Kosidlak J G
Peninsula Health District, Virginia Department of Health, Newport News 23601, USA.
Public Health Nurs. 1999 Oct;16(5):311-20. doi: 10.1046/j.1525-1446.1999.00311.x.
Mandatory enrollment of Medicaid recipients into managed care organizations (MCOs) in 1994 resulted in a major reduction in primary medical care provided by the Peninsula Health District (PHD) in southeastern Virginia. This article describes how the PHD responded proactively by changing from a predominantly primary care clinic practice to a population-based public health practice and changed the role of public health nursing. A participatory planning process involving all PHD employees carefully defined this new direction over several years. As public health care resources were redirected into preventive programs to serve the health needs of the entire community rather then the individual, a new intervention model evolved. The intervention model became the framework for program planning and implementation and has now been in use by the PHD for 3 years. The planning process used by the PHD to devise a population-based intervention model is described in this article.
1994年强制医疗补助受助者加入管理式医疗组织（MCOs），导致弗吉尼亚州东南部半岛卫生区（PHD）提供的初级医疗服务大幅减少。本文描述了PHD如何通过从主要的初级保健诊所业务转变为基于人群的公共卫生业务来积极应对，并改变了公共卫生护理的角色。一个涉及PHD全体员工的参与式规划过程在数年里仔细地确定了这个新方向。随着公共卫生保健资源被重新导向预防性项目，以满足整个社区而非个体的健康需求，一种新的干预模式应运而生。该干预模式成为了项目规划与实施的框架，目前已被PHD使用了3年。本文介绍了PHD用于设计基于人群的干预模式的规划过程。
