community Together (PACT) and the medical director of the practice in Rochester, NY, collaborated on all phases of the COPC project. Papanicolaou smear and mammography screening, childhood immunizations, diabetes control, and smoking cessation were targeted for intervention. A practice/community awareness campaign was instituted and individual and group incentives were developed. Progress was monitored through a computerized medical record that included all active patients in the practice.Results: Rates of annual Papanicolaou smears increased from 46% to 71%; annual mammography for women older than age 50 years, from 56% to 86%; completed childhood immunizations when younger than 6 years, from 78% to 97%; and performance of semiannual glycosylated hemoglobin, from 85% to 92%. Rates of patients with glycosylated hemoglobin values under 10% improved from 56% to 77%. There were 5 smokers who successfully quit.Conclusion: This project illustrates how practice-based COPC can be successfully implemented within a private practice setting. It also shows how COPC principles can be used to achieve the goals for Healthy People 2000 within inner-city practices.